An abscess is called inflammation of the lung tissue with its melting and the formation of purulent masses in the cavity. This pathology occurs due to the spread of pathogenic microorganisms. Readers have already learned what a lung abscess is. How it manifests itself and how to treat it - read below.
Etiology of lung abscess
Most often, an abscess occurs in the following groups of people:
- Persons with cancer, pulmonary tuberculosis and pneumonia. Exacerbation of these diseases most often causes an abscess.
- Elderly people suffering from diabetes.
- Those who have cardiovascular disease and unhealthy habits.
The causes of the disease:
- Aspiration by vomiting during sleep. It occurs in people who are intoxicated. Vomiting in the respiratory tract contributes to the rapid multiplication of microorganisms.
- A complication of the inflammatory processes of ENT organs is one of the main factors in the development of lung disease and their abscess.
- Ingestion of a foreign body in the respiratory tract. Ingestion of small beads or toys by a child can also provoke the occurrence of this pathology, but it should be noted that in this case, the disease develops in a preschool child.
- Postponed heart attack.
- Thrombosis of large vessels of the lung.
- Sepsis (an infectious disease characterized by the ingress of pathogens into the bloodstream).
- Decrease in the body's immune forces, hypothermia.
- Lung injury.
- Received injuries of the respiratory organ at the time of surgery, tissue damage, mechanical organ contusion.
All enumeration of the causes of lung abscess can contribute to the occurrence of this disease. The only preventive measure in this case is the annual monitoring of their condition and the passage of all necessary hardware examinations.
Symptoms
Symptoms in the case of lung abscess are directly dependent on the stage of the disease. This is due to differences in the signs of pathology and the degree of their severity. At the initial stage of the disease, when a purulent abscess only forms in the tissues of the lung, the symptoms are increasing in nature and very often are similar to signs of pulmonary pneumonia. For this period of development of the abscess, the most characteristic are:
- fever;
- cough, characterized as dry, shortness of breath is frequent;
- a febrile state develops as a symptom of intoxication of the body;
- pain in the chest area intensifying with a sharp cough and deep breathing.
The further the abscess develops, the above the symptoms of intoxication are aggravated:
- headaches appear;
- the patient complains of a lack of appetite, nausea;
- general weakness.
When listening to the patient, you can see that the chest rises asymmetrically when inhaling. In addition, the intensity of the symptoms depends on the size and number of formed abscesses, as well as on the type of pathogen of the infection. The development of a lung abscess does not have clear deadlines and can pass rapidly from 2 days or can drag on for up to 2 weeks.
The onset of the second stage of the disease, namely the opening of an abscess with a simultaneous outflow of contents through the bronchi, is characterized by a sharp exacerbation of the patient's condition. The main symptom that indicates this stage is the appearance of a sudden wet cough with intense sputum discharge (the amount of sputum depends on the size of the abscesses and can reach 1 liter).
With the release of the lungs from the purulent contents, the symptoms begin to gradually decrease:
- temperature decreases;
- appetite is normalized.
In some cases, for example, with the localization of an abscess in the lower part of the lung (which makes it difficult to discharge the infiltrate) or due to incorrect treatment, the disease takes a chronic form and has the following symptoms:
- exhaustion;
- general weakness;
- cough with periodic sputum discharge;
- periods of exacerbation are replaced by periods of improvement and vice versa.
Stages
Abscess of the lung - the disease is quite fleeting. Its development can be divided into three main stages:
- formation and suppuration;
- autopsy (breakthrough);
- recovery.
The formation of a purulent lung abscess , depending on the type of pathology, can occur within two to ten days. In severe forms, it drags on for up to a month. At this time, severe intoxication occurs and symptoms such as temperature, pain behind the sternum at the site of inflammation, shortness of breath, cough, weakness and loss of appetite occur.
Then comes the autopsy stage. Pus breaks through the film and begins to exit through the respiratory tract. At this moment, the state of health becomes very difficult, a strong cough appears with the active release of purulent and fetid sputum, the volume of which can reach one liter or even more.
After a lung abscess passing this stage, the patient begins to feel better. Shortness of breath and cough decreases, the temperature drops and the appetite returns. The period of full recovery depends on the quality of the drainage and the general severity of the abscess itself. In the most difficult cases, with incorrect or ineffective therapy, the disease can develop to the stage when the removal of the damaged lobe of the lung is required.
Diagnostics
When diagnosing a lung abscess (differential), the surgeon carefully studies the patient’s history and the availability of data on the inflammatory process, as well as the mechanisms of its development. The specialist also applies the following methods to obtain all the necessary information about the etiology of the violation:
- Analysis of the nature of patient complaints.
- X-ray examination for lung abscess. This method of examination is a classic hardware type of differential diagnosis of this state from adjacent ones. The borders and structure of the lung are clearly visible in the obtained images, which allows you to clearly determine the degree of development of tissue abscess and the place of its localization. At the time of the procedure, the patient must follow all the instructions of the laboratory doctor to obtain high-quality images.
- Polymerase chain reaction to tuberculosis. For the examination, blood is taken from the patient, then it is examined for the presence of cells of pathogenic microorganisms in samples of biological material. The effectiveness of this method lies in the possibility of early diagnosis of diseases, namely, before the onset of symptoms of the disease.
