Lung Abscess in the Mentally Ill as a Complication of Electric Shock Treatment

¹ The Thoracic Service, Tuberculosis Unit, Patton State Hospital.

1. Any patient who is mentally ill and receiving electric shock treatment and develops a sustained elevation of temperature should have an immediate chest x-ray film and should be considered to have pulmonary abscess until proved otherwise.

2. Patients who are to have electric shock treatment should have a dental survey prior to the administration of such treatment.

3. Care should be taken during electric shock treatment to prevent aspiration of oral or gastric contents into the tracheobronchial tree. The greater the amount of material within the mouth just prior to such treatment the higher the incidence of tracheobronchial aspiration.

4. When a patient is found to have a lung abscess, bronchoscopy, aspiration of sputum, cultures, and the administration of appropriate antibiotics are mandatory.

5. Pulmonary resection was required in every case in which bronchoscopy and antibiotics had been delayed longer than three months following the initial aspiration.

6. We believe careful observance of the procedures outlined will reduce the incidence of pulmonary complications following electric shock treatment and reduce the mortality rate when they do occur.