Lung abscess chest pain in the elderly is caused by inflammatory lesions involving the pleura, and the pain is aggravated during breathing. If the abscess breaks into the chest cavity, it can form an abscess chest, pneumothorax, or an encapsulated abscess chest due to fibrin wrapping, where the patient has restricted respiratory movements and increased shortness of breath. Lung abscess is caused by various purulent bacterial, mycobacterial, fungal or parasitic infections, and the most common pathogenic bacteria are anaerobic bacteria, such as Streptococcus alginolyticus, Clostridium perfringens, melanin-producing bacilli, Bacteroides fragilis, Aeromonas purpurea, etc.; followed by a variety of gram-negative and gram-positive bacteria, such as Escherichia coli, Klebsiella, Enterobacter cloacae, Citrobacter floridis, Fusobacterium roxellanae, Haemophilus influenzae, Haemophilus parainfluenzae, Haemophilus influenzae, Haemophilus parainfluenzae, Legionella, Staphylococcus aureus, Streptococcus, Enterococcus faecalis, and rare bacteria such as Pseudomonas aeruginosa and Streptococcus pneumoniae; in addition, certain fungal infections can cause cavitation in diabetic patients and immunosuppressed individuals, such as Nocardia and Actinomyces; parasites such as Amoeba lysis, an important but uncommon pathogen of lung abscesses, mainly causing basal parts of the lower lobe Mycobacteria such as Mycobacterium tuberculosis, Mycobacterium avium, and Mycobacterium intracellulare can also cause lung abscesses. Anaerobic infections account for 60%-85% of out-of-hospital acquired lung abscesses, and are mostly mixed with several anaerobic bacteria. Recent studies have shown that 10%-15% of Bacteroides fragilis, 60% of non-Bacteroides fragilis, and 40% of Clostridium perfringens can produce β-lactamase in isolated anaerobes, so infection by penicillin-resistant anaerobes has become a problem that cannot be ignored. In nosocomially acquired lung abscesses, there is often a mixture of gram-negative bacilli and positive cocci. What are the prevention methods for abscesses breaking into the chest cavity? Acute lung abscess used to have a 34% morbidity and mortality rate, which has been below 5% with the use of antibiotics. Lung abscesses of aspiration or secondary to pneumonia can have normal body temperature in 7 to 21 days with timely and reasonable treatment, but closure of the abscess cavity takes several months. Chronic lung abscess can be combined with brain abscess, other metastatic abscesses, complications such as amyloidosis, fatal hemoptysis and bronchopleural fistula, which are no longer common. There are limited preventive measures for lung abscesses caused by anaerobic bacteria. Care should be strengthened for those with impaired consciousness to prevent inhalation of secretions and vomit; oral hygiene should be paid attention to, treatment of oral and periodontal diseases and timely and correct use of antibiotics for pulmonary infections.