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Ann Thorac Surg 1997;64:973-974
© 1997 The Society of Thoracic Surgeons

Invited Commentary

Invited Commentary

John A. Odell, FRCS(Ed)

Division of Cardiovascular and Thoracic Surgery, Mayo Clinic Jacksonville, 4500 San Pablo Rd, Jacksonville, FL 32224.

The first 20% of the full text of this article appears below.

See also page 970.

Livid, bloody, foul-smelling or billious sputum supervening in cases of continued fever is of bad significance. However if such expectoration removes the diseased tissues all may be well Hippocrates [1]

The association of lung abscess with a poor prognosis has been known since the age of Hippocrates. A lung abscess usually follows aspiration or a pneumonia occurring in a compromised patient. Sequelae depend on the volume and composition of the inoculum and the resistance of the host, which may be modified by malnutrition, anemia, the presence of underlying disease or damaged lung, and the adequacy of antibiotic therapy. Microabscesses or larger abscesses, single, multiple, or multiloculated may then develop depending on the extent of necrotizing gangrenous infection. The visceral pleura and a thin layer of subjacent lung usually survive owing to independent blood supply from the subpleural vascular plexus. A pleuritis usually results in the visceral pleura adhering to the parietal pleura, but occasionally progression is so rapid that an associated empyema develops as in the patients described by Refaely and . . . [Full Text of this Article]


Related Article

Gangrene of the Lung: Treatment in Two Stages
Yael Refaely and Dov Weissberg
Ann. Thorac. Surg. 1997 64: 970-973. [Abstract] [Full Text]





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