Lung abscess: a changing pattern of the disease.

Alcoholic stupor with aspiration has been the most commonly recognized cause of lung abscess. Eighty-nine patients treated for lung abscess in a large community hospital from 1968 through 1982 have been described. Forty-six percent of these patients were 60 to 80 years of age. The most common predisposing factors included pneumonia, immunosuppression steroid therapy, carcinoma at a distant site, alcoholism, and lung cancer. Surgical therapy was employed in 23 patients when there was suspicion of cancer and failure to improve with medical management. Fifty-seven percent of patients were either cured or improved at the time of discharge. Twenty-nine percent died from other causes during hospitalization, and 9 percent died as a direct result of the abscess. Thus, the patients encountered in the community hospital setting tended to be older and had a wide variety of illnesses that precipitated the development of lung abscesses.