Lung abscess: analysis of 252 consecutive cases diagnosed between 1968 and 2004.
OBJECTIVE
To relate the experience of the staff at a health care facility specializing in the management of patients with aspiration lung abscess.


METHODS
Diagnostic aspects and therapeutic results of 252 consecutive cases of lung abscess seen in patients hospitalized between 1968 and 2004.


RESULTS
Of the 252 patients, 209 were male, and 43 were female. The mean age was 41.4 years, and 70.2% were alcoholic. Cough, expectoration, fever and overall poor health were seen over 97% of patients. Chest pain was reported by 64%, 30.2% presented digital clubbing, 82.5% had dental disease, 78.6% reported having lost consciousness at least once, and 67.5% presented foul smelling sputum. In 85.3% of the patients, the lung lesions were located either in the posterior segments of the upper lobe or in the superior segments of the lower lobe, and 96.8% were unilateral. Concomitant pleural empyema was seen in 24 (9.5%) of the patients. Mixed flora was identified in the bronchopulmonary or pleural secretions of 182 patients (72.2%). All patients were initially treated with antibiotics (mainly penicillin or clindamycin), and postural drainage was performed in 98.4% of cases. Surgical procedures were performed in 52 (20.6%) of the patients (drainage of empyema in 24, pulmonary resection in 22 and drainage of the abscess in 6). Cure was obtained in 242 patients (96.0%), and 10 (4.0%) died.


CONCLUSIONS
Lung abscess occurred predominantly in male adults presenting dental disease and having a history of loss of consciousness (especially as a result of alcohol abuse). Most of the patients were treated clinically with antibiotics and postural drainage, although some surgical procedure was required in one-fifth of the study sample.
Moreira
José da Silva
Jda S
Universidade Federal do Rio Grande do Sul, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. moreirapneumo@bol.com.br
Camargo
José de Jesus Peixoto
Jde J
Felicetti
José Carlos
JC
Goldenfun
Paulo Roberto
PR
Moreira
Ana Luiza Schneider
AL
Porto
Nelson da Silva
Nda S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D001999:Bronchoscopy; D002648:Child; D015916:Drainage, Postural; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents