Lung Abscess: Diagnosis, Treatment and Mortality

Lung abscess is the necrosis of pulmonary tissue with formation of cavities (more than 2cm)..Predisposing factors include bronchogenic carcinoma or other bronchial obstructions,bronchiectasis and pulmonary infarction. Diagnosis is by chest radiography and computed tomography(CT),Frequently isolated pathogens include anaerobes and nosocomial microorganisms,Staphylococcus aureus, Pseudomonas aeruginosa, mycobacteria,parasites and fungi.Antibiotics of choice include penicillin with β lactamase inhibitors., carbapenem, quinolones, amoxicillin-clavulanate and amoxicillin sulbactam. Metronidazole not so effective because of microaerophilic streptococci. Medical management failure often is secondary to undrained pleural collections, endobronchial obstruction caused by a neoplasm or foreign body. High rates of morbidity and mortality associated with lung abscess despite antibiotic therapy and supported care. Patients with predisposing conditions like a large sized abscess and right-lower lobe location, have the worst prognosis. The prognosis of lung abscess has not improved sufficiently since the introduction of antibiotics, other modalities should be considered for patients with prognostics signs.