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Vol. 14. Issue 1.
Pages 141-149 (January - February 2008)
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Vol. 14. Issue 1.
Pages 141-149 (January - February 2008)
Artigo de Revisão/Revision Article
Open Access
Os abcessos pulmonares em revisão
Pulmonary abcess, a revision
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Ana Moura Gonçalves1,
Corresponding author
anapmgoncalves@gmail.com

Serviço de Medicina 1– sector C, Hospital de Santa Maria, Lisboa, Director: Professor Dr. Luciano Ravara, Avenida Professor Egas Moniz, 1649-035 Lisboa.
, Luiz Menezes Falcão2, Luciano Ravara3
1 Interna do Internato Complementar de Medicina Interna, no Hospital de Santa Maria, Lisboa.
2 Assistente Hospitalar Graduado do Hospital de Santa Maria, Cardiologista, Professor Auxiliar da Faculdade de Medicina de Lisboa.
3 Professor Catedrático da Faculdade de Medicina de Lisboa, Director do Serviço de Medicina 1 do Hospital de Santa Maria, Lisboa.
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Resumo

Os abcessos pulmonares são cavidades que surgem no parênquima pulmonar, apresentando maior ou menor quantidade de tecido necrosado no seu interior. Surgem em indivíduos predispostos, como sejam os doentes com doença pulmonar crónica ou obstrução secundária a neoplasia e os doentes com maior risco de aspiração, estando incluidos os doentes com alteração do estado neurológico, os utilizadores de drogas endovenosas, os doentes com alcoolismo, patologia da faringe e esofágica, doença neuromuscular, entre outras. É feita a revisão dos principais agentes causais, da metodologia diagnóstica, da abordagem terapêutica na actualidade e do prognóstico destas situações.

Os abcessos pulmonares, para além de relativamente pouco frequentes, são difíceis de caracterizar, sendo a resistência aos antibióticos um problema a ter presente, na sua abordagem terapêutica.

Rev Port Pneumol 2008; XIV (1): 141-149

Palavras-chave:
Abcesso pulmonar
pneumonia de aspiração
resistência antimicrobiana
anaeróbios
Abstract

Lung abscesses are cavitating lesions containing necrotic debris caused by microbial infection. Patients with chronic lung disease, bronchial obstruction secondary to cancer, a history of aspiration or risk of aspiration caused by alcoholism, altered mental status, structural or physiologic alterations of the pharynx and esophagus, neuromuscular disorders, anesthesia, are among others at higher risk of developing lung abcess.

The main bacteriological characteristics, the diagnosis, therapy and prognosis are considered. The problem of antimicrobial resistance is also referred.

