Pulmonary Infections in Adults: Lung Abscess and Pleural Effusion

Abstract

A lung abscess is a cavity with a well-defined wall that develops in the lung due to microbial infection. This most commonly occurs with polymicrobial aerobic and anerobic infections related to aspiration pneumonia. Lung abscess may also be related to necrotizing pneumonia from aerobic organisms (eg, Staphylococcus aureus, Pseudomonas aeruginosa), septic emboli, or bronchial obstruction (eg, tumor). Most patients respond to appropriate antimicrobial therapy. However, catheter or surgical drainage may be needed if initial therapy is ineffective or the patient has complications such as extension into the pleural space (empyema). Pleural effusion is a manifestation of various underlying pathologies with a broad differential diagnosis. Defining the etiology of pleural effusion is critical for appropriate management. Thoracentesis should be considered for all pleural effusions associated with pneumonia. Parapneumonic effusions and empyema should be treated with prompt initiation of antibiotics and drainage of infected pleural fluid.