Lung abscesses: review of 60 cases

Lung abscesses (LA) carry with them severe clinical and social implications. The authors retrospectively analyse case files from a tertiary hospital. Admissions from 2000 to 2005 codified as LA were identified. Forty-five patients were males and the mean age was 56.2 (+/-15.1) years. The average duration of symptoms pre-hospitalisation was 23.0 (+/-50.2) days, with acute respiratory infection the initial syndrome in 36 patients. Clinical data show LA could have been suspected in 40 patients. Diagnosis was established 8.7 (+/-11.4) days after admission. A microbial pathogen was recovered in 26 cases. Primary LA was diagnosed in 27 patients. Dental disease and immunodeficiency were the main risk factors. Other co-morbidities were present in 34 patients. Af- ter LA diagnosis, intravenous (IV) antibiotic (AB) was prescribed for 16.5 (+/-10.9) days with mean total AB time 39.2 (+/-15.7) days. Ten options of AB were used and 23 patients had their initial IV AB changed to a second choice. Six patients needed surgery. Apyrexia was achieved after 6.4 (+/-6.4) days of treatment. 21 patients had complications and 7 died. The mean length of hospital admission was 27.5 (+/-16.3) days and 38 patients were called for a follow-up visit. These data are generally in accordance with the literature. The high male percentage agrees with the similarly high prevalence of alcoholism and lung neoplasms in males. Key facts to ameliorate in order to improve prognosis and length of hospital admission could be a swifter diagnosis and consensus on the AB treatment.