Pulmonary abscess: a 111-case series in Madagascar

The purpose of this report is to present a series of 111 cases of pulmonary abscess observed over a 4-year period in Madagascar. There were 75 men (67.6%) and 36 women (32.4%) with a mean age of 38 years. Alcohol and tobacco use was found in 32.2% of cases. Thirteen patients (11.7%) used chewing tob...

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Published in:Médecine tropicale Vol. 71; no. 5; p. 454
Main Authors: Rakotoson, J L, Rebasy, L, Andrianasolo, R, Rakotoharivelo, H, Rakotomizao, J R, Andrianarisoa, A C F
Format: Magazine Article
Language:French
Published: France 01.10.2011
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Drainage
Female
Humans
Lung Abscess - diagnosis
Lung Abscess - epidemiology
Lung Abscess - therapy
Madagascar - epidemiology
Male
Middle Aged
Prospective Studies
Radiography, Thoracic
Respiratory Therapy
Risk Factors
Young Adult
Madagascar
ISSN:0025-682X
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Summary:The purpose of this report is to present a series of 111 cases of pulmonary abscess observed over a 4-year period in Madagascar. There were 75 men (67.6%) and 36 women (32.4%) with a mean age of 38 years. Alcohol and tobacco use was found in 32.2% of cases. Thirteen patients (11.7%) used chewing tobacco and all patients were exposed to passive smoking. Eighty-eight patients (79.2%) had a history of bronchopulmonary disorders. Onset was progressive in 63% of cases. The main symptoms were fever (81.9%), pulmonary condensation (74.7%) and pleurisy (9.9%). Coughing was productive in 91.8% cases including 54% of patients having muco-purulent expectorations. In 49 patients (44.1%), chest radiography showed an opacity with a hydroaeric level. The abscess was solitary in 40 cases, multiple in 9, and bilateral in 5. In-hospital antibiotherapy was performed on a presumptive basis: tritherapy in 92 patients (82.9%), bitherapy in 18 (16.2%) and monotherapy in one (0.9%). Other treatment modalities inculuded respiratory kinesitherapy in 57 cases (51.3%), surgical drainage in four (3.6%) and pneumonectomy in one (0.9%). Outcome was favorable in 93 cases (8,7%) but there were 18 deaths (16.2%). This study emphasizes the value of achieving early diagnosis, identifying supporting factors and starting appropriate treatment promptly.
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ISSN:0025-682X