Clinico-radiological profile of lung abscess: Analysis of 120 cases

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Lung abscess is continuing to be a diagnostic and therapeutic challenge to the pulmonologists, despite remarkable advancement in investigation modalities as well as therapeutic armaments. The study was taken with the object of evaluation of varied clinical and radiological presentations, predisposing factors and etiological spectrum. This is a cross-sectional study over 120 patients with lung abscess who attended outpatient and inpatient department of Pulmonology of Nilratan Sarkar Medical College and hospital, Kolkata during the period of January 2008 to October 2009. Male was predominant than female (3:1). Major age group was above 60 years (22.5%). Mean age in the study group was 45.15 years. Most common symptom was cough with expectoration (77.5%). Poor oral hygiene was found in 64%. Overall addiction to smoking and or alcohol was 65%. Diabetes mellitus was associated in 27.5% patients. Majority of lung abscesses were solitary (82.5%) and situated in the right side (67.5%). Multiple lung abscesses predominantly found amongst immuno compromised (71.42%). Etiologically tubercular lung abscess was diagnosed in 25% patient. Bacterial cause in 20% and majority were klebsiella pneumoniae (62.5%). malignancy in 12.5% and histologically were squamous cell carcinoma and adeno carcinma. Hydatid cyst was seen in 2.5%, fungal in 2.5%. In 37.5% etiology remains undetermined. Yield from fibre optic bronchoscopy and CT guided FNAC for diagnosis of lung abscess was 38.7 and 31.58%, respectively. In Tubercular, Pyogenic and malignant variety, most of the abscesses were situated in the upper lobe. Key words: Lung abscess, etiological type, addiction, anaerobic lung abscess.