Abscess of the lung: symptoms and treatment
Abscess of the lung is a process that results in the formation of limited necrotic cavities in the tissues.It is accompanied by inflammation and the formation of pus.Contents: Description of the disease Varieties of the disease Complications of the disease Diagnosis Treatment of lung abscess Prevention Prophylaxis
Description of the disease
The pathological process is caused by specific pathogens that penetrate the lungs through the bronchi.It can be aerobic bacteria of the gram-negative line, anaerobic microorganisms, Staphylococcus aureus, streptococcus, etc. The inflammatory diseases in the nasopharynx and the oral cavity, such as gingivitis, periodontal disease, and tonsillitis, are an aggravating factor. Pulmonary tissue abscess can result from the penetration of vomit into the bronchial cavity, which often occurs during severe alcohol intoxication, during anesthesia.Aspiration can also occur as a result of ingress of foreign bodies into the respiratory tract and bronchi.In some cases, the focus of infection is formed as a result of the pathology of pulmonary capillaries.This variant is characterized by rapidly developing sepsis.Lung infarction, provoked by embolism, is also dangerous.This process leads to secondary bronchogenic infection and development of the abscess.The cause of the abscess can be traumatic injuries, knife and gunshot wounds to the chest.
Classification of lung abscesses by development mechanism:
- is hematogenous;
- is traumatic.
Note: if the process occurs in the center of the lung - this is the central abscess, if at the edges - peripheral. There are also single and multiple abscesses, the disease can affect only one lung or spread to both halves.
Causes and factors of occurrence
The disease develops as a result of many reasons. The most common lung abscess occurs as a consequence:
- of viral and bacterial diseases;
- traumatic injury of thoracic tissues;
- inflammatory processes in the oral cavity and pharynx.
Often, necrosis pneumonia, immunodeficiencies, fungal lesions, tuberculosis, amoeba invasion can lead to an abscess. Other causes of lung abscess are:
- aspiration pneumonia, infarct and septicopyemia of the lung;
- defeat septic emboli, which fall into the lung tissue from the foci of inflammation( prostatitis, otitis, osteomyelitis);
- contact and lymphogenous spread of infectious agents( the latter occurs with furuncles of the mucous lips, phlegmon of the oral cavity);
- disintegration of a malignant tumor in the lung tissue.
The risk group includes patients suffering from:
- pulmonary tumors;
- with diabetes mellitus;
- with sinusitis;
- with gastrointestinal diseases, as a result of which surgical intervention was performed on the organs of the thoracic and abdominal cavities;
- with immunodeficiency diseases;
- gastroesophageal reflux.
Note: presents the danger of lung abscess development in foreign bodies entering the bronchi that contribute to mechanical damage to tissues and the subsequent formation of inflammatory-purulent processes.
Signs and symptoms of lung abscess
Lung abscess is accompanied by a clinical picture characterized by the following symptoms:
- weakened breathing;
- three-layered sputum with pus, watery and yellowish mucus;
- asymmetry of the thorax during respiratory movements;
- muffling percussion sound in the area of the inflammation focus;
- various wet rales;
The acute course of the pulmonary abscess is characterized by the following symptoms:
- cough with discharge of purulent sputum;
- dyspnea and shortness of breath;
- pain in the chest;
- temperature curve of a hectic type;
- shortness of breath.
Chronic lung abscess is characterized by periodic exacerbations with the formation of purulent sputum. For the period of remission( fading of the disease) is characterized by:
- increased fatigue;
- weight loss;
- paroxysmal barking cough;
- abundant purulent sputum, which increases in volume as soon as the patient takes a different position of the body;
- development of right ventricular failure.
Note: should be aware that an abscess can break through into the lung tissue.It is accompanied by the sudden appearance of a large amount of fetid pus and some improvement in the patient's condition for a while. The disease goes through two stages:
- The first is characterized by the direct formation of an inflammation focus - an abscess( in this phase there may be a slight increase in body temperature, fever, coughing, dyspnea);
- second - opening of the cavity( marked increase in symptoms of the first stage, as well as the withdrawal of purulent masses from the cavity formed in the lung tissue).
Complications of the disease
Abscess of the lung is fraught with various complications.Often it results in:
- abscess of the second lung;
- for chronic inflammation of the lung;
- rupture of the cavity of the abscess, the consequences of which can spread to the heart bag;
- pyopneuromotorax - involving the pleura tissue in the process with the formation of pus;
- purulent metastases in the brain, liver;
- bronchiectasis( enlargement and deformation of the bronchi);
- Amyloidosis of the internal organs( deposition in the tissues of the pathological amyloid complex that causes a disruption of the functions)
For the diagnosis of lung abscess, a blood test for neutrophilic leukocytosis, anemia, and hypoalbuminemia is performed.A microscopic examination of sputum for the detection of bacterial pathogens or neutrophils is shown.Pleural fluid is also taken for examination.
Treatment of lung abscess
Therapy of lung abscess is performed using antibacterial drugs.Appointed drugs that selectively act on the type of bacteria that led to the emergence of a hotbed of inflammation.Often used beta-lactam antibiotics with beta-lactamase inhibitors.They are administered intravenously or intramuscularly, but with a mild course of the disease, oral administration is possible.Also, the tablet form can be used at the patient's recovery stage.The average duration of treatment for the lung abscess is about 4 weeks.The specific figure depends on the severity of the process and the stage at which the diagnosis was carried out.Large abscesses require longer treatment. It is important to know that physiotherapy is not applicable in this case.This threatens a rupture of the pleura and the spread of infection to the second lung or other internal organs.In the case of severe weakness of the patient, if there is paralysis or respiratory failure, tracheostomy and suction of secretion are required.Surgical or percutaneous drainage is performed.There may be resistance to antibiotic therapy.Usually this is accompanied by a large abscess and complicated infection.If surgical treatment is indicated, lobectomy is performed - removal of the lobe of the lung.With small lesions, segmental resection is done.If multiple lesions or gangrene of the lung are observed, in the presence of resistance to antibiotics, then pulmonectomy is shown - the complete removal of one lung.
There is no specific prevention of lung abscess.It is important to diagnose and treat pneumonia in a timely manner, various inflammatory diseases of the mouth, pharynx and bronchi.It is necessary to prevent the risk of ingress of foreign objects into the cavity of the bronchi.Especially it concerns small children, as well as patients with swallowing disorder.It is important to properly care for bed patients who have had a stroke, cerebral hemorrhage, there is vomiting, necrosis and other conditions, potentially dangerous in terms of development of pulmonary suppuration.
During the treatment of lung abscess, diet therapy plays an important role, helping to strengthen the body during the fight against the disease and accelerate recovery. When starting treatment, try to observe the following rules:
- Limit the use of salt.As the salt delays the fluid, which in turn provokes a load on the cardiovascular system, it is necessary to reduce its daily amount in the diet.
- Refuse alcohol, harmful to the tissues of the body.In this case, it is important to determine whether the patient has previously suffered from alcoholism, since this disease repeatedly worsens the prognosis of lung abscess treatment.
- Regularly eat protein foods of animal origin.
- Include in the diet food containing calcium.It can be a variety of dairy products.The daily intake of this element should not be less than one and a half grams.
- Focus on vegetables and fruits rich in minerals and vitamins of groups A and B.
- Enter the yeast in the form of an additive in various dishes.They contain a large amount of vitamin B, which is so necessary during the treatment of purulent diseases.In addition, yeast has carbohydrates, fats, folic acid, various minerals.It is best to pour the yeast on a water bath, mixing with water at the rate of 2.5 parts of the liquid for one part of the yeast.
Trofimova Yaroslava, medical reviewer