Lung abscess

Lung abscess
Definition Lung abscess is a specific form of inflammation of lung parenchyma, characterized by the presence of hollow spaces filled with pus. In many cases of purulent accumulations (less than 2 cm) speaks about "necrotizing pneumonia.
Etiology Lung abscess is most commonly due to bacterial infections, the pulmonary infarctions, malignant diseases, degenerative processes of silicosis, but after a bronchiectasis. Most lung abscesses are caused by anaerobic bacteria (living without air only). Poor oral hygiene and periodontal disease can lead to inflammation of lung parenchyma, because small amounts of saliva containing bacterial lung capacity to counteract overloading infections. More rarely, lung abscess can occur as a result of the dissemination of bacteria in blood by an infected thrombophlebitis or bacterial endocarditis (heart valve infection).
Clinical The clinical picture of lung abscess may develop within a few weeks (most common) or on the contrary, can suddenly dubuteze. Initial symptoms are similar to those of pneumonia: patients feel tired, exhausted, no appetite, have high fever chills and a cough is accompanied by purulent sputum. The sputum is often a disagreeable odor and may contain traces of blood (hemoptysis). He notifies the patient and caregivers of a mouth odor (halitosis). In addition to chest pain may occur dependent on breathing movements, indicating additional inflammation of the pleura. Symptoms vary in the disease and may even improve the phase insignificant fever and mild cough. If lung abscess develops slowly and insidiously that the patient signs of disease occur in any infectious disease: tiredness, fatigue, weight loss strong, heavy night sweats and fever during the day. These symptoms require emergency medical consultation.
Diagnosis To correctly diagnose any disease doctor will make the initial history, which summarize the history of the patient who suffered disease and symptoms that occur when presenting them to the doctor. For all lung diseases is very important to identify smoking as a risk factor. Medical history is followed by clinical examination (palpation, percussion and auscultation), a chest x-ray. Radiological examination usually reveals the presence of a lung abscess. If lung abscess is not visible on X-rays, can be a computertomografie (radiological procedure on sections of the body), which provides additional information and exact location, extension and possibly other associated pathology. To assess the degree of extension of inflammation and to assess the respiratory function of blood are harvesting. Bacteriologic analysis of expectorated sputum reveals this pathogen responsible for pulmonary abscess formation. Depending on the disease can recommend further investigation To exclude the possibility of confusion due to similar symptoms in many lung diseases may be a bronchoscopy to visualize the lungs. Bronchoscopy involves inserting a flexible tube, thinner, called a bronchoscope in the airways, either by mouth or nose. At the end of the bronchoscope is attached a tiny camera that allows viewing from inside the airway. You can attach sumplimentar medical instruments for taking a sample of tissue or puncturing and draining the abscess. If the abscess is located on the surface of lung parenchyma, which is near the chest wall, its contents can be emptied and outside, by percutaneous introduction of a thin tube to the abscess cavity. Through this tube will be draining purulent collection.
Treatment Treatment of lung abscess is usually in hospital with antibiotics that are given initial infusion. Once the clinical picture improves, lowers fever, improves mood and decrease inflammation in blood values, antibiotics may be continued at home, in the form of tablets. Treatment should be continued until all symptoms and loss on disposal of any X-ray evidence of pulmonary abscess control. Treatment usually lasts several weeks to several months. Etiologic treatment may be completed adminsitrate inhaled preparations with mucolytic and expectorant action. If the inflammatory process and affect the pleura, causing considerable pain during breathing, we recommend administration of medicines. To remove the pus can set up a transcutaneous drainage of abscess cavity. If the channel is obstructed by a bronchial tumor or a foreign body, foreign body be removed by bronchoscopy. The same technique can be used in case of an abscess unresponsive to antibiotics. If such methods do not work, surgery remains the last alternative therapy to remove the inflamed lung segment. However, treatment with antibiotics would be enough if the body has a good immune system. Prognosis If not properly treated, lung abscess or a person is immunosuppressed or lung cancer, the risk of death is very high. In 30% of cases following treatment still remains a remnant of the cavity with pus, which may constitute the starting point for a new abscess or chronic pneumonia.