[Diagnosis and therapy of lung abscess]

10 patients with primary lung abscess have been treated for 2 years. The patients were predominantly middle-aged men with predisposing factors for aspiration such as, essentially, alcoholism. All patients were in a fairly good general condition. The most frequent symptom was purulent foul smelling sputum. Most abscesses were found in the dorsal segments of both lower lobes and of the right upper lobe. Bacteriological examination of abscess punctate frequently revealed anaerobic bacteria. The primary treatment in all cases was conservative, including postural drainage and longterm therapy with high dose penicillin or amoxicillin. In 9 cases this led to complete clinical and radiological recovery; only 1 patient had to be operated on because of failure of conservative therapy. Aspiration of anaerobic bacteria from the oropharynx is of prime importance in the genesis of primary lung abscess. Therapy is conservative, with penicillin as the drug of choice.