pulmonary disorders
Lung Abscess
Key Points
Lung abscesses are most often caused by aspiration of oral secretions by patients who have impaired consciousness; thus, anaerobic bacteria are among the common pathogens. Suspect lung abscess in patients prone to aspiration, who have subacute constitutional and pulmonary symptoms, and whose chest x-ray shows compatible lesions such as cavities. Treat initially with antibiotics; if patients do not respond within 7 to 10 days, evaluate them for unusual or resistant pathogens, bronchial obstructive lesions, and noninfectious causes of lung cavitation. Drain empyemas and consider surgical removal or drainage of lung abscesses that do not respond to drug therapy and for pulmonary gangrene. 