Lung abscess and other anaerobic pulmonary infections

Abstract

Anaerobes are ubiquitous members of the normal flora of the body. Anaerobic lung infections are relatively uncommon in children. Most of these infections are the result of aspiration of oral flora. Predisposing factors include underlying illness, impaired consciousness, seizures, swallowing dysfunction, intubation, foreign body aspiration, and periodontal disease. Types of lung infection include aspiration pneumonitis, necrotizing pneumonia, lung abscess, and empyema. Most anaerobic infections are polymicrobial. Definitive diagnosis is difficult because of the fastidiousness of the agents and the frequent failure to obtain appropriate specimens. Therapy often requires drainage, as well as antibiotics. Resistance to penicillin among the oral anaerobes has increased over the last 20 years. Current antibiotics of choice include clindamycin, cefoxitin, penicillin with metronidazole, or combinations of a penicillin and a β-lactamase inhibitor.