Lung abscess is characterized by accumulation of pus and destruction of lung tissue. It is usually caused by aspiration or inhalation of bacteria like Staphylococcus aureus or Klebsiella pneumoniae. Clinically, it presents with cough producing foul smelling purulent sputum, fever, and chest pain. Diagnosis involves chest X-ray, CT scan, and sputum culture. Treatment consists of antibiotics based on culture results along with drainage of pus in some cases. Complications include pneumonia, empyema, and spread to other organs.

1. Presented by:
Ankita Roy
BSc Nursing 2nd Year
Royal School of Nursing

2. DEFINITION
● Lung (pulmonary) abscess is a local suppurative
process within the lung.
● Characterized by:
○ Accumulation of pus accompanied by the destruction of lung tissue.

3. CLASSIFICATION
● Based on it’s duration
○ Acute Abscess
○ Chronic abscess
● Based on it’s etiology
○ Primary Abscess
○ Secondary Abscess

4. Etiology and Pathogenesis
● Causative organisms
○ Any pathogen can produce lung abscess.
○ It is usually due to aerobic and anaerobic organisms.
○ Inhalation of foreign material.

5. ● Causative agents
○ Anaerobic bacteria, with or without mixed aerobic infection
○ Staphylococcus aureus
○ Klebsiella pneumoniae
○ Streptococcus pyogenes
○ Type 3 Pneumococcus

6. Etiopathogenesis
● Aspiration of infective material
○ Common in acute alcoholism, coma, anesthesia etc.
● Antecedent primary lung infection
○ Microbes usually associated are:
■ S. aureus
■ K. pneumoniae
■ Type 3 Pneumococcus
● Bronchial Obstruction

7. ● Septic embolism
● Miscellaneous
○ Direct penetrating trauma to the lungs.
○ Spread of infections from neighboring organs.

8. Morphology
● Gross
○ Size: Vary from few millimeters to large cavities of
5-6cm
○ Content:
■ Abscess cavity may contain suppurative
debris.
■ Communication with an air passage 
abscess partially drained to produce an air-
containing cavity
○ Continued infection may result  gangrene of
the lung

9. ● Microscopy
○ Cardinal feature: It is characterized by
suppurative destruction of the lung
parenchyma within the central area of
cavitations.
○ Abscess shows numerous
polymorphonuclear leukocytes and
variable numbers of macrophages.
○ The abscess is surrounded by fibrous
wall infiltrated by inflammatory cells.

10. Clinical Features
● Cough with foul- smelling
● Purulent
● Sanguineous sputum
● Occasionally hemoptysis
● Spiking fever
● Malaise
● Clubbing of the fingers
● Weight loss
● Anemia

11. Diagnostic findings
● History taking
● Physical examination
● Chest X-Ray
● CT Scan
● CBC
● Sputum culture and sensitivity tests
● Fiberoptic bronchoscopy

12. CHEST X-RAY

13. CT SCAN

14. CBC TEST

15. Sputum Culture Test

16. Fiber-optic bronchoscopy

17. Prevention
● Appropriate antibiotic therapy before any dental procedures in
patients who must have teeth extracted while their teeth and
gums are infected.
● Adequate dental and oral hygiene, because anaerobic bacteria
play a role in the pathogenesis of lung abscess.
● Appropriate antimicrobial therapy for patients with pneumonia.

18. Management
● Pharmacological Management
○ Treatment focus on cause of cough
○ Symptomatic treatment elimination of irritant and pain relief analgesic
and antipyretic
○ Antibiotic treatment may be indicated depending on the symptoms,
sputum purulence, and results of the sputum culture
○ Antihistamine are usually not prescribed
● Surgical Management
○ LOBECTOMY

19. Complication
● Pneumothorax or empyema
● Hemorrhage into the abscess cavity
● Meningitis or brain abscess
● Secondary amyloidosis

20. THANK YOU