Pediatric lung abscesses: a 13-year journey from diagnosis to treatment

Lung abscess is a relatively rare but potentially serious condition in childhood. It is characterized by a localized collection of pus within the lung parenchyma resulting from infectious necrosis. Although its incidence is low, it presents significant clinical challenges due to the risk of severe complications and the prolonged treatment course. This study aims to evaluate the clinical characteristics of pediatric lung abscesses. We also describe diagnostic methods and treatment approaches to contribute to improved disease management. This study included patients aged 1 month to 18 years who were diagnosed with and treated for lung abscess at our center between 2012 and 2025. Data on demographic characteristics, as well as clinical, laboratory, and radiological findings and treatment outcomes, were obtained from patient files and hospital electronic medical records. A total of 33 pediatric patients with lung abscess were included; the median age was 8 years, and 66.7% were male. The most common symptoms were fever (78.8%), cough (78.8%), and dyspnea (39.4%). The median length of hospital stay was 34 days. Primary lung abscesses accounted for 36.4% of cases, whereas 63.6% were secondary and associated with underlying conditions such as immunodeficiency or bronchiectasis. Most abscesses were uniloculated. The most frequently isolated pathogens were Pseudomonas spp. and Staphylococcus aureus. All patients received antibiotic therapy, with a median treatment duration of 34 days. Invasive procedures were required in 30.3% of patients, most commonly percutaneous abscess drainage. The overall mortality and survival rates were 12.1% and 87.9%, respectively; however, all deaths were attributable to underlying diseases rather than lung abscess–related complications. Understanding the clinical spectrum and appropriate management of pediatric lung abscess is essential for reducing morbidity and preventing long-term complications. This study contributes to the current literature by providing an up-to-date overview of the diagnostic and therapeutic approaches used in this rare patient population.