A 40-year-old man comes to the physician because of a 6-week history of increasing shortness of breath, fatigue, and fever. He has had a cough productive of foul-smelling sputum for 4 weeks. He was hospitalized for alcohol intoxication twice over the past 6 months. He has smoked one pack of cigarettes daily for 20 years and drinks 6 alcoholic beverages daily. He appears malnourished. His temperature is 38.3°C (100.9°F), pulse is 118/min, respirations are 24/min, and blood pressure is 147/96 mm Hg. Chest imaging reveals a nonspecific pulmonary lesion. A transthoracic needle aspiration is performed. The specimen is cultured and grows several bacterial species, including Peptostreptococcus and Fusobacterium. Which of the following predisposing factors is most likely responsible for this patient's condition?

Question

A 40-year-old man comes to the physician because of a 6-week history of increasing shortness of breath, fatigue, and fever. He has had a cough productive of foul-smelling sputum for 4 weeks. He was hospitalized for alcohol intoxication twice over the past 6 months. He has smoked one pack of cigarettes daily for 20 years and drinks 6 alcoholic beverages daily. He appears malnourished. His temperature is 38.3°C (100.9°F), pulse is 118/min, respirations are 24/min, and blood pressure is 147/96 mm Hg. Chest imaging reveals a nonspecific pulmonary lesion.  A transthoracic needle aspiration is performed.  The specimen is cultured and grows several bacterial species, including Peptostreptococcus and Fusobacterium.  Which of the following predisposing factors is most likely responsible for this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: Lung abscess is most often due to aspiration of anaerobic oral bacteria such as Peptostreptococcus, Prevotella, Bacteroides, and Fusobacterium species.  Risk factors for lung abscess include conditions that increase aspiration risk, such as alcoholism, drug abuse, seizure disorders, previous stroke, and dementia.

A 40-Year-Old Man Comes to the Physician Because of a 6-Week