Lung Absess With Complication of Bronchopleural Fistula in A Patient With Type 2 Diabetes mellitus at Klungkung Regional Hospital
DOI:
https://doi.org/10.38035/ijphs.v2i3.597Keywords:
Lung abscess, bronchopleural fistula, diabetes mellitusAbstract
Lung abscess is a clinical condition characterized by the accumulation of purulent material in the necrotic lung parenchyma. One of the complications is a bronchopleural fistula, which is an abnormal channel that connects the bronchus to the pleural cavity. KS, a 65 years old male, presented with complaints of intermittent shortness of breath for 3 months, which had worsened the day before hospital admission. The patient also reported fever and cough with foul-smelling phlegm for 1 week. Physical examination revealed tachypnea and decreased breath sounds in the right intercostal spaces 3-6. Laboratory examination showed anemia, leukocytosis, and hyperglycemia. A plain chest radiograph revealed a loculated right pleural effusion, with suspected empyema, and a chest CT scan with contrast showed pneumonia with suppurative fluidopneumothorax and fistulation into the bronchus. Examination of the patient's pleural fluid revealed increased ADA test results and isolation of Candida spp on culture. Additional tests showed that MTB was not detected, and the IGRA was negative. Patient management included antibiotics, transfusions, and insulin administration. A bronchopleural fistula is a complication of a lung abscess that occurs when a channel forms from the abscess to the bronchus, creating a sinus between the main branch of the bronchus, lobe, or bronchial segment and the pleural space. Management includes controlling infection, treating respiratory dysfunction, and controlling air leaks. A 65-year-old male patient with a history of type 2 diabetes mellitus complained of coughing and shortness of breath for 3 months, which had worsened over the past week. Examination revealed a lung abscess with a bronchopleural fistula. Therapy included antibiotics to eradicate the infection and thoracentesis to treat respiratory dysfunction.
References
Lawrensia, S. (2021). Lung Abscess: Diagnosis and Treatment. Cermin Dunia Kedokteran, 48(5), 286–288
Kuhajda, I., Zarogoulidis K., Tsirgogianni, K., et. Al. Lung abscess-etiology, diagnostic and treatment options. Ann Transl Med 2015;3(13):183-192
Septiana, VT., Febrianto, BY., Afifi, R., Singh, G. Radiological Features of Lung Abscess. Eduhealt. 2021;11(2):86-100
Egyud M, Suzuki K. Post-resection complications: abscesses, empyemas, bronchopleural fistulas. J Thorac Dis. 2018 Oct;10(Suppl 28):408-418
Uppe A, Nikalji R, Dubey M, Kadu N. Nephrobronchial fistula and lung abscess secondary to Xanthogranulomatous pyelonephritis. Lung India. 2015 Jul-Aug;32(4):392-396
Marra A, Hillejan L, Ukena D. [Management of Lung Abscess]. Zentralbl Chir. 2015 Oct;140 Suppl 1:S47-53.
Yanti, B., Hadi, S., Harrika, F., Shehzad. 2022. Giant bronchopleural fistula and empyema in a tuberculosis patient with diabetes mellitus: Vista from a high tuberculosis burden country in Southeast Asia. Narra J;2(2):81
Abdelhadi, A., Kessem, A. 2021. Candida Pneumonia with Lung Abscess as a Complication of Severe COVID 19 Pneumonia. Int Med Case Rep Journl;14: 853-61
Salik, I., Vashisht, R., Abramowicz, AE. 2023. Bronchopleural Fistula. Diakses 10 Juni 2024. https://www.ncbi.nlm.nih.gov/books/NBK534765/
Keshishyan S, Revelo AE, Epelbaum O.. Bronchoscopic management of prolonged air leak. J Thorac Dis2017;9(1):S1034–46.
Takamatsu, J., Kang, J., Fukuhara, A., Yasue, Y., Kawata, S. Lung Abscess with a Refracrory bronchopleural Fistula Saved from Potentially Fatal Sepsis by Omentoplasty and Extracorporeal membrane Oxygenation. Case rep Crit Care; 2021 diakses pada 16 Juni 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553482/
Pedoman Nasional Pelayakan Kedokteran Tata Laksana Pneumonia pada Dewasa. 2023
Sabbula, BR., Rammohan, G., Sharma, S., Akella, J. 2021. Lung Abscess. Diakses pada 16 Juni 2024
Meiliana, ML. Lestari, YE. 2023. Pengaruh Pemberian Steroid sebagai terapi Adjuvan terhadapa Parameter Inflamasi Pasien Pneumonia Komunitas Berat di Rumah Sakit X Kota Bandar Lampung. Jurnal Medika Malahayati;7(4): 1182-119
PERKENI. Pengelolaan dan ssoPencegahan Diabetes Melitus Tipe 2 di Indonesia, Jakarta: 2021
Downloads
Published
Issue
Section
License
Copyright (c) 2024 I Gusti Agung Wedanta Mahadewi, Ni Komang Ari Sepriyanti, Ida Bagus Putu Ekaruna
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their manuscripts in this journal agree to the following conditions:
- The copyright on each article belongs to the author(s).
- The author acknowledges that the International Journal of Psycology and Healt Science (IJPHS) has the right to be the first to publish with a Creative Commons Attribution 4.0 International license (Attribution 4.0 International (CC BY 4.0).
- Authors can submit articles separately, arrange for the non-exclusive distribution of manuscripts that have been published in this journal into other versions (e.g., sent to the author's institutional repository, publication into books, etc.), by acknowledging that the manuscript has been published for the first time in the IJPHS.