Rev Port Pneumol 2008; XIV (1): 141-149

Key-words:
Lung abscesses
aspiration pneumonia
antimicrobial resistance
anaerobes
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Bibliografia
[1.]
Q.T. Tan, D.K. Seilheimer, S.L. Kaplan.
Pediatric lung abscess: clinical management and outcome.
Pediatric Infect Dis J, 14 (1995), pp. 51-55
[2.]
J.G. Bartlett.
Anaerobic bacterial pleuropulmonary infections.
Semin Respir Med, 13 (1992), pp. 159-164
[3.]
D.T. Smith.
Experimental aspiratory abscess.
Arch Surg, 14 (1927), pp. 231-239
[4.]
D.T. Smith.
Fuso-spirochetal disease of the lungs.
Tubercle, 9 (1928), pp. 420
[5.]
W. Weiss, N.S. Cherniack.
Acute nonspecific lung abscess: a controlled study comparing orally and parenterally administered penicillin G.
Chest, 66 (1974), pp. 348-351
[6.]
J.G. Bartlett.
HIV infection and surgeons.
Curr Probl Surg, (1992), pp. 197-280
[7.]
E.C. Pohlson, J.J. McNamara, C. Char, et al.
Lung abscess: a changing pattern of the disease.
Am J Surg, 150 (1985 Jul), pp. 97-101
[8.]
B. Hirshberg, M. Sklair-Levi.
Nir-Paz R:Factors predicting mortality of patients with lung abscess.
Chest, 115 (1999 Mar), pp. 746-750
[9.]
J.G. Bartlett.
Lung abscess and the necrotizing pneumonia.
Infectious Diseases,
[10.]
B. Davis, D.M. Systrom.
Lung abscess: pathogenesis, diagnosis and treatment.
Curr Clin Topics Infect Dis, 18 (1998), pp. 252-273
[11.]
J.-L. Wang, K.-Y. Chen, C.-T. Fang, et al.
Changing Bacteriology of Adult Community-Acquired Lung Abscess in Taiwan: Klebsiella pneumoniae versus Anaerobes.
CID, 40 (2005), pp. 915-922
[12.]
T. Yoneyama, M. Yoshida, T. Matsui, H. Sasaki.
Oral care and pneumonia.
[13.]
G. Chung, M.B. Goetz.
Anaerobic infections of the lung.
Curr Infect Dis Rep, 2 (2000), pp. 238-244
[14.]
P.E. Marik.
Aspiration pneumonitis and aspiration pneumonia.
N Engl J Med, 344 (2001), pp. 665-671
[15.]
A. Torres, J. Serra-Batlles, A. Ferrer, et al.
Severe community-acquired pneumonia: epidemiology and prognostic factors.
Am Ver Respir Dis, 144 (1991), pp. 312-318
[16.]
P. Moine, J.P. Vercken, S. Chevret, C. Chastang, P. Gajdos.
Severe Community-acquired pneumonia: etiology, epidemiology, and prognosis factors.
Chest, 105 (1994), pp. 1487-1495
[17.]
G.L. Olsson, B. Hallen, K. Hambraeus-Jonzon.
Aspiration during anaesthesia: a computer-aided study of 185.358 anaesthesics.
Acta Anaesthesiol Scand, 30 (1986), pp. 84-92
[18.]
M.A. Holas, K.L. DePippo, M.J. Reding.
Aspiration and relative risk of medical complications following stroke.
Arch Neurol, 51 (1994), pp. 1051-1053
[19.]
G. Mann, G.J. Hankey, D. Cameron.
Swallowing function after stroke: prognosis and prognostic factors at 6 months.
Stroke, 30 (1999), pp. 744-748
[20.]
T.M. Roy, M.A. Ossorio, L.M. Cipolla, C.L. Fields, H.L. Snider, W.H. Anderson.
Pulmonary complications after tricyclic antidepressant overdose.
Chest, 96 (1989), pp. 852-856
[21.]
T. Aldrich, J. Morrison, T. Cesário.
Aspiration after overdosage of sedative or hypnotic drugs.
South Med J, 73 (1980), pp. 456-458
[22.]
M.A. Warner, M.E. Warner, J.G. Weber.
Clinical significance of pulmonary aspiration during the perioperative period.
Anesthesiology, 78 (1993), pp. 56-62
[23.]
J.G. Bartlett, S.L. Gorbach, F.P. Tally, S.M. Finegold.
Bacteriology and treatment of primary lung abscess.
AM Rev Respir Dis, 109 (1974), pp. 510
[24.]
A.M. Fisher, R.W. Trever, J.A. Curtin, et al.
Staphylococcal pneumonia; a review of 21 cases in adults.
N Engl J Med, 258 (1958), pp. 919-928
[25.]
J.G. Bartlett.
The role of Anaerobic Bacteria in Lung Abscess.
