What Is Your Diagnosis? And How To Proceed In Management?

A 53-year-old diabetic presented with fever, chills and rigor, cough and purulent sputum for 5
days. He was febrile and examination of the respiratory system was unremarkable apart from
increased respiratory rate. Laboratory investigations showed marked leukocytosis and raised ESR
and sputum and blood culture grew Klebsiella. A CXR was performed as the initial investigation. As the patient’s condition did not improve after 3 days of antibiotics treatment a contrast CT thorax was performed


Right Answer Is : Rt middle lobe abscess
Treatment : Antibiotic therapy
* Standard treatment of an anaerobic lung infection is clindamycin (600 mg IV q8h followed by 150-300 mg PO qid).
*Although metronidazole is an effective drug against anaerobic bacteria, the experience with metronidazole in treating lung abscess has been rather disappointing because these infections are generally polymicrobial.
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Surgical Care :
either percutaneous catheter drainage or surgical resection is usually considered.

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