Experience with Putrid Lung Abscess in Negro Patients

Abstract

SUMMARY Based on a series of 62 cases, an account is given of experience gained with treatment of putrid lung abscess in Negro patients in a hospital in Jamaica, British West Indies. Most patients are found on admission to have passed the early stage when bronchoscopy, antibiotic treatment and chemotherapy would have their greatest value. Aetiological and Pathologic factors have been briefly reviewed, and the importance of aspiration of infective material, and bronchial embolism have been stressed. Surgical drainage has been touched upon, and primary resection has been suggested as the probable future treatment of choice in the case of the late, tough walled cavity. A simple, but so far satisfactory method of dealing with acute fulminating putrid empyema has been described. A brief table has been given to illustrate what results have been obtained on the patients in this series. Of all cases, approximately two-thirds appear to have been cured, while one-quarter or a little less have died. With drainage one in 10 have failed to close their cavities, and though they have lived they are not cured. Seven cases of putrid empyema all recovered from their empyemata, though two required further surgery for their abscesses, and one of the others died later of a brain abscess. This was the only brain abscess in the series. Four children were treated by resection, and they all did well. Hospital stay in the cured surgical drainage cases was twice as long as those cured by medical measures. Resection cases spent the least time in the hospital.