Massive pulmonary gangrene (MPG) is a rare complication of bacterial pneumonia.
Features of massive pulmonary gangrene:
(1) It is preceded by lobar or aspiration pneumonia.
(2) The patient develops extensive lung necrosis that involves all or most of a lobe.
(3) There is variable hemoptysis which can be massive.
(4) The patient may have a fulminant clinical course.
(5) There is variable empyema.
This is most often associated with Klebsiella species but can be seen with Streptococcus pneumoniae and other bacteria.
Risk factors:
(1) chronic alcoholic
(2) elderly
(3) debilitated
It must be treated aggressively. Surgery with lobectomy and empyema drainage can be life-saving. Antibiotic resistance may complicate antibiotic management.
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