Lung abscess: stages, diagnosis, symptoms and treatment

An abscess of the lung is a severe pathology, which is accompanied by the formation of pus in the tissues with its further accumulation in necrotic cavities. In the absence of timely treatment, the disease can result in serious complications until the death of the patient. That is why in no case can you ignore the symptoms of the disease.

Of course, many people are interested in additional questions. Why does an abscess occur in lung tissue? What violations should you pay attention to? What treatment methods does modern medicine offer? The answers to these questions are important.

The main causes of the development of pathology

Sometimes, against the background of an infectious lesion of the lung, an inflammation center is formed in the tissues of the organ. The pathological process is accompanied by the collapse of the lung tissue and the formation of purulent masses that accumulate in the cavity formed against the background of inflammation - this is how an abscess forms. Sometimes the formation of such an abscess clogs the lumen of the bronchus, which leads to a violation of the natural discharge of sputum, and this only worsens the patient's condition.

Causes of lung abscess

The cause of the inflammatory process is the activity of pathogenic microflora. The causative agent may be streptococci and staphylococci (Staphylococcus aureus is considered the most dangerous), aerobic and anaerobic bacteria, as well as fungal microorganisms. In addition, an abscess sometimes develops against the background of the penetration of parasites, for example, some types of amoeba, as well as echinococci.

Pathogens can enter the respiratory system in different ways.

  • Infection can enter the respiratory tract from the oral cavity. The risk group includes patients with periodontal disease, tonsillitis and gingivitis. The risk of developing an ailment increases if a person does not follow the rules of oral hygiene.
  • The cause may be necrotizing pneumonia.
  • An abscess of the lungs often develops against the background of purulent thromboembolism, as well as with the intravenous administration of narcotic drugs.
  • The infection enters the lungs and through the hematogenous route - pathogenic microorganisms spread along with the blood stream, and the primary focus of inflammation can be located in any organ system.
  • Bacteria and fungi often enter the chest organs during wounds and injuries.
  • An abscess can develop against a background of systemic damage to the body (sepsis).
  • A similar pathology may be the result of lung cancer.
  • Possible aspiration of the respiratory tract by vomit.

During the diagnosis, it is very important to determine the cause of infection and the nature of the pathogen - the treatment regimen depends on this.

The list of predisposing factors

Purulent sputum with lung abscess

We have already examined the causes of lung abscess. But it is worth noting that there are risk factors, the presence or impact of which increases the likelihood of ulcer formation. Their list includes:

  • smoking;
  • local or systemic hypothermia of the body;
  • alcohol abuse;
  • decreased activity of the immune system (the body cannot cope with the infection);
  • flu, colds;
  • diabetes;
  • the presence of chronic pathologies of the respiratory system (for example, chronic bronchitis is potentially dangerous, especially if the patient has not been adequately assisted).

Lung abscess: symptoms

Signs of lung abscess

Many people are interested in information about such a pathology. Signs of lung abscess in the initial stages may be blurred. First, the body temperature rises . Patients complain of chills, weakness, body aches, constant drowsiness and fatigue. There is increased sweating and headaches.

As the disease progresses, more specific symptoms of lung abscess occur. Patients suffer from shortness of breath, which appears even at rest. The patient's breathing is difficult, there is no way to take a deep breath.

In the future, there is a dry cough. During coughing attacks, a person notes chest pains, a feeling of fullness on the affected side.

Due to respiratory failure, tissues do not receive enough oxygen - the skin becomes pale, and then a bluish tint. Blood pressure is significantly reduced, the pulse becomes too frequent and arrhythmic.

If the abscess erupts on its own, then the cough becomes moist and is accompanied by the release of purulent, yellowish-green sputum.

Forms and varieties of the disease

In modern medicine, several systems are used to classify a similar pathology.

If we take into account the causes of the formation of an abscess, then two groups can be distinguished.

  • The primary form of the disease develops if the infection enters directly into the chest, for example, during a penetrating wound or open injury.
  • A secondary abscess manifests itself against the background of an existing disease of the respiratory system (for example, with severe forms of pneumonia).

Take into account the location of the abscess. For example, it can be central or peripheral (if the abscess is closer to the edge of the lung).

