11- LUNG ABSCESS

• Lung abscess

  Localized suppuration of the lung associated with cavity formation, often with an air-fluid level on CXR
• Causes of lung abscess

  • Aspiration pneumonia (most common); anaerobes
  • Bacterial pneumonia (S. aureus, Klebsiella, Tb, gram negative)
  • Bronchial obstruction (tumor/foreign body)
  • CF, bronchiectasis
  • Septic emboli
• Presentation of lung abscess

  • Persisting or worsening pneumonia
  • Copious foul-smelling sputum
  • May have finger clubbing on examination
• Investigations for lung abscess

  1. Bacteriological investigation is best conducted on specimens obtained by transtracheal aspiration, bronchoscopy or percutaneous transthoracic aspiration

  2. Gram stain, culture, sensitivity
• Treatment of lung abscess

  1. Antibiotics (broad spectrum aerobic & anaerobic gram +ve & -ve coverage, ex: cefuroxime and metronidazole)

  2. Occasionally need surgical drainage