Lung Abscess

Lung abscess is a pus-filled cavity in your lung surrounded by inflamed tissue.

It usually results from breathing bacteria that normally live in your mouth or throat into the lungs, leading to an infection.

Symptoms of a lung abscess commonly come slowly over weeks. They may include:

  • Chest pain, especially when you breathe in
  • Cough
  • Fatigue
  • Fever
  • Loss of appetite
  • Night sweats
  • Sputum (a mixture of saliva and mucus) with pus that’s often sour-tasting, foul-smelling, or streaked with blood
  • Loss of Weight

A number of things can cause a lung abscess, including:

  • Not being able to cough. This often happens as a result of:
    • Anesthesia
    • Alcohol or drug use
    • Nervous system diseases
    • Sedation
  • Poor oral health - People with gum disease are more likely to get an abscess.
  • Your immune system isn’t working well - This can let in germs that aren’t usually found in your mouth or throat, like fungi or the bacteria that cause tuberculosis, strep throat, and MRSA
  • Blocked airway - Mucus can form behind a tumor or foreign object in your windpipe and lead to an abscess. If bacteria get into the mucus, the blockage stops you from coughing it out.
  • Blood-borne causes - It’s rare, but bacteria or infected blood clots from an infected part of your body can travel through your bloodstream and into your lung, where they cause an abscess.

How is it diagnosed?

A lung abscess is typically diagnosed in two ways:
  • Chest X-ray: This shows your doctor where the abscess is.
  • CT scan of the chest: Your doctor is looking for an air- and fluid-filled cavity in the middle of your lung.
Lung Abscess

How is it treated?

Broad spectrum antibiotic to cover mixed flora is the mainstay of treatment.

Pulmonary physiotherapy and postural drainage are also important. Surgical procedures are required in selective patients for drainage or pulmonary resection. The treatment is divided according to the type of abscess, acute or chronic. For acute cases the treatment is

  • Antibiotics:
    • if anaerobic: metronidazole or clindamycin
    • if aerobic: beta-lactams, cephalosporins
    • if MRSA or Staphylococcus infection: vancomycin or linezolid
  • Postural drainage and chest physiotherapy
  • Bronchoscopy is used for the following cases:
    • Aspiration or installation of antibiotics
    • Patients with atypical presentation suspected of having underlying foreign body or malignancy

Most cases respond to antibiotics and prognosis is usually excellent unless there is a debilitating underlying condition. Mortality from lung abscess alone is around 5% and is improving


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