Lung Abscess

Lung Abscess is a topic covered in the Johns Hopkins ABX Guide.

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PATHOGENS

Some pathogens that may routinely cause lung abscesses/cavities. Lung abscesses often polymicrobial and involve oral flora.

Bacteria:
- S. aureus including MRSA and MSSA
- Anaerobes: most common cause; putrid sputum is diagnostic of this class of pathogens
  - Fusobacterium nucleatum,Bacteroides melaninogenicus and Peptostreptococcus are leading anaerobic pathogens.
- Aerobic and microaerophilic streptococci including S. anginosus complex and Gr. A streptococci.
- Gram-negative bacteria, especially in Taiwan, an unexplained strong association with Klebsiella pneumoniae
  - Also, P. aeruginosa.
  - Meloidosis (Burkholderia pseudomallei) is a concern, especially in SE Asia.
- Legionella
- Nocardia
- Actinomyces
- Group A streptococci
- H. influenzae (type b)
- Rhodococcus equi
Mycobacteria: M. tuberculosis, MAI, M. kansasii, M. abscessus
- Also, almost any non-tubercular mycobacteria may produce an abscess/cavity.
Fungi: Aspergillus, Cryptococcus, Coccidioides, Histoplasma, Blastomyces, Fusarium, Mucor, Rhizopus
Parasitic: usually more cystic
- Hydatid cysts (Echinococcus)
- Paragonimiasis

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