Depending on the course of the disease, the following types are distinguished:

  • an mild abscess in which the symptoms are not too pronounced (the patient has shortness of breath, cough, fever, but in moderate form);
  • moderate course - the symptoms are more pronounced, but the ailment responds well to drug therapy;
  • severe form of pathology - disturbances in the work of the respiratory system are pronounced, the patient's condition is severe, the risk of complications is high.

It is worth paying attention to the duration of the development of the disease:

  • acute abscess - the pathology appears suddenly, the symptoms intensify quickly, but the ailment lasts no more than 6 weeks and ends with a full recovery;
  • the chronic form of pathology is characterized by a sluggish course, in which periods of remission are replaced by relapses (lasts more than six weeks and is difficult to treat).

Stages of the development of the disease

Symptoms of lung abscess

In modern medical practice, two stages of lung abscess are distinguished.

  • The first stage is, in fact, the formation of an abscess. This stage is accompanied by fever, chest pain when coughing, shortness of breath and other symptoms listed above.
  • In the second stage, a lung abscess breaks through. At this phase, there is a short-term worsening of discomfort, after which a cough appears. The attack is accompanied by the release of a large amount of sputum. The discharge is purulent, with a very unpleasant odor. The volume of sputum, as a rule, is 100-150 ml. In the future, the patient's condition improves, however, only temporarily.

Chronic form of the disease

Chronic lung abscess is much more difficult to treat and even diagnose, as the symptoms of the disease are blurred. The disease is characterized by periodically occurring exacerbations, which are accompanied by approximately the same disorders as the acute form of inflammation. But during the remission, the clinical picture is very vague.

  • Periodically, shortness of breath occurs, a feeling of lack of air.
  • Patients suffer from persistent coughing, which is often accompanied by sputum production.
  • Sometimes during coughing attacks chest pains appear.
  • Chronic inflammatory process leads to increased sweating. Patients complain of constant fatigue, fatigue, loss of appetite. This, in turn, is accompanied by a decrease in body weight, a gradual depletion of the body.
  • Gradually, the chest deforms, and the fingers acquire a very characteristic form of drumsticks, which indicates a protracted violation of the respiratory system.

The chronic form of the disease often develops against the background of lack of therapy in acute lung abscess. The transition of the disease to this stage may be associated with a sharp weakening of the immune system.

Possible complications

X-ray of lung abscess

According to statistics, correctly conducted therapy in most cases really helps to get rid of the disease. However, the consequences are not always avoided. Complications of a lung abscess can be very dangerous. You should definitely familiarize yourself with their list.

  • Quite often, acute inflammation becomes chronic, which is much more difficult to treat.
  • Sometimes the pathological process goes to another, healthy lung.
  • Due to changes in the structure of the lungs, respiratory failure may develop - the body does not receive the necessary amount of oxygen, which affects the work of all organ systems.
  • There is a chance of developing pyopneumothorax. An abscess breaks into the pleural cavity - air and purulent masses accumulate in it.
  • The list of possible complications also includes pleural empyema. Pathology is accompanied by inflammation of the pleural sheets and the accumulation of purulent masses in the pleural cavity.
  • Some patients with pulmonary abscess develop pulmonary hemorrhage.
  • In the tissues of the affected lung, various deformations (bronchiectasis) sometimes form, which become foci of chronic, purulent inflammation.
  • Among the most dangerous complications include septicopyemia. Infection from purulent foci in the lungs penetrates the bloodstream and spreads throughout the body, affecting the liver, brain and other organ systems.

Diagnostic measures

Diagnosis of lung abscess

Diagnosis of lung abscess is a complex process during which it is necessary not only to confirm the presence of ulcers, but also to find out the cause of their formation, the degree of spread.

