Mordasini C, Baumann H R
Schweiz Med Wochenschr. 1986 Sep 20;116(38):1309-16.
10 patients with primary lung abscess have been treated for 2 years. The patients were predominantly middle-aged men with predisposing factors for aspiration such as, essentially, alcoholism. All patients were in a fairly good general condition. The most frequent symptom was purulent foul smelling sputum. Most abscesses were found in the dorsal segments of both lower lobes and of the right upper lobe. Bacteriological examination of abscess punctate frequently revealed anaerobic bacteria. The primary treatment in all cases was conservative, including postural drainage and longterm therapy with high dose penicillin or amoxicillin. In 9 cases this led to complete clinical and radiological recovery; only 1 patient had to be operated on because of failure of conservative therapy. Aspiration of anaerobic bacteria from the oropharynx is of prime importance in the genesis of primary lung abscess. Therapy is conservative, with penicillin as the drug of choice.
10例原发性肺脓肿患者已接受治疗2年。患者主要为中年男性，有诸如酗酒等易导致误吸的诱发因素。所有患者的一般状况相当良好。最常见的症状是咳出脓性、有恶臭的痰液。多数脓肿位于双下叶背段及右上叶。脓肿穿刺液的细菌学检查常发现厌氧菌。所有病例的初始治疗均为保守治疗，包括体位引流以及大剂量青霉素或阿莫西林的长期治疗。9例患者经此治疗后临床及影像学表现完全恢复；仅1例患者因保守治疗失败而接受了手术。口咽部厌氧菌的吸入在原发性肺脓肿的发病机制中至关重要。治疗以保守治疗为主，首选药物为青霉素。
