A clinical, radiological and microbiological profile of lung abscess

Introduction Lung abscesses continue to be a frequent presentation for physicians in Pakistan.With little local data available on the clinical correlations of the disease,there is a pressing need to describe the various factors associated with the condition. Objectives To evaluate the clinical,radiological and microbiological profile of lung abscess. Methods A retrospective case study was done through studying hospital records of 41 patients admitted with lung abscess at a tertiary care hospital in Karachi,Pakistan.Demographical data,clinical symptoms,risk factor assessment,radiological findings and culture reports were studied to outline a relevant profile. Results Over half the cases comprised of adult,male patients.Clinically,90.2% presented with productive cough,followed by 82.9% with fever, and 58.5% with haemoptysis.A significant association of 65.9%was found with smoking.Among other risk factors, poor oral hygiene was found in 56.1% of the cases, diabetes mellitus in 43.9%, pneumonia in 22%, and malignancy was diagnosed in 4.9%. Radiographically, 56.1% showed bilateral and 51.2% had right lower lung zone involvement. Sputum Gram staining revealed Gram negative rods and Gram positive cocci in 36.6% of the cases. AFB smear was positive in 22%. Sputum cultures showed Pseudomonas aeruginosa was present in 29.3%. No growth on blood cultures was seen in 86.6% and only 9.8% exhibited growth of E. coli. Conclusion Lung abscess was found to be more common in adult men,and was significantly related to smoking.The other common risk factor was found to be poor oral hygiene,while the right lower lung zone was the main site of abscess formation.Pseudomonas aeruginosa was the major pathogen implicated on sputum cultures.