Abscess of the lung

Abscess of the lung - purulent melting of the pulmonary parenchyma. The most common cause is pneumonia caused by staphylococcus, klebsialoy, anaerobes, as well as contact infection with pleural empyema, sub-diaphragmatic abscess; Aspiration of foreign bodies, infected contents of the paranasal sinuses and tonsils. Indirect causes include septic emboli that enter the hematogenous path from the foci of osteomyelitis, gonitis, prostatitis, less often a lymphogenous path occurs - a skid with furuncles of the upper lip, phlegmon of the bottom of the oral cavity. Multiple abscesses, more often bilateral, arise as a result of septicopyemia. Abscess of the lung can be a complication of a lung infarction, the disintegration of a cancerous tumor in the lung.

Acute abscess with perifocal inflammatory infiltration of the lung tissue can go into a chronic form with the formation of a dense pyogenic shell.

Symptoms, course. Signs of purulent-resorptive fever, hectic temperature, dyspnea, local aspiration, paroxysms of barking cough with an increase in the amount of sputum when the position of the body changes. Physically: bronchial breathing, various rales. Typical three-layer sputum: yellowish mucus, watery layer, on the bottom - that. In the blood-leukocytosis with a shift to the left, anemia, hypoalbuminemia and disproteinemia. Possible spontaneous internal drainage of the abscess as a result of its breakthrough into the nearby bronchus, a sign of which is the sudden release of a large amount of fetid (full mouth) sputum. A frequent complication is perforation into the free pleural cavity with the formation of pleural empyema. The final diagnosis is established by X-ray examination in the direct and lateral projections, as well as tomogram4.) More informative is computer X-ray tomography.

An important role is played by bronchoscopy with aspiration of pus for the determination of microflora and choice of antibiotics, biopsy for differential diagnosis with a disintegrating tumor.

Treatment is carried out in a hospital. Postural drainage, bronchoscopic sanitation, antibiotic therapy, taking into account the weekly repeated antibioticogram. Surgical treatment is indicated only in the absence of the effect of conservative treatment.

The prognosis is favorable: in most cases obliteration of the abscess cavity and recovery is noted. X-ray control is mandatory at 3 and 6 months after recovery.