Gangrene of the lungs: signs, causes, treatment

The health of the respiratory system must be taken care of from a young age. The human body is constantly attacked by various bacteria, viruses, microbes. The risk of diseases during frosts and colds, which replaced sunny warm days, is especially increasing.

Air pollution, smoking exacerbate the condition and allow the infection to penetrate much deeper into the respiratory canals. The disease affects the upper respiratory organs. Their weakness, combined with the inability of the immune system to resist the attack of pathogenic microorganisms, leads to the development of serious pathologies in the lower sections. One of them is lung gangrene.

What is an ailment? What symptoms are characteristic of the disease? How to deal with it and is it possible to defeat this unpleasant pathology? First things first.

Disease characteristic

What is lung gangrene? This is a pathology in which lung tissue breaks down - necrosis. Such a process has a putrefactive character. Purulent fusion of the tissue is not limited to one area. The pathological process is capable of rapidly spreading, covering new areas. The disease can affect several lobes, sometimes it spreads to the entire lung.

The affected tissue is brown. Offensive pus is localized inside. Necrosis does not have strict outlines, and, as mentioned above, has a tendency to proliferate.

Pathology is divided into 2 types:

1. Common: localization of the disease is observed lobar.
2. Limited: a segmental location is detected. Often such a process is characterized as an abscess that is gangrenous in nature.

The disease is caused by pathogenic microflora. Abscess and gangrene of the lung are essentially stages of a single process. However, the first ailment is characterized by a limited purulent process in the tissues. Thoracic surgeons and pulmonologists attribute these pathologies to the most severe and dangerous forms of destruction.

Most often, the disease is diagnosed in middle-aged men.

Lung gangrene is an extremely dangerous ailment. It often leads to fatal complications:

• purulent destruction of the pleura;
• pulmonary hemorrhage;
• suppuration of the chest wall;
• sepsis;
• multiple organ failure.

About 60% of patients faced with such consequences die.

Causes of the disease

Why does lung gangrene occur? The causes of the disease are hidden in one single factor - tissue damage by infection. Often the microorganisms that trigger the disease are anaerobic bacteria.

The disease can be an independent pathology or a consequence of intoxication of the body. Thus, there are several mechanisms for the development of such a painful disease as lung gangrene.

The etiology of the disease is as follows:

1. Diseases of the gums, teeth, and nasopharynx can provoke the entry of microbes into the lungs and bronchi. In such conditions, pathogenic microflora can spread down the respiratory tract.
2. Sometimes there is a penetration into the respiratory organs of a microscopic amount of discharge from the nasopharynx or stomach contents during reflux, dysphagia, during vomiting. The latter phenomenon is often triggered by head injuries or intoxication. The aggressive contents of the stomach penetrated into the bronchi cause a purulent-necrotic process in the tissues.
3. Pathology may result from insufficient ventilation of the lungs. This condition often occurs when the bronchi are compressed by a foreign body or tumor. Microbes appear on this site, and an abscess and gangrene begin to form.
4. The cause of the development of pathology can be purulent ailments of the bronchopulmonary system. We are talking about the following diseases: bronchiectasis, pneumonia, lung abscess.
5. The traumatic mechanism of gangrene development is also distinguished. Infections in the chest can be caused by penetrating wounds.
6. Pathogenic microflora can spread to the lungs through the system of lymphatic and blood vessels. This is observed with osteomyelitis, sepsis, mumps, tonsillitis and many other pathologies.

An important role in the development of the disease plays a weakening of the immune system. In this case, the body is not able to fight microorganisms, and therefore can not prevent the occurrence of gangrene.

The following risk factors are distinguished:

• smoking;
• alcoholism;
• addiction;
• HIV infection
• senile age;
• the use of glucocorticoid hormones;
• diabetes.

Symptoms of the disease

Quite rapid development differs gangrene of the lung. Symptoms are acute. The disease progresses rapidly and the patient's condition seriously worsens. Consider what clinical signs manifest lung gangrene.

