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In traditional Chinese medicine, the disease is called "feiyong".
1. Medical history and onset of the disease: Pulmonary abscess due to aspiration is frequently caused by vomit resulting from coma, drunken state and esophageal and; pylonic ob-struction, or by oral inflammation and pharyngolaryngeal oper-ation, The pathogenic bacteria, carried into the lung through respiratory movements, multiply there. Hematogenous pul-monary abscess is often secondary to pyemia due to the pyo-genic infections of the skin and deep tissues, osteomyelitis, etc.
2. Clinical manifestations: The onset is abrupt withdni-tial symptoms of chills, fever, chest pain, cough, hemoptysis and the production of a large amount of purulent sputum. The sputum is viscid and fetid. At the initial stage physical exami-nation may show no obvious changes on the lung. When there is consolidation resulting from inflammation, there may be dullness on percussion. If there is a cavity formation, an am-phoric sound may be elicited on percussion.
3. In blood examination leukocyte count is markedly in-creased up to 20*10/L—30*10/L, increased neutrophil with a shift to left. In hemato genous pulmonary abscess blood culture may be positive and pathogenic bacteria can be identi-fied. Bloody sputum culture and antimicrobial sensitive test should be done, which are helpful for selecting effective antibi-otics. Chest X-ray examination is useful for discovering early lesions. Aspiration pulmonary abscess in mostly located in the posterior segment of the right upper lobe and apical segment of the right lower lobe. At the initial stage there is a large area of consolidation. When abscess or abscess cavity is formed, fluid level within it can be seen. In hematogenous pulmonary ab-scess, many small dense shadows or globular shadows or thin-wall cavities in both left and right middle and lower lobes may be present. Computerized tomography is helpful in making correct diagnosis and in identifying the degree of involvement of the bronchi.
