Os abcessos pulmonares em revisão

Pulmonary abcess, a revision

 

Ana Moura Gonçalves 1

Luiz Menezes Falcão 2

Luciano Ravara 3

 

 

Resumo

Os abcessos pulmonares são cavidades que surgem no parênquima pulmonar, apresentando maior ou menor quantidade de tecido necrosado no seu interior. Surgem em indivíduos predispostos, como sejam os doentes com doença pulmonar crónica ou obstrução secundária a neoplasia e os doentes com maior risco de aspiração, estando incluidos os doentes com alteração do estado neurológico, os utilizadores de drogas endovenosas, os doentes com alcoolismo, patologia da faringe e esofágica, doença neuromuscular, entre outras. É feita a revisão dos principais agentes causais, da metodologia diagnóstica, da abordagem terapêutica na actualidade e do prognóstico destas situações.

Os abcessos pulmonares, para além de relativamente pouco frequentes, são difíceis de caracterizar, sendo a resistência aos antibióticos um problema a ter presente, na sua abordagem terapêutica.

Palavras-chave: Abcesso pulmonar, pneumonia de aspiração, resistência antimicrobiana, anaeróbios.

 

 

Abstract

Lung abscesses are cavitating lesions containing necrotic debris caused by microbial infection. Patients with chronic lung disease, bronchial obstruction secondary to cancer, a history of aspiration or risk of aspiration caused by alcoholism, altered mental status, structural or physiologic alterations of the pharynx and esophagus, neuromuscular disorders, anesthesia, are among others at higher risk of developing lung abcess.

The main bacteriological characteristics, the diagnosis, therapy and prognosis are considered. The problem of antimicrobial resistance is also referred.

Key-words: Lung abscesses, aspiration pneumonia, antimicrobial resistance, anaerobes

 

 

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1 Interna do Internato Complementar de Medicina Interna, no Hospital de Santa Maria, Lisboa.

2 Assistente Hospitalar Graduado do Hospital de Santa Maria, Cardiologista, Professor Auxiliar da Faculdade de Medicina de Lisboa.

3 Professor Catedrático da Faculdade de Medicina de Lisboa, Director do Serviço de Medicina 1 do Hospital de Santa Maria, Lisboa.

Serviço de Medicina 1– sector C, Hospital de Santa Maria, Lisboa

Director: Professor Dr. Luciano Ravara

Avenida Professor Egas Moniz, 1649-035 Lisboa

e-mail: anapmgoncalves@gmail.com

 

Recebido para publicação/received for publication: 06.05.17

Aceite para publicação/accepted for publication: 07.09.12