Akciğer apseli hastaların retrospektif olarak incelenmesi
Küçük Resim Yok
Tarih
2001
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Akciğer apsesinin klinik, bakteriyolojik, radyolojik bulguları ve predispozan faktörler ile tedavi yeterliliği retrospektif olarak 1990-1998 yılları arasında hastanede yatmış olan 42 hastada incelenmiştir. Hastaların yaş ortalaması 46.7 ± 2.1'di. En sık karşılaşılan yakınma balgam çıkartma ve ateş olmuştur. Dokuz olguda diabetes mellutus, 7 olguda kronik obstrüktif akciğer hastalığı (KOAH) ve 4 olguda malignite en sık eşlik eden hastalıklardı. Apsenin radyolojik lokalizasyonu hastaların %50'sinde sağ hemitoraksta, %35.7'sinde sol hemitoraksta ve %14.3'ünde bilateraldi. Yirmisekiz (%66.6) hastada etken izole edilmişti ve en sık 8 (%19.0) hastada Staphylococcus epidermidis, 7 (%16.6) hastada Staphylococcus aureus ve 6 (%14.2) hastada anaerobik bakteri bulunmuştur. Medikal tedavinin başarısız olduğu 2 hastada cerrahi tedavi uygulanmıştı. Semptomları ağır olan ve ciddi ek hastalığı olan 2 hasta da sepsisten ölmüştür. Otuziki (%76.2) olguda semptomların ve radyolojik bulguların tamamen rezolüsyonu ile tam yanıt elde edildiği, 8 (%19.0) olguda klinik yanıta rağmen rezidüel fibrozis kaldığı izlendi. Hastanede kalış süresi ortalama 26.5 ± 1.1 gündür. Uygun antimikrobiyal tedaviye rağmen hastanede kalış süresi uzayabilmekte ve akciğer lezyonları hızlı progresyon gösterebilmektedir. Bu bulgular; akciğer apsesinde eşlik eden ciddi bulguların varlığında, ölümcül komplikasyonların olabileceğini ve yoğun tedavi gerekliliğini göstermektedir.
The clinical, bacteriological, radiological findings and the predisposition factors of lung abscess with the efficiency of treatment were retrospectively reviewed in fourty-two cases whom were hospitalized during years between 1990-1998. the mean age of patients was 46.7 ± 2.1 years. the most common complaints were increased amount of sputum production and fever. Diabetes mellitus in nine cases, chronic obstructive pulmonary disease in seven cases and malignancy in four cases were the most common accompanying diseases. the radiological localization of abscess in 50% cases was found in the right hemitorax, in 35.7% cases in the left hemitorax and in 14.2% cases bilaterally. in 28 (66.6%) cases the causative agent could be isolated, Staphylococcus epidermidis in 8 (19.0%), Staphylococcus aureus in 7 (16.6%) and anaerobic bacteria in 6 (14.2%) cases. Two patients who had not responded to the medical treatment were operated. Another two cases who were seriously ill and had a severe underlying disease were died due to septicemia. Complete response to treatment, with total resolution of symptoms and radiographic findings was obtained in 32 cases and in 8 cases residual fibrozis was observed despite clinical response. the mean duration of stay in hospital was 26.5 ± 1.1 days. Despite adequate antimicrobial treatment, duration of stay in hospital might be long and the lessions in lung sometimes progresssed very quickly. These data show that, lung abscess may have fatal complications in patients with severe comorbidities and should be agressively treated.
The clinical, bacteriological, radiological findings and the predisposition factors of lung abscess with the efficiency of treatment were retrospectively reviewed in fourty-two cases whom were hospitalized during years between 1990-1998. the mean age of patients was 46.7 ± 2.1 years. the most common complaints were increased amount of sputum production and fever. Diabetes mellitus in nine cases, chronic obstructive pulmonary disease in seven cases and malignancy in four cases were the most common accompanying diseases. the radiological localization of abscess in 50% cases was found in the right hemitorax, in 35.7% cases in the left hemitorax and in 14.2% cases bilaterally. in 28 (66.6%) cases the causative agent could be isolated, Staphylococcus epidermidis in 8 (19.0%), Staphylococcus aureus in 7 (16.6%) and anaerobic bacteria in 6 (14.2%) cases. Two patients who had not responded to the medical treatment were operated. Another two cases who were seriously ill and had a severe underlying disease were died due to septicemia. Complete response to treatment, with total resolution of symptoms and radiographic findings was obtained in 32 cases and in 8 cases residual fibrozis was observed despite clinical response. the mean duration of stay in hospital was 26.5 ± 1.1 days. Despite adequate antimicrobial treatment, duration of stay in hospital might be long and the lessions in lung sometimes progresssed very quickly. These data show that, lung abscess may have fatal complications in patients with severe comorbidities and should be agressively treated.
Açıklama
Anahtar Kelimeler
Kulak, Burun, Boğaz, Solunum Sistemi
Kaynak
Tüberküloz ve Toraks
WoS Q Değeri
Scopus Q Değeri
Cilt
49
Sayı
1
