Lung abcess?

Question

After many many weeks of testing, horrible pain in my shoulder and neck and several misdiagnoses, doctors found that I had an 8" abcess of the plural space which was also pressing on my liver. I also had pneumonia. All the specialists that were consulted on my case were shocked by my final diagnoses, especially considering what seemed like unrelated symptoms and said that they had never really seen this type of thing, they had no idea what caused it (they did ask me if I raised birds or if I had been out of the country) and weren't exactly sure how to treat it. Has anyone else heard of anything similar to this and what kind of treatment was done?

Answer 1

Probably look under "Pleural Effusion" in Wikipedia.

The first question is the fluid truly an abcess? Did they take a sample? If the effusion is 8", that's pretty severe and would cause severe shortness of breath.

If it's truly an abscess, the bug in question is usually Staphylococcus aureus , an anti-Staphylococcus antibiotic such as Flucloxacillin or dicloxacillin often used to combat the "growth" of Staph aureus... but because it's in the pleural space, the stuff still needs to come out. You'll probably have to have it aspirated or drained out. You can look under "thoracentesis", which is basically tapping/draining of pleural fluid from the pleural cavity.

The other question is what caused the effusion in the first place? Do you or your family have a history of cancer? History of TB? Have you had any surgical procedures done? Car accidents? Chest trauma? The list goes on, but there has to be a definite cause for the effusion... and you need to find the underlying cause (or you may get it again). However if it "truly" is an abscess, it would more than likely an exudative cause (e.g. the pneumonia you mentioned).

To figure out the underlying cause, you need to find out whether it is a systemic cause for the effusion (e.g. cardiac failure, renal [kidney] failure, etc...) or something more regional to the lung (e.g. pneumonia, cancer, etc...)

There is a test for this called the Light's Criteria. I won't go into the details, but you can do a Wiki lookup. I'll include a link in the source's list below.

Anyway, good luck... get it treated ASAP, and make sure they find out "why" it happened. The fact that you have the pleural effusion means there may be a much larger problem (not a scare tactic, just an urgency to get it taken care of).