Lung abscess

Lung abscess
Computed tomography (CT) scan of chest showing bilateral pneumonia with abscesses, effusions, and caverns. 37-year-old male.
Classification and external resources
Specialty	pulmonology
ICD-10	J85
ICD-9-CM	513.x
DiseasesDB	7607
eMedicine	med/1332
MeSH	D008169
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Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.

This pus-filled cavity is often caused by aspiration, which may occur during anesthesia, sedation, or unconsciousness from injury. Alcoholism is the most common condition predisposing to lung abscesses.

Lung abscess is considered primary (60%) when it results from existing lung parenchymal process and is termed secondary when it complicates another process e.g. vascular emboli or follows rupture of extrapulmonary abscess into lung.

Onset of symptoms is often gradual, but in necrotizing staphylococcal or gram-negative bacillary pneumonias patients can be acutely ill. Cough, fever with shivering, and night sweats are often present. Cough can be productive of foul smelling purulent mucus (≈70%) or less frequently with blood in one third of cases). Affected individuals may also complain of chest pain, shortness of breath, lethargy and other features of chronic illness.

Those with a lung abscess are generally cachectic at presentation. Finger clubbing is present in one third of patients.Dental decay is common especially in alcoholics and children. On examination of the chest there will be features of consolidation such as localized dullness on percussion and bronchial breath sounds.

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