Clinical and Radiological Features of Lung Abscesses and their Management: A Retrospective Observational Study

Abstract

Introduction: A lung abscess is a localised area of destruction of lung parenchyma in which infection by pyogenic organisms results in tissue necrosis and suppuration. It is one of the common diagnosis in patients presenting to the respiratory Outpatient Department (OPD) and accounts for up to 4.0 to 5.5 per 10,000 hospital admissions each year. Aim: To study the clinical profile, predisposing factors, anatomical location and response to medical treatment in patients with lung abscesses. Materials and Methods: This was a retrospective observational study conducted on patients who had lung abscesses from the outpatient and inpatient departments of Respiratory Medicine at LG Hospital, Ahmedabad, Gujarat, India during January 2019 to December 2020. Parameters such as clinical profile, demographic profile, predisposing factors, radiological profile and response to medical treatment were assessed in all patients. All data were collected and analysed statistically using Statistical Package for Social Sciences (SPSS) Software version 21.0. Results: In the study of 50 patients, 36 (72%) were in the 41-60 years age group, with a mean age of 47.56 years; the male-to-female ratio was 3.2:1. The most common symptom in the study was cough with expectoration, which was present in all the patients. Poor oral hygiene was a predisposing factor in the majority of patients, i.e., 22 (44%). Other factors included low Body Mass Index (BMI), alcohol use, diabetes, seizures and pre-existing lung disease. Mixed organisms were found in the sputum culture reports. Upper zone distribution was the most common radiological finding, observed in 29 (58%) cases. The majority of lung abscesses were located in the upper lobes of both lungs. A total of 48 (96%) cases showed clinical improvement and 42 (84%) cases showed radiological improvement after 28 days of broad-spectrum antibiotics. Conclusion: The study found that lung abscesses are more common in males in the middle age group, particularly in individuals with addiction and co-morbidities such as diabetes, with upper lobe presentation being the most common. Most patients will improve if broad-spectrum antibiotics are started timely, at optimal doses and for the appropriate duration.

Keywords

• mycobacterium tuberculosis
• poor oral hygiene
• pyogenic organism