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 severe complications up to the death of the patient. That is why the symptoms of the disease should never be ignored.
Of course, many people are interested in additional questions. Why does an abscess occur in the tissues of the lung? What violations should be paid attention to? What methods of treatment does modern medicine offer? The answers to these questions are important.
Main causes of pathology
Sometimes, against the background of an infectious lesion of the lung, a focus of inflammation is formed in the tissues of the organ. The pathological process is accompanied by the disintegration of lung tissues and the formation of purulent masses that accumulate in the cavity formed against the background of inflammation - this is how an abscess is formed. 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.
The cause of the inflammatory process is the activity of pathogenic microflora. The pathogen can be streptococci and staphylococci (the most dangerous is Staphylococcus aureus), aerobic and anaerobic bacteria, as well as fungal microorganisms. In addition, an abscess sometimes develops against the background of the penetration of parasites into the body, for example, some types of amoebas, as well as echinococci.
Pathogenic microorganisms can enter the organs of the respiratory system in different ways.
- Infection can enter the respiratory tract from the mouth. The risk group includes patients with periodontitis, tonsillitis and gingivitis. The risk of developing the disease increases if a person does not follow the rules of oral hygiene.
- Necrotizing pneumonia could also be the cause.
- Lung abscess often develops against the background of purulent thromboembolism, as well as with intravenous administration of narcotic drugs.
- Infection enters the lungs and hematogenously - pathogenic microorganisms spread along with the bloodstream, and the primary focus of inflammation can be located in any organ system.
- Bacteria and fungi often enter the chest during wounds and injuries.
- Abscess can develop against the background of a systemic lesion of the body (sepsis).
- This pathology may be the result of lung cancer.
- Possible airway aspiration of vomit.
During the diagnosis, it is very important to determine the cause of infection and the naturepathogen - the therapy regimen depends on this.
List of predisposing factors
We have already covered the causes of a lung abscess. But it is worth noting that there are risk factors, the presence or impact of which increases the likelihood of the formation of ulcers. 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 mellitus;
- presence of chronic pathologies of the respiratory system (for example, chronic bronchitis is potentially dangerous, especially if the patient has not been given proper care).
Lung abscess: symptoms
Many people are interested in information about this pathology. Signs of a 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 a lung abscess occur. Patients suffer from shortness of breath, which appears even at rest. The patient's breathing is difficult, unable to take a deep breath.
In the future, there is a dry cough. During bouts of coughing, a person notes chest pains, a sensationbursting from the affected side.
Due to respiratory failure, the tissues do not receive enough oxygen - the skin becomes pale, and then bluish. Blood pressure is significantly reduced, the pulse becomes too frequent and arrhythmic.
If the abscess erupts on its own, the cough becomes wet and is accompanied by purulent, yellowish-green sputum.
Forms and varieties of the disease
In modern medicine, several systems are used to classify such a pathology.
If we take into account the causes of abscess formation, we can distinguish two groups.
- The primary form of the disease develops if the infection enters directly into the chest, for example, during a penetrating wound or open injury.
- Secondary abscess appears on the background of an already existing disease of the respiratory system (for example, in severe forms of pneumonia).
The location of the abscess is also taken into account. For example, it can be central or peripheral (if the abscess is located closer to the edge of the lung).
Depending on the course of the disease, the following types are distinguished:
- mild abscess, in which the symptoms are not too severe (the patient has shortness of breath, cough, fever, but in a moderate form);
- moderate course - the symptoms are more pronounced, but the disease responds well to drug therapy;
- severe form of pathology - disorders in the respiratory system brightlyexpressed, 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 quickly increase, but the disease lasts no more than 6 weeks and ends with complete recovery;
- The chronic form of the 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 disease development
In modern medical practice, there are two stages of lung abscess.
- 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.
- At the second stage, a lung abscess breaks through. In 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 is usually 100-150 ml. In the future, the patient's condition improves, however, only for a while.
Chronic 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 recurrent exacerbations, which are accompanied by approximately the same disorders as the acute form of inflammation. But during remission, clinic althe picture is very fuzzy.
- Periodically there is shortness of breath, a feeling of lack of air.
- Patients suffer from a persistent cough that is often accompanied by sputum production.
- Sometimes chest pains occur during coughing fits.
- Chronic inflammation leads to excessive 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 is deformed, and the fingers acquire a very characteristic shape of drumsticks, which indicates a prolonged disruption 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
According to statistics, properly conducted therapy in most cases really helps to get rid of the disease. However, consequences are not always avoided. Complications of a lung abscess can be very dangerous. Be sure to check out their list.
