Lung abscess: epidemiological, clinical aspects and outcome of 116 cases admitted to El Mahalla El-Koubra chest hospital

ABSTRACT

The incidence of lung abscess declined since the introduction of antibiotic treatment and the prognosis has improved. However, this improvement is not sufficient in spite of medical drug's efficacy. The aim of this work was to study the epidemiological, clinical aspects and outcome of lung abscess cases admitted to El Mahalla El Koubra Chest Hospital during five years period [1999-2003]. The medical records of diagnosed cases of lung abscess admitted to the hospital during the period from January 1999 to December 2001 were reviewed and studied retrospectively. On the other hand cases admitted in the years 2002 and 2003 were studied prospectively. The results of this work revealed that there were 116 diagnosed cases of lung abscess admitted to the hospital during the period from January 1999 to December 2003. Of the 1 16 cases 75.1% were aged between 20 and 60 years, 66.44 % were males. 67.2% were of rural residence. Housewives farmers and unskilled manual workers constituted 29.3%, 25% and 20.6% of cases respectively. One or more predisposing factors were identified in 46.6% of patients. Diabetes and pneumonia were the most common [21.6% and 18.1 % respectively]. Cough [88.8%] and purulent sputum [87.1 %] were the most common presenting symptoms followed by fever [69.13%] and chest pain [44%], the abscesses were located mainly in right lower lobe, left lower lobe and right upper lobe. Sputum was positive for TB in two cases and there was need for surgery in five cases [4.3%]. The results of culture and sensitivity test revealed that aminoglycosides group, was ranked on top of the first choice of drug. Metronidazole ranked the first on the 3rd choice drugs. Only 54.3% of cases had favorable outcome, with significant difference in mean age between favorable [38 +/- 15.9 years] and unfavorable ones [47.5 +/- 17.1 years]. The mean duration of hospitalization for the favorable cases was 45.7 +/- 29.2 days. Private clinics were the source of reference in 14.7% of cases and only 29.4% of them were had favorable outcome the case fatality rate was 2.6% this study recommends health education for the vulnerable groups and private physicians for early detection and admission of lung abscess cases to the hospital and to be patient for the needed period of treatment