Symptoms that characterize the ailment are as follows:

1. Pain in the sternum. It increases significantly during coughing.
2. Severe condition of the patient: high fever, chills, pronounced intoxication of the body.
3. There is a lack of appetite, weight loss, up to anorexia, tachycardia, shortness of breath.
4. Intense cough is accompanied by frothy sputum and pus. The discharge is offensive. They have a brown tint and contain a foamy layer. With lung gangrene in the sputum, particles of dead tissue, blood, can be found.
5. The patient begins to choke.
6. There is profuse sweating.
7. A lack of oxygen leads to hypoxia, which is manifested by cyanosis of the fingers, integuments of the skin, lips.
8. The patient quickly gets tired.
9. Sometimes confusion occurs.
10. The patient is painfully given a deep breath. Calm breathing does not cause discomfort.

Course of the disease

Consider how lung gangrene develops. The pathogenesis of the disease is very similar to the course of a lung abscess. Clinically, gangrene can be distinguished by a characteristic fetid odor and a high tendency to chronic the process.

The disease manifests itself in this way:

1. Initially, the patient has a fever. The thermometer records high readings. However, this is characteristic of those patients who do not have immunodeficiency. A person's health worsens. He experiences severe weakness, nausea, lethargy. Often comes to vomiting. Pain appears in the sternum. Trying to take a deep breath causes extreme discomfort. If you press between the ribs, over the affected area, the person develops pain.
2. Coughing usually occurs immediately. It is initially dry. Then it becomes wet. Sputum begins to cough, which has an extremely unpleasant odor. If such detachable is left in the container for a while, then it will be divided into 3 layers. In the upper - there will be a foam with mucus. The middle layer contains a clear liquid. Pus will precipitate.
3. Symptoms progress very quickly. The patient has shortness of breath, tachycardia appears, and weakness is pronounced. The patient’s consciousness is inhibited. In some cases, a coma develops. The temperature may drop. Sometimes it drops below 38 C. This condition is quite critical, since a large amount of infected contents is absorbed into the blood.
4. If the patient survives in this period, then one or more abscesses form in him. Such cavities containing pus tend to break through in the bronchus. This phenomenon signals the next period of development of the disease.
5. The patient develops or intensifies a cough, in which a large amount of sputum is secreted. If abscesses are emptied through the large bronchi, then the patient immediately exudes a lot of pus, in some cases with blood. The condition improves quite quickly. But most often, emptying does not occur directly, but through the small bronchi. This significantly delays the release of the abscess from pus, so the patient's condition continues to remain severe. Sputum with gangrene of the lung has a fetid odor. Sometimes in it there are small fragments of lung tissue - sequesters.

Diagnosis of the disease

A significant role in determining the pathology is played by physical examination. The patient has a lag during breathing of the affected part of the chest, percussion sound is shortened. During auscultation, respiratory weakened noises, dry rales are found.

In addition, the diagnosis of lung gangrene includes instrumental and laboratory research methods:

1. Blood analysis. It shows an increase in the number of leukocytes, a reduced level of red blood cells, an increase in ESR. There is a decrease in total blood protein.
2. X-ray of the sternum. Gangrene and lung necrosis appear in the image by darkening the tissue. Decay cavities with uneven or scalloped edges are often found. Dimming has a tendency to rapidly spread and over several days can affect the adjacent lobes, and sometimes the entire lung. X-ray shows the occurrence of effusion in the pleural cavity.
3. CT scan. This is a modern x-ray method. It is especially informative in this pathology. The tomogram allows you to detect all the decay cavities that correspond to the zones of fusion of the lungs.
4. Fibrobronchoscopy. The endoscopic diagnostic method determines purulent endobronchitis, obstruction. The study makes it possible to observe the dynamics of the pathological process.
5. Sputum analysis. After bronchoscopy, the resulting contents and sputum are sent for laboratory tests. Diagnostic tests identify the pathogen and determine the sensitivity of microorganisms to antibiotics.

Possible complications

Only timely access to doctors can stop such a pathology as lung gangrene. Complications arise, as a rule, if the visit to the doctors is delayed.

In this situation, serious consequences can be observed:

1. Dry, exudative pleurisy.
2. A breakthrough in the pleura of the gangrenous cavity leads to pyopneumothorax. The patient has acute pain in the side, shortness of breath appears, a displacement of the heart occurs. The patient's condition worsens sharply. Collapse phenomena occur.
3. Profuse bleeding.
4. Septicopyemia. Pathology occurs against the background of destruction in the lungs of a large vessel.
5. Amyloidosis of the kidneys. It develops in the case of a chronic form of the disease.

