Lung abscess

Lung abscess's disease overview

lung abscess is a lung infection. Lung parenchyma is necrotic due to acute inflammation in diseases such as pneumonia, pleura, pus formation and pus abscesses, dead leukocytes and pathogenic microorganisms. Bacteria are the most common cause of pulmonary abscess, a small percentage of cases caused by parasites.

lung abscess is divided into 2 types:

Nguyen Phat lung abscess: is the formation of pus burners on a healthy lung, no damage or previous pathology.

Secondary pulmonary abscess: Pus burners are formed on a pathological lung, existing old lesions such as tuberculosis cave, bronchodilator, lung cyst.

lung abscess accounts for about 4.8% of all lung diseases. This is a condition that can be encountered at any age, of which middle age accounts for a higher proportion. Thanks to the development of imaging, lung abscesses are detected early and more firmly diagnosed.

lung abscess if not treated early or improper treatment is likely to cause many dangerous complications such as:

Coughing of blood: due to vascular rupture, especially serious when the abscess is near the navel. If not emergency in time can affect life.

Pur pleural spill: occurs when the abscess is broken with pleura.

Blood infection: When the bacteria in the abscess enter the bloodstream, shock the infection and may die.

In addition, lung abscess also causes other complications such as pulmonary fibrosis, bronchiectasis, brain abscess ...

Causes of Lung abscess's disease

Causes of pulmonary abscess can be divided into the following groups:

Infection: This is the cause of most cases of lung abscess. Bacteria, fungi and parasites are the causes of lung parenchymal necrotic infections. Pathogens often by gas - bronchial to lungs.

Anaerobic bacteria is the most common group of bacteria, does not require a lot of oxygen to grow, accounting for about 89%, usually derived from the oral area. Pus fluid caused by anaerobic bacteria is characterized by a stench. They can cause many spreading lung abscesses, and often combined with other bacteria such as streptococcus, pneumococcal ... Some common anaerobic bacteria are bacteroide melaniogenicus, bacteroide fragilis peptococus, peptostreptoccus, Fusobaterium nucleotum, ...

Staphylococcus aureus: called Staphylococcus aureus. Staphylococcus aureus causes severe clinical illness, lung parenchymal and pleural damage, acute respiratory failure and toxic infection. This agent is common in young children. Klebsiella Pneumoniae (Friedlander): Clinically progresses very quickly with blood cough. The disease has a high risk of death.

Some other bacteria can also cause lung abscess such as pneumococcal, hemolytic streptococcal group A, Gram (-) bacteria such as Pseudomonas Aeruginosa, Legionella Pneumophila, Hemophillus Influenzae .

parasites: The most common is secondary amoeba after liver abscess. The abscess is common in the right bottom of the lungs and the reaction lesions in the pleura. The patient spoke dark brown like chocolate, accompanied by fresh blood.

Fungus often causes lung abscess in patients with diabetes, alcoholism or immunodeficiency due to many other causes. Some types of pathogenic fungi such as mucoraceae, Aspergillus spp.

Diocese: Food, drinking water, vomiting or saliva from the mouth are inhaled into the lungs, causing pneumonia, the premise to form lung abscess after 7-14 days . The objects into the lungs in the context of patients with coma, choking, swallowing reflexes, gastroesophageal reflux, airway obstruction.

Pathological pathology in the lungs: For patients with diseases such as obstructive lung tumors, lung cancer causing superinfection or necrosis, pulmonary infarction, bronchodilator, TB with cave, congenital cocoons, open chest injuries, ... are at high risk of lung abscess. The manifestation of the lung abscess may start at the same time or later with the expression of the background disease.

Symptoms of Lung abscess's disease

Clinical symptoms of pulmonary abscess often develop within weeks, divided into the following stages: The month includes: fever, chills, sweating, cough with odors and saliva There is an uncomfortable taste. Patients are often tired, weak, anorexia and weight loss.

Closed pus: dry cough, high fever, chills, can be up to 39-40 degrees Celsius, fatigue, loss of appetite, weight loss. Patients often have chest pain in a site of damage, may have shortness of breath.

Pus: Cough and chest pain symptoms are more severe. Or out of many thick pus. Characteristics of latex can suggest the cause of the disease: Chocolate color is usually caused by amoeba, foul pus is often caused by anaerobic bacteria, blue pus is often caused by streptococcus. The whole body is tired, sweating. After the pus is pus, the whole situation improves, the patient feels more comfortable and eaten.

Pus opened with bronchial: The patient continues to cough, especially when changing the posture, the pus is less.

Transmission route of Lung abscess's diseaseLung abscess

Is the lung abscess contagious?

