Clinical features

Lung abscess most commonly runs a sub-acute or chronic course with an insidious onset of non-specific symptoms and general malaise, but it may present acutely with aggressive infection. The duration of symptoms before diagnosis is extremely variable, ranging from several days to 6 weeks.

The typical clinical features of a lung abscess include:

• the symptoms and signs of a pneumonitis:
  • shivers
  • fever
  • pleuritic chest pain
  • general systemic upset, malaise and fatigue
• the discharge of the abscess into a bronchus:
  • cough
  • the sputum is copious and foul smelling
  • the sputum is initially blood-stained but may become green or brown with time
• fever and malaise may abate in a chronic lung abscess
• clubbing, which may develop rapidly
• signs of a pleural effusion or consolidation
• pleural rub
• symptoms relating to metastatic abscesses e.g. cerebral

Reference

1. Maitre T, Ok V, Calin R, et al. Pyogenic lung abscess in an infectious disease unit: a 20-year retrospective study. Ther Adv Respir Dis. 2021 Jan-Dec;15:17534666211003012.