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Lung Abscess

Lung Abscess

Lung Abscess

A lung abscess is a localized area of lung suppuration, leading to necrosis of the lung parenchyma with or without cavity formation. They are most common in alcoholic men over the age of 50 and usually occur in patients with altered consciousness, as most are the result of aspiration.

Although most commonly secondary, lung abscesses can be primary and also single or multiple, acute or chronic.

The presentation is often of an insidious onset with fever, weight loss, and respiratory symptoms such as chest pain and a cough that can be productive of foul smelling sputum or haemoptysis,which can be massive and life threatening.

Lung Abscess Surgical Treatment

The treatment of lung abscess is steered by the obtainable microbiology with contemplation of the underlying or related conditions. Present management of lung abscesses via Dr. Pramoj Jindal, a lung abscess surgeon in Delhi, concentrates on antibiotic treatment that covers gram-positive, gram-negative and anaerobic organisms. The majority of lung abscesses can be treated fruitfully with antibiotics unaccompanied. Any patient who shows no reaction to antibiotic therapy after 7-10 days should be reexamined for resilient organisms or airway obstruction. It is imperative to note that surgery is required for only a trivial percentage of lung abscesses. Only cases that have failed to react to antibiotics or the organism is unaffected are considered for operation.

If treatment is begun in the acute phase of the disease and is continued for 4-6 weeks, almost 85-95% of patients with anaerobic lung abscesses react to medical management alone. The accomplishment of medical therapy via lung abscess surgeon in Delhi is reliant on the period of symptoms and the size of the cavity before the commencement of therapy. Antibiotic therapy is seldom efficacious if symptoms are present for lengthier than 12 weeks before the commencement of antibiotic therapy or if the original diameter of the cavity is more than 4 cm. When patients with lung abscesses do not react to appropriate medical therapy, the likelihood of an underlying malevolence must be considered.


There is a mixed flora in at least 50%, with anaerobes being present in 30–50%.


The mainstay of treatment is antibiotics plus physiotherapy to aid drainage. A prolonged course of antibiotics (4–6 weeks depending on clinical and radiological response) is required.

Differential Diagnosis Of A Cavitatory Mass

  • Cavitating carcinoma
  • Tuberculosis
  • Wegner’ granulomatosis
  • Infected pulmonary cyst or bulla
  • Aspergilloma
  • Pulmonary infarct
  • Rheumatoid Nodule
  • Sarcoidosis
  • Bronchiectasis
Surgery Surgery is rarely necessary but may be required if the abscess is:
  • Large (>6 cm),
  • Resistant to medical treatment
  • Significant haemorrhage.

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