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aerobic alone only 16% of the time.
Gram + anaerobic cocci
pigmented Gram Ð bacilli
in nosocomial infection, must consider Staph. aureus, and enteric Gram
often do not need invasive diagnostic techniques. Can treat empirically.
immunocompromised patients, do not forget:
Aspergillus, Legionella, Cryptococcus, Pseudomonas, Nocardia
AIDS population usually get cavitary upper lobe lesions, and lack typical aspiration risk factors
immunocompetent patients, must consider:
endemic fungi (Histoplasmosis, Coccidioides, Blastomyces)
parasitic (Entamoeba, Echinococcus)
Streptococcus pneumoniae rarely causes lung abscesses. If it does, it
is usually in the context of obstruction, or of a mixed infection or superinfection.
However, the type 3 strain can cause lung abscess as an isolated infection,
because of its thick mucoid capsule.
antiobiotic resistance increasing (esp. Bacteroides resistance to penicillin)
Open TABLE 5 (antibiotic resistance)
have seen treatment failures to penicillin that have responded to clindamycin.