Pathophysiology

Primary lung abscess usually results from aspiration of anaerobic oropharyngeal bacteria into the dependent portions of the lung. Any breakdown of the normal protective mechanisms predisposes patients to aspiration, which is also the predominant cause of a lung abscess in infants and children. 13 Aspiration of the bacteria leads to pneumonitis, which impairs drainage of fluids and/or aspirated material and results in inflammatory vascular obstruction, leading to tissue necrosis, abscess formation, or empyema. Lung abscesses resulting from bacteremia are usually due to S. aureus that enters the blood via skin lacerations, soft tissue infection, and injected drug use.

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