Pulmonary abscess can be transmitted from a sick to a healthy person if the pathogen in the abscess spreads to the outside environment. The transmission paths may be encountered:

Gas - Bronchial: Patients inhaling bacteria into the lungs from the air, from infections in the nose and throat, oral, surgical procedures in the ear, nose and throat, heterosexual airway objects, intubation, gastroesophageal reflux ...

Blood sugar: endocarditis diseases, venous inflammation, embolism, infarction and blood infection, can cause abscess in both lungs.

Serious lines: abscess under the diaphragm, liver abscess due to amoeba, biliary tract abscess, mediastinum abscess, esophageal abscess, ... when breaking can cause pressure Lung car.

People at risk for Lung abscess's disease

The factors that increase the risk of lung abscess include:

Age: Adults over 60 are at higher risk.

Alcoholism, tobacco, drug use.

Total exhaustion, fatigue, malnutrition.

Diabetes and other chronic lung diseases such as lung tumors, lung cancer, bronchiectasis, pulmonary tuberculosis, congenital pulmonary cocoons, pulmonary embolism.

Mechanical immunodeficiency

After anesthesia, intubation, long -term intravenous tract.

After surgery, the maxillary, ear, nose and throat surgery.

Open chest injury, with an object attached.

Difficult to swallow, pharyngeal dysfunction.

Prevention of Lung abscess's disease

Measures to help prevent and limit the progression of lung abscess:

Dental hygiene, nose, throat clean.

A good manner of the doctor's instructions to definitely treat the diseases of the oral infection, the ear, nose and throat.

Preventing objects falling into the neck

Be careful when feeding patients through stomach sonde tube

Eat full of nutrients, supplement lots of green vegetables and fruits containing vitamin C.

When experiencing any abnormal symptoms such as chest pain, cough, should immediately go to medical facilities for timely examination and treatment.

Diagnostic measures for Lung abscess's disease

The diagnosis of pulmonary abscess needs to coordinate between clinical symptoms suggesting such as high fever, chilling, chest pain and damage, coughing with pus, etc. combined with subclinical tests and the following diagnostic means:

Blood formula: Increased leukocyte advantages

Increased blood deposit speed

Phuc, suction fluid from bronchial to identify pathogenic bacteria and make antibiotics.

Pulmonary X -ray: The typical image of the lung abscess is a circular shape with irregular shape, quite thick and has a slightly fluid inside. It is necessary to take a tilted film to determine the exact position of the abscess. There are cases where thick pleura is recorded if the abscess breaks into the pleura causing pleura.

CT scan of lungs: Give a special image of lung x -ray.

Lung abscess's disease treatments

Treatment of lung abscess needs the coordination of many measures. The principle of treatment should be followed, including:

Medical treatment with antibiotics promptly, positively and persevere. Antibiotic changes based on clinical and antibiotics. Antibiotics are often used at least 2 or more antibiotics in intramuscular or veins. Duration of antibiotic use at least 4 weeks.

Early surgical indications before complications such as severe hematuria, pleural inflammation, etc. occur.

Treatment of lung abscess with drugs

Antibiotics are indicated for experience for experience for each agent. After that, the selection of drugs is changed according to the clinical response of the patient and the results of antibiotics.

Treatment of lung abscess by intervention

Opercard drainage: Based on straight, tilted lung x -ray films or CTSCAN to locate the abscess and choose the appropriate patient posture for drainage and chest vibration . Loading posture performed several times a day, initially for a few minutes, then extend the time and combine with chest vibration. Flap vibrating 2-3 times a day, at first 5 minutes later increased to 10-20 minutes.

can use bronchoscopy to suck pus in the bronchial drainage of the abscess. Soft pipe bronchoscopy also helps to detect accompanying lesions such as tumors, objects that cause bronchial obstruction.

Pus drainage through the skin applies to peripheral lung abscesses, chest walls, abscesses without bronchial. Pus drainage through the skin can be performed under the guidance of chest walls.

Surgery

Pulmonary stool surgery or one side of the lungs depending on the extent in the following cases:

ASCRAGS> 10cm.

Chronic lung abscess treatment for 3 months of medical treatment has no results.

Coughing up blood relapses, repeatedly, coughing at lightning, life -threatening.

Abscess in combination with severe localized bronchodilions.

There are bronchial leaks - pleural cavity.

Background disease suspected lung tumor, lung cancer

Support treatment

Diet: Ensuring adequate nutrients and energy, providing a lot of protein and vitamins.

Maintain water and electrolyte balance, alkaline balance

Pain relief, fever

oxygen: high amount of about 6 liters/minute in acute respiratory failure. If there is a chronic respiratory failure, oxygen breathing with a lower supply, about 2 liters/minute.

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