Lung abscess

Question 1

Organisms causing lung abscess

Answer 1

95% anaerobic (oral caries)
1. Peptostreptococcus
2. Prevotella
3. Fusobacterium

Aerobic bacteria
1. Klebsiella
2. E. coli
3. Pseudomonas
4. S. aureus

Question 2

Non-infectious causes of lung abscess

Answer 2

Aspiration
Pulmonary infarction
cancer
vasculitis (like Wegener granulomatosis)

Question 3

Symptoms of lung abscess

Answer 3

1. Cough
2. Fever
3. Foul smelling sputum
4. Weight loss
5. Poor dental health
   long history

Question 4

Best initial test for lung abscess

Answer 4

CXR - air fluid level
Upper lobe when cause is aspiration

Question 5

Sputum culture in lung abscess is diagnostic. true or false

Answer 5

false
detected anaerobes can be present in normal sputum culture as well. Hence not specific or diagnostic

Question 6

Mx of lung abscess

Answer 6

Initial
Antibiotics
Clindamycin or penicillin

Best/Specific - lung biopsy

Abscess drainage not required

Question 7

Is drainage of lung abscess necessary?

Answer 7

Not in most cases
(in contrast to other abscess which are commonly drained