title: [Pulmonary abscess: a 111-case series in Madagascar].
abstract: The purpose of this report is to present a series of 111 cases of pulmonary abscess observed over a 4-year period in Madagascar. There were 75 men (67.6%) and 36 women (32.4%) with a mean age of 38 years. Alcohol and tobacco use was found in 32.2% of cases. Thirteen patients (11.7%) used chewing tobacco and all patients were exposed to passive smoking. Eighty-eight patients (79.2%) had a history of bronchopulmonary disorders. Onset was progressive in 63% of cases. The main symptoms were fever (81.9%), pulmonary condensation (74.7%) and pleurisy (9.9%). Coughing was productive in 91.8% cases including 54% of patients having muco-purulent expectorations. In 49 patients (44.1%), chest radiography showed an opacity with a hydroaeric level. The abscess was solitary in 40 cases, multiple in 9, and bilateral in 5. In-hospital antibiotherapy was performed on a presumptive basis: tritherapy in 92 patients (82.9%), bitherapy in 18 (16.2%) and monotherapy in one (0.9%). Other treatment modalities inculuded respiratory kinesitherapy in 57 cases (51.3%), surgical drainage in four (3.6%) and pneumonectomy in one (0.9%). Outcome was favorable in 93 cases (8,7%) but there were 18 deaths (16.2%). This study emphasizes the value of achieving early diagnosis, identifying supporting factors and starting appropriate treatment promptly.
authors.affiliation: Unité de Soins, de Formations et de Recherches (USFR) de Pneumologie, Centre Hospitalier Universitaire, Antananarivo, Madagascar. jrakotoson@yahoo.fr
authors.forename: J L
authors.initials: JL
authors.lastname: Rakotoson
authors.forename: L
authors.initials: L
authors.lastname: Rebasy
authors.forename: R
authors.initials: R
authors.lastname: Andrianasolo
authors.forename: H
authors.initials: H
authors.lastname: Rakotoharivelo
authors.forename: J R
authors.initials: JR
authors.lastname: Rakotomizao
authors.forename: A C F
authors.initials: AC
authors.lastname: Andrianarisoa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012138:Respiratory Therapy; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents