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Lung Abscess 

Lung Abscess
Chapter:
Lung Abscess
Author(s):

Kevin Gibbs

DOI:
10.1093/med/9780199976805.003.0025
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date: 27 July 2021

Lung abscesses are intraparenchymal collections of purulent and necrotic tissue caused by infectious organisms that present with subacute pulmonary symptoms. Primary lung abscess is classically a disease of middle-aged men. Infection and subsequent abscess formation result from large-volume aspiration of oral secretions. Therefore, conditions that predispose to aspiration also predispose to lung abscess. Such conditions include all causes of depressed sensorium as well as both mechanical and neurologic causes of dysphagia. The burden of oral anaerobes also plays an important role in disease pathogenesis. It can be difficult to differentiate a lung abscess from pneumonia. Patients with lung abscess generally appear less acutely ill, and have fewer rigors or shaking chills. These infections are typically polymicrobial and difficult to accurately culture, requiring empiric therapy with antibiotics with broad anaerobic coverage. Most patients respond well to antimicrobials, but mortality remains high in the subset who fails medical therapy.

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