ANAEROBIC PLEURO-PULMONARY INFECTIONS

Anaerobic pleuropulmonary infections most frequently occur after aspiration of oral secretions. These infections are polymicrobial and are manifested as pneumonia lung abscess, or empyema. The three sites of predilection are the posterior segment of the right upper lobe and the superior segment of the right and left lower lobes. Diagnosis depends on the clinical picture, especially the presence of foul-smelling sputum or empyema fluid, and on radiologic and bacteriologic clues. Gram stain of material obtained by transtracheal aspiration or thoracentesis usually provides a definitive diagnosis. Parenteral administration of penicillin G is preferred for the initial treatment of all forms of anaerobic pleuropulmonary infection; indications for surgery are few.