Primary lung abscess
Resurgence of interest in defining the specific pathogens involved in anaerobic infections has prompted a reexamination of many previously accepted concepts. Primary lung abscess has long been recognized as a prime example of a mixed anaerobic infection, although little attention has been paid to the specific bacterial components of this syndrome. With modern techniques, investigators have now carefully identified the specific anaerobic pathogens most often associated with primary lung abscess.1 Not surprisingly, the role of these pathogens, and indeed the need for identifying them, has caused some confusion and disagreement. We reviewed a series of cases managed for the most part without benefit of specific anaerobic pathogen identification, but managed nonetheless according to established principles of dealing with anaerobic infections.Materials and methods
The charts of all patients with a final diagnosis of lung abscess seen at the Veterans Administration Hospital in Cleveland from January 1966 through June 1974 were reviewed. With few exceptions, all patients were actively evaluated by members of the Infectious Disease Section. Patients with tuberculous and mycotic cavities, infected pleural cysts, cavitating tumors, septic or bland pulmonary infarcts, or specific cavitating pneumonias (e.g., staphylococcal and Friedlander’s) were excluded. Patients with putrid or anaerobic empyemas, most often secondary to underlying or previous lung abscess, were also excluded because surgical drainage of the chest is mandatory and the most important aspect of therapy when that complication is present. The diagnosis of primary lung abscess was established on the basis of (1) an appropriate clinical history including circumstances favoring. . .