Contents
What is a lung abscess
A lung abscess is a serious pathology in which part of the lung tissue becomes inflamed and melted, resulting in a cavity filled with pus in the lung. The inflammatory process begins with the entry of bacteria into the lungs, and the prerequisites for an abscess are:
- decreased immunity (for example, due to immunodeficiency, severe hypothermia, prolonged alcohol intake);
- circulatory disorders in the area of inflammation;
- blockage of the bronchus with a plug of viscous sputum or a foreign body.
The delay in the outflow of purulent sputum increases inflammation, due to which the lung tissue begins to disintegrate and turn into a purulent mass limited by the capsule. At some point, the capsule under the pressure of pus can break through, and then the pus enters the bronchi, and the patient can cough it up along with sputum. The very same cavity of the abscess falls, shrinks, after which a scar or compaction of the lung tissue forms in its place.
– An abscess is a purulent destructive disease of the lung parenchyma, when the lung tissue is melted, destroyed, a cavity filled with pus is formed. There is a big classification of abscesses, so, for example, abscesses can be acute and chronic, explains pulmonologist of the first category, Ph.D. Irina Chibisova.
Causes of lung abscess in adults
Lung abscess in adults is an infectious disease that causes pathogenic bacteria or fungi – most often it is Staphylococcus aureus, Klebsiella, pneumococcus, etc. Pathogenic microorganisms enter the lungs with the blood stream from the foci of infection in the body, especially if the immune system is reduced and the body cannot fight the pathogens on its own.
Also, a lung abscess can form later:
- complications of pneumonia;
- blockage of the bronchus with a plug of sputum or a foreign body;
- aspiration (entering the bronchi of gastric contents or vomit);
- after a serious chest injury.
There are also several aggravating factors that make a lung abscess more likely to develop:
- immunodeficiency states (for example, HIV infection);
- lung disease (eg pneumonia);
- smoking or alcohol abuse;
- old age;
- diabetes;
- neurological diseases in which swallowing function is impaired.
Symptoms of lung abscess in adults
During the formation of a lung abscess, the patient complains of high body temperature (up to 40 ° C), chills and sweating, severe weakness, headache and shortness of breath, dry exhausting cough. There may be pain or a feeling of fullness, discomfort in the lungs. On average, it takes about a week for a lung abscess to form in adults.
After the breakthrough of the abscess, the patient develops a strong cough with copious purulent discharge (up to a liter of sputum can be discharged per day), while the sputum itself is dark in color and has a sharp unpleasant odor, sometimes with an admixture of blood. At the same time, the body temperature drops sharply, and the patient himself feels much better.
– Lung abscess is always accompanied by intoxication, high fever, general weakness, sweating and severe cough. If it is an acute abscess, then when it breaks into the bronchus, the patient notes that he has coughed up a very large amount of purulent, fetid sputum mixed with blood. At the same time, his condition improves after drainage of the abscess. A chronic abscess, that is, an abscess that exists for a long time and communicates with the bronchus, is accompanied by a long, painful cough. Patient develops a fetid, putrid odor from the mouth, and also expectorates a significant amount of sputum – lists the symptoms pulmonologist Irina Chibisova.
Treatment of lung abscess in adults
Lung abscess is a very dangerous pathology that requires urgent medical intervention and is always treated in a hospital.
Diagnostics
Diagnosis of a lung abscess begins with an anamnesis – the doctor specifies how long ago and what symptoms appeared, what preceded the onset of the disease, what comorbidities the patient has. A general examination includes an assessment of the skin, auscultation of the lungs with a phonendoscope.
From laboratory tests, the doctor prescribes a general and biochemical blood test, a sputum test for the pathogen and sensitivity to antibiotics. An x-ray or CT scan of the lungs is also prescribed. If pleurisy is suspected, a pleural puncture is prescribed.
Modern treatments
The tactics of treating a lung abscess directly depends on the severity of the disease, but is always carried out in a hospital setting. The patient is prescribed bed rest, and it is also necessary to observe a special position of the body (drainage), in which sputum is better removed – for example, lying on the side opposite to the abscess. It is also mandatory to prescribe antibiotic therapy, mucolytics, which dilute viscous sputum and improve its discharge, immunomodulators (during remission). If the sputum does not come out well, a sanitation bronchoscopy is prescribed – removal of purulent sputum with a bronchoscope, after which the cavities are treated with antiseptics.
In difficult cases or in chronic lung abscess, surgical treatment is prescribed – puncture, thoracocentesis and drainage of the abscess cavity, and sometimes resection (removal) of a lobe of the lung.
– If we are talking about small acute abscesses that usually occur against the background of abscessing pneumonia, that is, those that drain and close in the future, then conservative treatment is possible in this case, patients can be treated with antibiotics. Large abscesses, multiple abscesses localized in one lobe of the lungs or some of its segments, chronic lung abscesses – thoracic surgeons are involved in their treatment. Largely due to the development of surgery, a formidable complication or patients with chronic abscesses are less common, notes pulmonologist Irina Chibisova.
Prevention of lung abscess in adults at home
In general, there is no specific prevention of lung abscess at home. To avoid this pathological process, doctors advise to treat all lung diseases in a timely manner and to the end, as well as to sanitize all existing foci of infection in the body.
It is also necessary to avoid hypothermia and a decrease in immunity, quit smoking and alcohol abuse, and walk in the fresh air as often as possible.