Lung abscess is a necrotic process of melting the body tissues, resulting in a cavity filled with pus.As a rule, its development due to the presence of a respiratory tract infection, with the presence of infection in the adjacent organs, with which this infection may move into the lung tissue, with processes such as pulmonary atelectasis or traumatic injury of the lung tissue.It is also the cause of an abscess in the lung may be aspiration of airway foreign substances (as in the case of bronchiectasis can occur aspiration of sputum, and people suffering from chronic alcoholism, often found aspirate vomit).An important role in the development of this pathology and act out of the mouth infection.An example is the periodontal disease, gingivitis and other
Expert opinion:. Aspiration is still the presence of foreign bodies in the airways externally.That is, during sputum aspiration bronchiectasis can occur only if it is from the oral cavity or the pharynx again falls into the trachea and bronch
At the expense of oral infection should be noted that their role in the formation of lung abscess secondary and depends on a number of predisposing factors.Many people with diseases of the oral cavity is never lung abscess - it all depends on the state of the immune system, a set of pathogenic and conditionally pathogenic microflora of body condition in general at the moment.
main pathogens of purulent infection, which may result in an abscess, are Staphylococcus aureus, anaerobic bacteria and aerobic bacteria asporogenous gram.
main ways of infection penetration into the lung tissue is aspirated, lymphogenous, traumatic and hematogenous.
must say that depending on the fact that as the basis for classification, distinguish different types of abscesses.Thus, the first classification of the main criterion takes the form of the infectious agent.The essence of the pathogenetic classification is to ensure that the basis is one way of spreading the infection.There is also a classification arrangement, according to which is the central and peripheral abscess also is plural and singular.In addition, this pathology can be isolated in one lung, or hitting on both sides.
Depending on the period of the disease, acute and chronic isolated abscess.
I must say that in the course of the disease distinguish two periods.The first - is the period of formation of a cavity filled with pus.As a rule, it will be observed symptoms such as severe pain in the chest cavity, which will be aggravated by coughing and breathing, shortness of breath, cough, usually dry, in which will be separated purulent, malodorous sputum may be hemoptysis.As the progression of the patient's general condition is deteriorating process, there is intoxication.It appears headache, weakness, nausea, loss of appetite, fatigue.To diagnose the stage of the disease can have on visual inspection.So, that part of the chest, which is struck by light, will keep breathing.It may be that while localized abscess in two lung.In this case, the movement of the chest when breathing is asymmetric.Typically, duration of the acute phase of approximately ten days.But there may be embodiments.It may either be delayed (up to three weeks) and quickly end (within three days).
second period corresponds to the state of the disease at which the autopsy lung cavity filled with pus.This is evidenced by a large number of foul-smelling sputum, separated at a time when you cough.During the same day separated by up to one liter of sputum.It must be said that the general condition of the patient improved somewhat since intoxication decreases, fever decreases.
Acute process may go into the chronic stage.In this case, there will be a periodic exacerbation.At the same time (in remission) will be observed symptoms such as cough, barking character, hemoptysis, increasing the number of sputum with a change position, severe fatigue, sweating, loss of appetite, general weakness.
diagnose the disease can be from the following data.
Firstly, complete blood count, urinalysis and stool.At the same time, the blood will be observed leukocytosis, toxic neutrophil granularity, increased erythrocyte sedimentation rate, leukocyte shift.But it is typical of the first period of the disease.In the second period CBC somewhat better.In chronic abscess erythrocyte sedimentation rate is increased, but kept at the same level, as will be observed signs of anemia.
changes will be and biochemical study of blood.It will increase the level of sialic acid, seromucoid and fibrin.
The urine will be found cylinders, blood (microscopic hematuria) and albumin.
Second, conducted a general analysis of sputum.Try to find abnormal cells, elastic fibers, Mycobacterium tuberculosis, fatty acids.
Third, spend bacterioscopy.Material taken at the same time, then subjected to bacteriological analysis to determine the type of pathogen.This in turn will help to establish the sensitivity of the bacteria or to chemotherapeutic agents.
Fourth, using X-ray and X-ray diffraction methods.
Fifth, used to identify complications of ECG data spirography and flexible bronchoscopy.
Expert Opinion: When it comes to laboratory diagnostics and instrumental methods of investigation, everything written above is true.However, if we talk about the diagnosis as a whole, the first place is the presence of certain symptoms and the patient's condition, which appear at the initial examination of the patient.In chronic abscess these symptoms may not be.
Treatment of lung abscess
If lung abscess is left untreated or treated improperly, they can develop complications.So, if the infection has spread to the pleura, it may be purulent pleurisy or pneumoempyema.If there is a destruction of the vessel walls, bleeding occurs in the lung.The infection can spread to other organs.Can develop bakteriemicheskogo shock.All this can lead to death.
Depending on what stage of the process, can be used as conservative and surgical treatment.
first is the reception of certain antibiotics, and in compliance with patient specific mode.Thus, the patient should be in a better position to drain the sputum discharge several times a day.It is desirable that such a "session" lasted for about an hour.If this does not help, it may hold a bronchoscopy, in which a cavity is washed by artificial means.
If conservative treatment is ineffective, remove the part of the lung abscess.