  • To begin with, a history is collected. The doctor is also necessarily interested in the presence of certain symptoms in patients.
  • During a general examination, a specialist listens to the lungs with a phonendoscope - the appearance of characteristic wheezing is possible. In addition, the doctor examines the skin (oxygen starvation is accompanied by pallor, cyanosis) and the chest (its deformations are possible).
  • A general blood test is mandatory. An increase in the number of leukocytes and an increase in ESR indicates the presence of an inflammatory process in the body.
  • Additionally, a biochemical blood test is performed.
  • A study of sputum with a lung abscess is necessary. Her samples are used for microscopic examination, as well as bacteriological culture. Such procedures make it possible to determine the type of pathogen, to check its sensitivity to the effects of a particular drug.
  • The patient is exposed to chest x-ray. In the picture, the doctor will be able to see the existing abscesses.
  • Fibrobronchoscopy is also performed. Using a bronchoscope, the doctor carefully examines the bronchi from the inside, checks for pathological neoplasms.
  • In controversial cases, computed tomography is additionally performed, which gives more information about the structure and origin of pathological structures in the lung tissue.

Based on the results, the doctor draws up a treatment plan for lung abscess.

Medication treatment

Oxygen therapy for lung abscess

In no case should you ignore the symptoms of the disease or refuse therapy. Treatment of lung abscess must necessarily be comprehensive, since much depends on the causes of the pathology and the general condition of the patient. Sometimes an abscess must be drained, purulent contents removed, and then treated with antiseptics. In addition, drug therapy is carried out.

  • First of all, antibiotics are prescribed to patients. Medicines are selected depending on the strain of pathogens. The most commonly used drugs are Ampicillin, Ceftriaxone, Amoxicillin, Metronidazole. The doctor selects the dose and regimen individually.
  • Sanitation bronchoscopy is also performed. During the procedure, the doctor using special equipment removes mucus and pus from the bronchi, treats the walls with antiseptics and antibacterial agents.
  • Expectorants and mucolytics are also used. Such drugs thin the sputum, enhance the activity of the cilia of the epithelium, facilitate the discharge of secretions and mucus from the bronchi.
  • Symptomatic therapy is also carried out. For example, patients are prescribed anti-inflammatory and antipyretic drugs, as well as drugs to relieve signs of intoxication.
  • Sometimes the doctor prescribes immunomodulators to the patient, which increase the body's resistance to various infections, and also accelerate the process of restoration of the respiratory system.
  • Oxygen therapy is sometimes performed, which helps prevent the development of severe forms of oxygen starvation.
  • During remission, patients are recommended a special vibration massage of the chest (facilitates sputum discharge) and regular breathing exercises (can be done at home).

Surgical intervention

Sometimes a lung abscess requires surgical intervention. The level of complexity of the procedure depends on the condition of the patient and the stage of development of the disease.

  • Many patients are prescribed a puncture. This is a fairly simple procedure, during which the abscess is punctured with a needle, after which the purulent contents are removed, the cavity is washed with antiseptic solutions, and then treated with antibacterial agents. This procedure is carried out if the abscess is located in the marginal areas of the lung, and the outflow of purulent masses from the cavity is impaired. Such a technique is effective only if the neoplasm is small (diameter does not exceed 5 cm).
  • Sometimes the patient needs a chest incision (thoracocentesis). During the procedure, a special tube is inserted through the incision into the abscess cavity, which provides drainage. A similar operation is carried out if ulcers of large diameter (more than 5 cm) are formed in the lungs or the patient is in serious condition.
  • Unfortunately, sometimes the only way to get rid of the pathology is to partially or completely remove the affected lung. Most often, a similar technique is used to treat a chronic form of abscess.

Predictions for Patients

Forecasts directly depend on at what stage the lung abscess was diagnosed. If we are talking about a mild form of the disease, then properly conducted therapy helps the patient's body recover - the last symptoms of the disease disappear about 6-8 weeks after the start of treatment. If we are talking about complicated forms, then it is difficult to predict the outcome of the disease. According to statistics, the acute form of the disease, even with proper treatment, in 20% of cases passes into chronic inflammation.

Preventive actions

Unfortunately, specific prophylaxis (for example, vaccines) does not exist today. Doctors recommend only adhering to the principles of a healthy lifestyle, maintaining good physical shape, eating right, in a word, strengthening the immune system. It is very important to give up smoking and drinking alcohol, as this increases the likelihood of an abscess, and significantly complicates its course.

All lung diseases (e.g. bronchitis, pneumonia) should respond to therapy on time. If any violations occur, you need to see a doctor - you can not ignore alarming symptoms.


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