Epidemiology

A pulmonary abscess is a localized area of suppuration and necrosis involving one or more areas of the lung parenchyma and leading to cavity formation and the characteristic radiographic finding of an air-fluid level. 11

The most common risk factors for lung abscess in adults are a history of alcohol abuse, a history of aspiration pneumonia, dental caries, and poor dental hygiene (Iable.,.60-1). About 90 percent of patients with lung abscess have obvious periodontal disease or some predisposition to aspiration. 1 I2

Limited data exist on lung abscesses in children, especially with regard to bacteriology, diagnosis, and management. In normal children with no known underlying disease, the most common organisms are Streptococcus pneumoniae, anaerobic bacteria, nontypable Haemophilus influenzae, and Staphylococcus aureus.13 Anaerobic bacteria are the predominant organisms isolated from children with underlying neurologic disorders. 11

Patients with HIV infection are at risk for lung abscesses, especially those with advanced disease and a low CD4 count (less than 50). 14 The microbiologic etiology of lung abscess in patients with advanced HIV infection differs from that in HIV-negative patients. Pseudomonas aeruginosa is one of the most commonly isolated pathogens from patients with advanced HIV infection or AIDS-defining illnesses. Lung abscesses in patients with advanced HIV infection respond poorly to antibiotic therapy.

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