Lung abscess

Lung abscess

Microbiology

• Usually polymicrobial, including oral anaerobes
• Can also be monomicrobial, caused by Klebsiella, Staphylococcus aureus, Pseudomonas aeruginosa, Burkholderia pseudomallei (melioidosis), Pasteurella multocida, group A streptococcus, Haemophilus influenzae types b and c, Legionella spp., Rhodococcus equi, Actinomyces spp., and Nocardia spp.

Pathophysiology

• Mostly from chronic aspiration

Risk Factors

• Chronic aspiration from any etiology
  • Alcohol use disorder
  • Seizures, stroke, drug overdose, general anesthesia
• Dysphagia or respiratory dysfunction from ALS, Parkinson’s disease, or stroke
• Tooth extraction

Management

• Antibiotics
• Rarely, surgical intervention