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40
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Text
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Pages
279–307
Issue
2
Volume
7
Dublin Core
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Title
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Aspiration pneumonia, necrotizing pneumonia, and lung abscess.
Publisher
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Emergency medicine clinics of North America
Date
A point or period of time associated with an event in the lifecycle of the resource
1989
1989-05
Subject
The topic of the resource
Humans; Necrosis; Combined Modality Therapy; Lung Abscess/diagnosis/etiology/*therapy; Pneumonia; Aspiration/diagnosis/*pathology/physiopathology/therapy
Creator
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Pennza P T
Description
An account of the resource
Suppurative complications to aspiration pneumonia occur if the initial aspiration and subsequent pneumonitis go unrecognized or untreated. Anaerobic cavitary disease is typically an indolent process, whereas necrotizing pneumonia is more fulminant and deadly. Rarely are aggressive diagnostic measures necessary in the community-acquired setting. Most patients, even with necrotizing pneumonia, respond well to high-dose penicillin and show clinical improvement within a week to 10 days. Clindamycin may be preferred in cases of severe underlying disease or when penicillin fails to yield signs of recovery. The presence of empyema not only increases the duration of therapy but also is fraught with complications and carries a higher mortality rate (20 vs 5 per cent). Necrotizing pneumonia and pulmonary abscess that develop in the nursing home or hospital setting require a more aggressive diagnostic approach, and broad-spectrum antibiotic coverage is necessary. In spite of these measures and appropriate antibiotic selection, nosocomial-acquired disease carries a mortality rate of 30 to 50 per cent. Surgical intervention, once the mainstay of therapy, is now reserved for patients with complications such as massive hemoptysis, failure to respond to chest tube thoracostomy in the presence of empyema, abscess drainage that fails with postural drainage, and diagnosis of carcinoma.
Rights
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
1989
Aspiration/diagnosis/*pathology/physiopathology/therapy
Combined Modality Therapy
Department of Internal Medicine
Emergency medicine clinics of North America
Humans
Lung Abscess/diagnosis/etiology/*therapy
Necrosis
NEOMED College of Medicine
Pennza P T
Pneumonia