- Quite often, acute inflammation turns into a chronic form, which is much more difficult to treat.
- Sometimes the pathological process moves to another, he althy lung.
- Due to changes in the structure of the lungs, respiratory failure may develop - the body does notreceives the required amount of oxygen, which affects the work of all organ systems.
- There is a possibility of developing pyopneumothorax. The abscess breaks into the pleural cavity - air and purulent masses accumulate in it.
- The list of possible complications includes pleural empyema. Pathology is accompanied by inflammation of the pleural sheets and accumulation of purulent masses in the pleural cavity.
- Pulmonary bleeding occurs in some patients with a lung abscess.
- In the tissues of the affected lung, various deformities (bronchiectasis) sometimes form, which become foci of chronic, purulent inflammation.
- Septicopyemia is one of the most dangerous complications. Infection from purulent foci in the lungs enters the bloodstream and spreads throughout the body, affecting the liver, brain and other organ systems.
Diagnostic measures
Diagnosing a lung abscess is a complex process, during which it is necessary not only to confirm the presence of abscesses, but also to find out the cause of their formation, the degree of spread.
- To begin with, an anamnesis is being collected. The doctor is also always interested in the presence of certain symptoms in patients.
- During a general examination, the specialist listens to the lungs with a phonendoscope - characteristic wheezing may appear. In addition, the doctor examines the skin (oxygen starvation is accompanied by pallor, cyanosis) and the chest (its deformation is possible).
- Requiredgeneral blood analysis. 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.
- Sputum examination for lung abscess is mandatory. Its samples are used for microscopic examination, as well as bacteriological culture. Such procedures make it possible to determine the type of pathogen, test its sensitivity to the effects of a particular drug.
- The patient is welded onto a chest x-ray. In the picture, the doctor will be able to see the existing abscesses.
- Fiberbronchoscopy is also carried out. With the help of a bronchoscope, the doctor carefully examines the bronchi from the inside, checks for the presence of pathological neoplasms.
- In controversial cases, computed tomography is additionally performed, which provides more information about the structure and origin of pathological structures in lung tissues.
Based on the results obtained, the doctor draws up a treatment regimen for lung abscess.
Medicated treatment
In no case should you ignore the symptoms of the disease or refuse therapy. Treatment of a lung abscess must necessarily be complex, since much depends on the causes of the pathology and the general condition of the patient. Sometimes the abscess needs to be drained, the purulent contents removed, and then treated with antiseptics. In addition, drug therapy is being carried out.
- First of allpatients are prescribed antibiotics. 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 mode of administration individually.
- Sanitary bronchoscopy is also carried out. 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, increase the activity of the cilia of the epithelium, and 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 a doctor prescribes immunomodulators to a patient, which increase the body's resistance to various infections, and also speed up the process of restoring the respiratory system.
- Sometimes oxygen therapy is given to help prevent severe oxygen deprivation.
- During remission, patients are recommended a special vibration massage of the chest (facilitates the discharge of sputum) and regular sessions of breathing exercises (can be done at home).
Surgery
Sometimes a lung abscess requires surgery. The level of complexity of the procedure directly depends on the condition of the patient and the stage of development of the disease.
- Manypatients are prescribed a puncture. This is a fairly simple procedure, during which the abscess is pierced 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. This technique is effective only if the neoplasm is small (diameter does not exceed 5 cm).
- Sometimes a patient needs a chest incision (thoracocentesis). During the procedure, a special tube is inserted through the incision into the abscess cavity, which provides drainage. Such an operation is performed if abscesses of large diameter (more than 5 cm) have formed in the lungs or the patient is in serious condition.
- Unfortunately, sometimes the only way to get rid of pathology is partial or complete removal of the affected lung. Most often, this technique is used to treat the chronic form of an abscess.
Prognosis for patients
Prognosis directly depends on the stage at which 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 approximately 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%cases progresses to chronic inflammation.
Prevention measures
Unfortunately, specific prevention (eg vaccines) does not exist today. Doctors recommend only adhering to the principles of a he althy lifestyle, maintaining good physical shape, eating right, in a word, strengthening the immune system. It is very important to stop smoking and drinking alcohol, as this increases the likelihood of abscess formation, and makes it much more difficult to develop.
All lung diseases (eg bronchitis, pneumonia) should be treated in time. If any violations appear, you should consult a doctor - alarming symptoms cannot be ignored.
