LUNG ABSCESS

General Information

DEFINITION--An infected area of lung tissue, surrounded by lung inflammation. The infected lung tissue dies and is replaced with pus. The infection is not contagious from person to person.

BODY PARTS INVOLVED--Lung.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Cough with sputum. The sputum is pus-like, often blood-streaked and sometimes smells bad.
• Bad breath.
• Sweating.
• Fever to 101F (38.3C) or higher.
• Chills.
• Weight loss.
• Chest pain (sometimes).

CAUSES--Usually a complication of pneumonia. A lung abscess sometimes occurs when an unconscious or sedated person inhales infected material from the upper-breathing passages. The patient may be unconscious from a head injury, an anesthetic (including dental anesthesia), intoxicated from alcohol or heavily sedated. Lung abscesses are generally caused by virulent bacteria, such as klebsiella, Pseudomonas, staphylococcus or beta-hemolytic streptococcus.

RISK INCREASES WITH

• Recent illness, especially pneumonia that has been slow to heal.
• Alcoholism.
• Recent general anesthesia or injury causing unconsciousness.

HOW TO PREVENT

• Obtain prompt medical treatment for respiratory infections, especially pneumonia.
• Keep the teeth and mouth in good condition to prevent oral infections that could result in a lung abscess.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood tests and a culture of pus from the abscess to determine what antibiotic to use.
• X-rays of the lung, lung scan, bronchoscopy (see Surgery section).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery (sometimes) to aspirate pus from the abscess or to remove the abscess and part of the lung, if the abscess does not heal.
• Self-care during convalescence.

POSSIBLE COMPLICATIONS

• Chronic abscess, leading to weight loss, anemia, bronchiectasis or chronic lung disease, if the abscess does not respond well to antibiotic treatment.
• Rupture of the abscess, causing empyema or massive bleeding in the lung.
• Spread of infection to other body parts, especially the brain.

PROBABLE OUTCOME--Usually curable with prolonged antibiotic treatment (up to 6 months).

How To Treat

GENERAL MEASURES--

• Don't smoke.
• Practice deep-breathing exercises as often as possible.
• Learn postural drainage to help rid the lung of bronchial secretions. Lie on the bed on your stomach with your head and chest hanging over the edge. Force yourself to cough. Continue until you cannot raise any more sputum. Practice this twice a day for 5 to 10 minutes.

MEDICATION--Your doctor may prescribe antibiotics for prolonged periods to fight infection and prevent a recurrence.

ACTIVITY--Reduced activity until x-ray shows evidence of clearing.

DIET--No special diet. Increase your fluid intake to a minimum of 1 glass of fluid at least 8 times a day. By drinking extra liquids, the body is forced to eliminate part of the fluid through the lungs. This makes thick lung secretions thinner, so they can be coughed up more easily.

Call Your Doctor If

• You have symptoms of a lung abscess.
• The following occurs during treatment: Fever rises to 101F (38.3C) or higher. Sputum thickens, despite treatment. Postural drainage reveals a change in color, amount or consistency of the sputum.
• Symptoms of a lung infection recur after treatment, especially a sputum-producing cough, fever or general ill feeling.