Diagnosis

Clinical findings can be unreliable and are often non-existent.

Haematology reveals:

• leucocytosis
• raised ESR

Sputum culture:

• send for Gram stain
• culture for aerobic and anaerobic organisms
• determine antibiotic sensitivity
• examine for acid fast bacilli

Chest radiography:

• may reveal one or more circular lesions of almost any size which may cavitate and show fluid levels

Chest ultrasound:

• can identify a fluid collection
• occasionally, aspiration of the abscess is possible

Fibre-optic bronchoscopy:

• permits sampling for bacteriology and for histological diagnosis of any lesions, e.g. neoplasms or foreign bodies

Reference

1. Walters J, Foley N, Molyneux M. Continuing education in anaesthesia, critical care and pain: pus in the thorax: management of empyema and lung abscess. 2011 Dec 1;11(6):229-33.