Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Aug;3(13):183.
doi: 10.3978/j.issn.2305-5839.2015.07.08.

Lung abscess-etiology, diagnostic and treatment options

Ivan Kuhajda  1 , Konstantinos Zarogoulidis  1 , Katerina Tsirgogianni  1 , Drosos Tsavlis  1 , Ioannis Kioumis  1 , Christoforos Kosmidis  1 , Kosmas Tsakiridis  1 , Andrew Mpakas  1 , Paul Zarogoulidis  1 , Athanasios Zissimopoulos  1 , Dimitris Baloukas  1 , Danijela Kuhajda  1
Affiliations
Review

Lung abscess-etiology, diagnostic and treatment options

Ivan Kuhajda et al. Ann Transl Med. 2015 Aug.

Abstract

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. It can be caused by aspiration, which may occur during altered consciousness and it usually causes a pus-filled cavity. Moreover, 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. There are several imaging techniques which can identify the material inside the thorax such as computerized tomography (CT) scan of the thorax and ultrasound of the thorax. Broad spectrum antibiotic to cover mixed flora is the mainstay of treatment. Pulmonary physiotherapy and postural drainage are also important. Surgical procedures are required in selective patients for drainage or pulmonary resection. In the current review we will present all current information from diagnosis to treatment.

Keywords: Lung abscess; antibiotics; thoracoscopy; video-assisted thoracoscopic surgery (VATS).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Chest X-ray with lung abscess.
Figure 2
Figure 2
Pathology findings with neutrophillic granulocytes with dilated blood vessels and inflammatory oedema. (HE, ×100).
Figure 3
Figure 3
CT scan with lung abscess.
Figure 4
Figure 4
Around pyogenic membrane lymphocytes, plasma cells and histiocytes are placed in connective tissue. (HE, ×100).
Figure 5
Figure 5
CT scan with thicker and irregular wall comparing to infectious lung abscess.
Figure 6
Figure 6
Radiological sign of air-fluid level can be seen and in hydatid cyst of lung.
Figure 7
Figure 7
Effects of antibiotic therapy on radiographic finding of lung abscess.
Figure 8
Figure 8
Chest tube drainage with trocar.
Figure 9
Figure 9
Chest tube drainage with Seldinger technique.
Figure S1
Figure S1
Acute phase.
Figure S2
Figure S2
Late phase.
See this image and copyright information in PMC

References

    1. Seo H, Cha SI, Shin KM, et al. Focal necrotizing pneumonia is a distinct entity from lung abscess. Respirology 2013;18:1095-100. - PubMed
    1. Yazbeck MF, Dahdel M, Kalra A, et al. Lung abscess: update on microbiology and management. Am J Ther 2014;21:217-21. - PubMed
    1. Bartlett JG. The role of anaerobic bacteria in lung abscess. Clin Infect Dis 2005;40:923-5. - PubMed
    1. Schweigert M, Dubecz A, Stadlhuber RJ, et al. Modern history of surgical management of lung abscess: from Harold Neuhof to current concepts. Ann Thorac Surg 2011;92:2293-7. - PubMed
    1. Moreira Jda S, Camargo Jde J, Felicetti JC, et al. Lung abscess: analysis of 252 consecutive cases diagnosed between 1968 and 2004. J Bras Pneumol 2006;32:136-43. - PubMed