Empyema and Abscess Pneumonia Follow-up

Updated: Mar 18, 2015
  • Author: Michael A Ward, MD; Chief Editor: Robert E O'Connor, MD, MPH  more...
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Follow-up

Further Inpatient Care

Inpatient care is mandatory for the management and assistance of the patient's respiratory status, continuation of intravenous antibiotics, and drainage of the lung abscess or empyema as needed.

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Inpatient & Outpatient Medications

Outpatient therapy for lung abscess or empyema is not indicated or advised; inpatient care is mandatory.

Antimicrobial therapy should be continued empirically until therapy can be guided with culture results.

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Transfer

Transfer of these patients is usually not indicated unless advanced respiratory management or surgical drainage is not available without transfer.

Patients should be transferred only after stabilization of their respiratory status and administration of intravenous antibiotics.

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Deterrence/Prevention

Prevention of aspiration is important to minimize the subsequent risk of lung abscess.

Cessation of alcohol and drug abuse, good dental hygiene, good nutrition, and management of gastroesophageal reflux disease.

Early intubation should be performed in patients who do not have a gag reflex or are in the process of respiratory failure.

Position the patient in a manner that minimizes the risk of aspiration. For example, a patient who is vomiting should be placed on his or her side.

Immediately suction the patient's orotracheal area if he or she aspirates in the emergency department.

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Complications

Complications of pulmonary abscess include pleural fibrosis, trapped lung, restrictive ventilatory defect, bronchopleural fistula, and pleurocutaneous fistula.

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Prognosis

The prognosis for both lung abscess and empyema generally is good. Ninety percent of lung abscesses are cured with medical management alone.

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Patient Education

For excellent patient education resources, visit eMedicineHealth's Infections Center and Lung Disease and Respiratory Health Center. Also, see eMedicineHealth's patient education articles Bacterial Pneumonia, Skin Abscess, and Antibiotics.

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