In addition, with gangrene of the lungs, the risk of death is very high.

Conservative treatment

Therapy is carried out in a hospital.

Treatment of lung gangrene consists of the following measures:

1. Intensive detoxification of the body. For these purposes, the patient is injected intravenously with plasma-replacing low molecular weight solutions: "Hemodez", "Reopoliglyukin", "Neocompensan". Assign plasma, water-electrolyte mixtures, albumin. Introduce glucose solutions (5%, 10%) with insulin, as well as proteolysis inhibitors "Trasilol", "Contrical".
2. Antibiotic therapy. This is the most important link without which treatment of lung gangrene is simply impossible. Initially, antibiotics are recommended, characterized by a wide range of effects. As a rule, these are the following drugs: Fortum, Cefepim, Meropenem, Tienam. Often, 2 antibiotics are prescribed immediately to patients. After determining the pathogen, a more accurate treatment regimen is selected. The combination of the Ampicillin drug with the Ceporin, Gentamicin, Kefzol, Tetraolean drugs is quite effective.
3. Desensitization of the body. The patient is prescribed medications Suprastin, Diphenhydramine, Pipolfen.
4. Recommended vitamin complexes Retinol Acetate, Riboflavin, Cyanocobalamin, Thiamine, Pyridoxine, Ascorbic Acid.
5. If high blood coagulability is observed, then the heparin drug is administered intravenously to the patient.
6. To ensure adequate breathing periodically or constantly inhaled with moistened oxygen.
7. If necessary, they fight against intestinal paresis, reorganization of the tracheobronchial tree.
8. Sputum-thinning drugs are prescribed. These funds are administered intravenously and are used for inhalation. The patient may be recommended medication "Ambroxol", "Lazolvan", "Ambrobene", "Halixol", "ACC Inject".

During therapy, the patient's condition is strictly controlled. The functioning of the cardiovascular system, liver, and kidneys is observed. The last organs are given special attention, because they provide the output of infected material and medicines.

Treatment of abscess and gangrene of the lung involves drainage of the cavity. Such an event is taken if the abscess is localized near the surface covered with pleura.

Surgical treatment

If the process cannot be stabilized by conservative therapy, then all indications for radical intervention arise. To do this, hemodynamic, metabolic disorders are corrected, the patient's condition is assessed (whether the operation can be performed).

Surgical intervention involves the removal of gangrenous lung tissue:

• lobectomy;
• bilobectomy;
• pulmonectomy.

Patient care

The disease is quite serious both for the patients themselves and for the people caring for them. A constantly present putrid odor is very burdensome.

Providing the necessary care to the patient, it should be considered:

1. The use of deodorizing agents. Creosote can play such a role.
2. Near the bed of the patient should always be a spittoon. To reduce the unpleasant odor, it is recommended to pour a little deodorizing solution into it. In addition, it must be covered with a lid.
3. A patient diagnosed with lung gangrene is prone to excessive sweating. Therefore, the patient will need a frequent change of bed and underwear.
4. Sometimes a person’s condition worsens so much that he is not even able to take food on his own. Therefore, those who care for such a patient, it is necessary to feed the patient with a spoon.
5. It is important to ensure complete physical and mental peace.
6. With hemoptysis, the patient should be in a half-sitting position.
7. The patient is forbidden to talk, to drink hot drink or food.

Life forecast

What awaits those patients who are diagnosed with pulmonary gangrene? The prognosis is only disappointing if there is no timely treatment. After all, the disease grows very quickly, covering healthy areas. If conservative therapy does not help, and surgical treatment is not performed, then the patient dies.

With timely access to doctors, a completely different picture is observed. Statistics say that in 70-80% of all cases, patients overdo gangrene and recover. A course of complete and adequate treatment returns a person to a full life.

Complications such as sepsis, pulmonary hemorrhage, and multiple organ failure need special attention . With these ailments, the patient needs emergency assistance. If for some reason it is not provided, then the risk of developing irreversible effects in the body is high.

That is why it is worth emphasizing once again the following: to cope with this pathology, you need to see a doctor in a timely manner and fully comply with all the recommendations of doctors.