Diagnosis, treatment and prognosis of lung abscess

Lung abscesses are usually caused by anaerobic or mixed bacterial infection of the lower respiratory tract. Conservative treatment with broad-spectrum antibiotics is established as the therapy of choice for most patients, with 80-95% responding to antimicrobial therapy. Conservative management failure, manifested by sepsis persistence and/or abscess complications, requires drainage with invasive techniques (percutaneous, endoscopic or surgical) or open surgical removal of the affected lung tissue (segmentectomy, lobectomy or rarely pneumonectomy) in patients with good performance status and sufficient respiratory reserve. Although surgical intervention is accompanied by relatively high mortality rates (11%-28%), it remains the most effective method in preventing complications or future relapses. Pneumon 2015, 28(1):54-60. Angeliki A. Loukeri, MD1 Christos F. Kampolis, MD2 Periklis Tomos, MD2 Dimosthenis Papapetrou, MD3 Ioannis Pantazopoulos, MD4 Aikaterini Tzagkaraki, MD1 Dimitrios Veldekis, MD1 Nikolaos Lolis, MD1 1Respiratory Intensive Care Unit, ‘Sotiria’ General Hospital of Athens, Greece, 2Second Department of Propaedeutic Surgery, University of Athens Medical School, General Hospital “Laiko”, Athens, Greece, 3“Iatriko” Hospital, Respiratory Department, P. Faliron, Piraeus, Greece, 44th Respiratory Clinic, ‘Sotiria’ General Hospital of Athens, Greece