- Purulent masses are collected. A bronchoscopy is performed. This is a hardware method of exposure, which consists in the introduction of a bronchofibroscope into the oral cavity and throat for a more thorough examination. It is used in cases where a lung abscess is caused by a foreign body entering the human respiratory tract. The procedure is performed on an empty stomach. After the specialist conducts differential diagnosis, all the necessary methods of therapeutic effect are selected to eliminate the abscess of the lung tissue.
Treatment
It should be started as early as possible, only in this case there is an opportunity to recover safely, otherwise it will turn into a chronic lung abscess. The main problem is that it is problematic to detect pathology in the initial stages.
There are several ways to carry out treatment:
- taking medications;
- the use of conservative methods;
- surgical intervention.
To achieve a more sustainable result, several directions in treatment can be combined, the most important thing is that the patient’s body is ready for such an effect. Drug treatment involves the use of antibiotics. Medications of this type are necessary in order to fight bacteria, because of which the disease began to progress.
Most often, the patient is prescribed drugs for oral administration, but in some cases it can be injections that are administered intravenously or intramuscularly. If the patient has a severe stage of the disease, the patient is prescribed an injection course of antibiotic therapy. Tableted drugs are rarely used in the acute stage of the disease, most often they are prescribed at the stage of recovery.
What to take
On average, treatment of a lung abscess lasts about 4 weeks, it all depends on the severity of the disease and the general condition of the patient. Additionally, the following types of drugs can be used:
- antiseptics;
- expectorant medication;
- oxygen therapy;
- detoxification drugs;
- immunomodulators.
Antiseptics help fight various bacteria and germs. Expectorant medicines cleanse the lungs and help the patient feel better, restore respiratory function faster.
Immunomodulators increase immunity, a weak body becomes stronger and more resistant to disease. Detoxification drugs help reduce the level of intoxication of the body after prolonged use of drugs that contribute to the accumulation of toxins in the body.
Oxygen therapy quickly helps the body recover; it also positively affects the body during treatment. During the procedure, the body is saturated with oxygen. Therapy can be carried out with or without inhalation. In the first case, using special masks, tubes or nasal catheters, the patient's lungs are saturated with special gas mixtures. In the second case, the procedure is performed subcutaneously and subcutaneously. It is used for preventive and restorative purposes.
Conservative treatment
The main objective of the conservative treatment of lung abscess (what a lung abscess is, you already know) is the removal of purulent sputum from an organ. In addition to expectorants, the patient may be prescribed the following types of physiotherapy:
- breathing exercises;
- chest massage using vibration exposure;
- bronchoscopy;
- postural drainage.
Additionally, a blood transfusion can be prescribed to the patient, which will accelerate the recovery of the body. Protein and steroid anabolic drugs help cells of the affected organ regenerate faster.
The most effective drugs of this type are Potassium Orotat and Albumin. Calcium chloride may be administered intravenously. In the presence of cavities with a bronchial lumen, purification of the lungs from purulent sputum is carried out using postural drainage. After this procedure, antibiotic therapy is necessarily carried out in the affected area.
Surgical intervention
If the above treatment did not give a positive result, the patient can only be helped with surgical intervention. It is worth considering the fact that with large abscesses, physiotherapy is unacceptable (there is a high probability of rupture of the pleura). Such processes will only aggravate the situation, because the infection can go to a healthy lung or other organs located nearby. It is better not to risk the patient’s health and immediately proceed to surgery.
If the patient feels severe weakness or has respiratory failure, specialists perform secretion suction and tracheostomy. The complexity of the treatment is that the patient may have resistance to antibiotic therapy, as a result of which the abscess will rapidly progress.
If the patient is shown surgery, then you can save a person only by removing part of the lung. Segmental resection is performed if the damage to the organ is minor. If there are extensive lesions on the lung, there is resistance to antibacterial treatment, it is necessary to completely remove the organ.
Diet
We learned what a lung abscess is. With such a disease, it is important to follow a diet that strengthens the body, helps to recover faster and achieve positive dynamics. Throughout the treatment, it is important to adhere to the following rules:
- It is necessary to forget about the use of salt or to reduce its daily amount to a minimum. Salt increases the load on the heart, and this should be avoided throughout the treatment.
- In no case is it allowed to take alcoholic beverages, which only aggravate the patient's standing.
- Protein food of animal origin must be present in the daily diet.
- In addition, you need to eat calcium-rich foods every day, such as milk, kefir, yogurt, cottage cheese, cheese and more.
- You need to eat as many fresh vegetables and fruits as possible, especially those that contain vitamins A and B.
- Yeast should also be included in the diet, it is they that contain vitamin B, folic acid, fats and various minerals that help fight purulent diseases.
Complications
What is a lung abscess is now clear. This disease can affect the pleura and pleural cavity, resulting in the development of pyopneumothorax and pleurisy. Such a complication can cause melting under the influence of pus on the walls of blood vessels, causing bleeding in the lungs. In addition, there may be an infectious lesion of the neighboring lung and the development of an abscess in it.
Since blood flow affects all body systems, the spread of infection without treatment can be a matter of time. Sepsis and pneumopericarditis are on the list of major complications of lung abscess. The most serious complication that may be is death (recorded in 5-10% of cases).