Type:
Educational Exhibit
Keywords:
Pathology, Infection, Diagnostic procedure, CT-High Resolution, CT-Angiography, CT, Thorax, Lung
Authors:
M. Valle Franco1, L. Martínez González1, J. de la Calle Lorenzo2, C. Torrez Villarroel2, M. Berlioz Ortiz1, I. M. LÓPEZ GARCÍA1, F. J. SOMALO ALFARO2, A. Pérez Termenón1, M. Pérez Rodríguez1; 1León/ES, 2León, Castilla y León /ES
DOI:
10.26044/ecr2019/C-3659
Background
Necrotizing pneumonia is a severe and rare complication of an infectious respiratory process - community-acquired pneumonia (CAP).
It's described around 30-75% mortality.
Bacterial is the most frequent etiology (S.
aureus,
S.
pneumoniae,
K.
pneumoniae,
P.
aeruginosa,
other bacteria).
Fungus is less frequent and predominates in immunosuppressed patients.
The most relevant risk factor mentioned in the literature is immunosuppression,
which can be aggravated by alcoholic and tobacco habits,
diabetes mellitus,
heart failure,
chronic liver disease,
etc ...
During an infectious respiratory process with the development of a pulmonary consolidation in the pulmonary parenchyma,
an inflammatory reaction occurs that affects the vascular supply of this area.
Consequently,
there is a compromise of the vascular supply that is slow and sometimes interrupted.
Therefore,
there is a lower blood supply of nutrients,
antibiotics and anti-inflammatory drugs that condition on the one hand the perpetuation of the infectious process in the consolidation zone and,
on the other hand,
the appearance of lung parenchyma liquefaction and necrosis areas whose radiological translation in the TC are air cavities that can present hydro-aerial levels due to the presence of detritus,
purulent material,
etc ...
The spectrum of the disease consists of lung abscess,
necrotizing pneumonia and in very few cases pulmonary gangrene as the last stage instead of the death.