Is Intercostal Drainage The Only Solution To Treat An Abscess In Lung?

Posted on Tue, 22 Sep 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 22 Sep 2015 Answered on

Fri, 23 Oct 2015 Last reviewed on

Question : 84 yr old male copd enphsesima right lung lower portion removed developed an abscess tried to drain now they want to remove portion of rib and leave chest open to drain. I think Lung air leak and will be repAired at same time do you think this is best course of action ?

Answered by Dr. Drkaushal85 (34 minutes later)

Brief Answer:
Yes, this is the only treatment left.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
By your history and description, this is the last option available.
You are having pyothorax.
And intercostal drainage is the treatment of choice.
If this fails than open surgical drainage is available option.
Just make sure that malignancy has been ruled out first.
And please let me know if you had culture of that pus.
Hope I have solved your query.
I will be happy to help you further.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Drkaushal85 (8 hours later)

Culture was confirmed as liosporm not sure that's correct explained as bacteria contracted in hospital assume at time of lung g surgery...could have been a week later with cardioversion, went into afib immediately following surgery and again 1 week after dischrg

Answered by Dr. Drkaushal85 (8 minutes later)

Brief Answer:
Total how many days antibiotics are given?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Sorry to say but I don't know any bacteria resembling to the name liospam. So please reply me correct spelling.
Also tell me total days of antibiotic treatment.
I will be happy to help you further.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Drkaushal85 (12 hours later)

9 days

Also original surgery 7-13 was to remove cancer lobeectomy of right lower lung

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
What is the name of isolated organism?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Please let me know
1. Name of the organism isolated from culture.
2. Which antibiotics you are taking?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Drkaushal85 (5 days later)

Pseudonymous was the bacteria.....was that from catheter ? thoracotemy wed 9-23 performed dressing changes for 4 days attempted wound vac placement, got loud vac sounds from mouth original surgeon said take it off and repack wound ......what do you think is gonna happen now ?

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
Pseudomonas is mostly hospital acquired infection.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
Pseudomonas is mostly hospital acquired infection.
And it is common in chronic lung parenchymal diseases. Pseudomonas, actually cause chronic infection. It is very hard to remove pseudomonas from damaged lungs.
You need to take antibiotics for atleast 1 month.
So possibility of pseudomonas from catheter is high in your case.
But we can not prove it.
So at present, you need to take antibiotics for atleast 1 month and wait for the improvement.
Please let me know
1. What is the sensitivity pattern?
2. Which antibiotics are you taking? Atleast 2 higher antibiotics according to sensitivity report is must for pseudomonas infection.
3. Do you have fever?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D