Bacteriological and therapeutic features of lung abscess

<b>Background:</b> Primary lung abscess is necrotic cavitary lesion of the lung parenchyma. It is usually caused by anaerobic bacteria or mixed flora. The aim of this study was to describe the epidemiological, clinical, bacteriological and therapeutic features of lung abscess. <b>Methods:</b> This is a retrospective, descriptive study, conducted over a period of 3 years, including patients hospitalized for lung abscess. <b>Results:</b> Our study included 24 patients which mostly were men. The average age was 46.8 years. Sixty percent were smokers. The main patient illness histories were COPD (25%), diabetes (15%), cerebral stroke (5%), epilepsy (5%) and cerebral palsy(5%). The clinical symptomatology was dominated by fever, chest pain and deterioration of the general state. The most common location was the right upper lobe (35%). The bacteriological examination of sputum was negative in 21 patients and positive for pneumococcus (1 case), staphylococcus (1 case) and E. coli (1 case). One case of pseudomonas aeruginosa was isolated by bacteriological examination of the percutaneous drainage fluid. Nine patients (37.5%) were treated with amoxicillin-clavulanic acid and fluoroquinolone and 33.5% of patients received triple therapy included C3G with metronidazeole and fluoroquinolone. The mean duration of treatment was 3.8 weeks. Percutaneous drainage was indicated in 3 patients. Complete resolution of radiological abnormalities was 30 days. <b>Conclusion:</b> The identification of the responsible bacteria in lung abcess remains difficult. Management is based mainly on antibiotics wich is often probabilistic, in some cases associated with physiotherapy, percutaneous scan-guided drainage or rarely surgery.