areas are gravity dependent when lying down. Presence of air-fluid levels implies rupture into the bronchial tree or rarely growth of gas forming organism. Laboratory studies Raised inflammatory markers (high ESR, CRP) are common but nonspecific. Examination of the coughed-up mucus is important in any lung infection and often reveals mixed bacterial flora. Transtracheal or transbronchial (via bronchoscopy) aspirates can also be cultured. Fiber optic bronchoscopy is often performed to exclude obstructive lesion; it also helps in bronchial drainage of pus. Management Broad spectrum antibiotic to cover mixed flora is the mainstay of treatment. Pulmonary physiotherapy and postural drainage are also important. Surgical procedures are required in selective patients for drainage or pulmonary resection. The treatment is divided according to the type of abscess, acute or chronic. For acute cases the treatment is antibiotics: if anaerobic: metronidazole or clindamycin if aerobic: beta-lactams, cephalosporins if MRSA or Staphylococcus infection: vancomycin or linezolid postural drainage and chest physiotherapy bronchoscopy is used for the following cases: aspiration or instillation of antibiotics patients with atypical presentation suspected of having underlying foreign body or malignancy Prognosis Most cases respond to antibiotics and prognosis is usually excellent unless there is a debilitating underlying condition. Mortality from lung abscess alone is around 5% and is improving. See also Empyema Bronchiectasis Abscess Pleural effusion References External links Lung disorders