Management of Lung Abscess : Review of 50 cases in Al-Hussein Teaching Hospital / Thi-Qar ( 2013-2018 )

Abstract

Background:  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. Aim: To present the effectiveness of conservative treatment in lung abscess and the rare indication of surgery for such disease in AL-Hussein teaching hospital in Thi-Qar Governorate and to compare our study with other study in Iraq and abroad Iraq. Patients and Methods: This is a retrospective study of 50 patients suffering from lung abscess over a period of 5 years from the first of  May  2013 till the first May 2018 in AL-Hussein teaching hospital in Thi-Qar governorate. The patient was admitted and received heavy antibiotics intravenously. In addition, good hydration was provided and also mucolytics, analgesic and antipyretic drugs were given along with good physiotherapy. Management continued on an inpatient basis for an average of 7 days. Follow up continued on an outpatient basis. Results: Males and and females were affected nearly equally. The ages affected ranged from ( 10 - 60 ) years  at presentation. 80% of the patients suffered from cough and most of our patients ( 90% ) had anorexia and fever. Conservative management was very effective in more than 90% of patients with lung abscess. Conclusions: Lung abscess was treated in most cases by conservative measures. All patients received initially injectable antibiotics and the treatment may continue for several weeks to several months. Hemoptysis was recorded in several patients only. Recommendations: Treatment should always begin by injectable antibiotics. Co-morbidities should be treated simultaneously with lung abscess. Malignancy should always be excluded especially in old aged people. Surgery is indicated only when conservative measures fail.