Chronic Pulmonary Suppuration

¹ Chest Division, Herman Kiefer Hospital.

1. Pulmonary suppurative disease is not primarily a surgical condition. It should always be treated medically initially. Whether or not surgical intervention will follow will be determined by the changes that occur in each case.

2. Bronchoscopy is indicated in almost every case, and may be used both diagnostically and therapeutically.

3. The laboratory should determine the pathogenic organism preferably from the bronchial secretions. Suitable antibiotics should be chosen on the basis of sensitivity study.

4. A lesion that is unresolved after a period of treatment, considered to be adequate, should be resected. In those cases where the suppurative process has resolved, but a slight degree of bronchiectasis persists with few or no symptom, resection should not be done.

5. Bronchographic study should be made in every case. This is of importance not only in the current therapy, but also as a reference point if there is recurrence of illness.