CID, 40 (2005), pp. 923-925
[26.]
J.G. Bartlett.
Anaerobic bacterial infections of the lung.
Chest, 91 (1987), pp. 901-909
[27.]
J.G. Bartlett.
Anaerobic bacterial infections of the lung and pleural space.
Clin Infect Dis, 16 (1993), pp. S248-S255
[28.]
Clinical conferences at the Johns Hopkins Hospital: lung abscess.
Johns Hopkins Med J, 150 (1982), pp. 141-147
[29.]
J. Pfitzner, M.J. Peacock, E. Tsirgiotis, H. Walkley.
Lobectomy for cavitating lung abscess with haemoptysis: Strategy for protecting the contralateral lung and also the non-involved lobe of the ipsilateral lung.
Br J Anaesth, 85 (2000), pp. 791-794
[30.]
D.D. Stark, M.P. Federle, P.C. Goodman, et al.
Differentiating lung abscess and empyema: radiography and computed tomography.
Am J Roentgenol, 141 (1983), pp. 163-167
[31.]
R.S. Irwin, F.L. Garrity, A.D. Erickson, W.M. Corrao, J.T. Kaemmerlen.
Sampling lower respiratory tract secretions in primary lung abscess: a comparison of the accuracy of four methods.
Chest, 79 (1981), pp. 559-565
[32.]
J.G. Bartlett.
The technique of transtracheal aspiration.
J Crit Iln, 1 (1986), pp. 43-49
[33.]
J.G. Bartlett.
Diagnostic accuracy of transtracheal aspiration bacteriology.
Am Rev Respir Dis, 115 (1977), pp. 777-782
[34.]
P.M. Small, P.I. Fujiwara.
Management of Tuberculosis in the United States.
N Engl J Med, 345 (2001), pp. 189-200
[35.]
M.J. Landay, E.F. Christensen, L.J. Bynum, C. Goodman.
Anaerobic pleural and pulmonary infections.
AJA Am Roentgenol, 134 (1980), pp. 233-240
[36.]
P.D. Bandt, N. Blank, R.A. Castellino.
Needle diagnosis of pneumonitis. Value in high-risk patients.
JAMA, 220 (1972), pp. 1578-1580
[37.]
N.W. Wimberley, J.B. Bass, B.W. Boyd, et al.
Use of a bronchoscopic protected catheter brush for the diagnosis of pulmonary infections.
Chest, 81 (1982), pp. 556-562
[38.]
F. Gudiol, F. Manresa, R. Pallares, et al.
Clindamicyn vs penicillin for anaerobic lung infections: high rate of penicillin failures associated with penicillin-resistant Bacteroides melaninogenicus.
Arch Intern Med, 150 (1990), pp. 2525-2529
[39.]
J.G. Bartlett, S.L. Gorbach.
Penicillin or clindamycin for primary lung abscess?.
Ann Intern Med, 98 (1983), pp. 546-548
[40.]
L.J. Teng, P.R. Hsueh, J.C. Tsai, S.J. Liaw, S.W. Ho, K.T. Luh.
High incidence of cefoxitin and clindamycin resistance among anaerobes in Taiwan.
Antimicrob Agents Chemother, 46 (2002), pp. 2908-2913
[41.]
P.C. Appelbaum, S.K. Spangler, M.R. Jacobs.
β-Lactamase production and susceptibilities to amoxicillin, amoxicillin-clavulanate, ticarcillin, ticarcillin-clavulanate, cefoxitin, imipenem and metronidazole of 320 non- Bacteroides fragilis Bacteroides isolates and 129 fusobacteria from 28 US centers.
Antimicrob Agents Chemother, 34 (1990), pp. 1546-1550
[42.]
D.T. Smith.
Medical treatment of acute and chronic pulmonary abscesses.
J Thorac Surg, 17 (1942), pp. 72-75
[43.]
C.I. Allen, J.F. Blackman.
Treatment of lung abscess with report of 100 consecutive cases.
J Thorac Surg, 6 (1936), pp. 156-162
[44.]
P. Harber, P.B. Terry.
Fatal Lung Abscesses: Review of 11 years experience.
South Med J, 74 (1981), pp. 281-283
[45.]
J.L. Hagan, J.D. Hardy.
Lung abscess revisited: a survey of 184 cases.
Ann Surg, 197 (1983), pp. 755-762
[46.]
E.C. Pohlson, J.J. Mc Namara, C. Char, et al.
Lung abscess: a changing pattern of the disease.
Am J Surg, 150 (1985), pp. 97-101
[47.]
J.G. Bartlett.
Lung abscess.
Textbook of Pulmonary Diseases, 5th ed., pp. 607-620
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