Pyogenic lung abscess in an infectious disease unit: a 20-year retrospective study

Area of Science:

• Pulmonology
• Infectious Diseases
• Medical Microbiology

Background:

• Pyogenic lung abscesses are uncommon and infrequently documented infections.
• Understanding prognostic factors is crucial for effective patient management.

Purpose of the Study:

• To identify and describe factors influencing the prognosis of pyogenic lung abscesses.
• To inform clinical guidelines for managing these infections.

Main Methods:

• Retrospective analysis of 64 patients diagnosed with pyogenic lung abscess (ICD-10) between 1998 and 2018.
• Exclusion of parasitic, fungal, or mycobacterial causes.
• Comparison of hematogenous versus bronchogenic abscess presentations.

Main Results:

• Immunosuppression was present in 28 patients.
• Hematogenous abscesses were associated with younger age, absence of smoking/emphysema, specific bacterial pathogens (S. aureus, Streptococcus spp.), and smaller size.
• Overall outcomes included radiological sequelae (46.9%), relapse (12.5%), and death (4.8%).
• Bronchogenic abscesses and antibiotic treatment <6 weeks correlated with poor outcomes.

Conclusions:

• Inadequate antibiotic duration (<6 weeks) and bronchogenic origin are associated with adverse outcomes in pyogenic lung abscess.
• Findings necessitate consideration in developing clinical care guidelines for pyogenic lung abscesses.