- How to identify
- How to confirm
- What causes lung abscess
- How the treatment is done
- Physiotherapy for lung abscess
Lung abscess is a cavity that contains pus in it, originated by a necrosis of the lung tissue, due to a microbial infection.
Generally, the abscess forms between 1 to 2 weeks after contamination by the microorganism, which most often happens due to a complication of pneumonia caused by aspiration of the contents of the mouth or stomach, as they contain bacteria more likely to develop this type of injury. Understand how aspiration pneumonia arises.
The diagnosis is made by the doctor through the evaluation of the clinical picture, pulmonary radiography and blood tests. Then, it is essential to start treatment with antibiotics that help to combat the microorganisms that cause it, in association with nutritional support and physiotherapy. In more severe cases, pulmonary drainage may be necessary.
How to identify
The main symptoms of lung abscess include:
- High fever; Shortness of breath and tiredness; Cough with mucopurulent discharge, which may contain an unpleasant odor and blood streaks; Pain in the chest that worsens with breathing; Loss of appetite; Night sweat and chills.
The worsening of the clinical picture can take days to weeks, depending on the bacteria that caused the infection, the health conditions and defenses of the affected person's body. Generally, only one abscess is formed, measuring more than 2 cm in diameter, however, in some cases, multiple abscesses may appear during infection.
When signs and symptoms appear that may indicate this type of pulmonary infection, it is necessary to consult the pulmonologist as soon as possible, or to go to the emergency room, so that the cause is identified and the appropriate treatment is started immediately.
How to confirm
The diagnosis of lung abscess is made by the doctor, through the analysis of symptoms, physical examination, in addition to tests such as chest radiography, which shows the presence of secretion infiltrates in the lung and the cavity area, usually rounded, filled with pus and air.
Blood tests, such as a blood count, can help demonstrate the presence of an infection and assess severity. Computed tomography of the chest can help to better define the location of the abscess, and to observe other complications such as a lung infarction or accumulation of pus in the pleural fluid.
The identification of the microorganism may be necessary in some cases, especially to guide the treatment, for which a culture of pulmonary sputum may be performed, or the collection of material from infection by tracheal aspirate or thoracentesis, for example, or even by a blood culture.. See how the test is done to identify the best antibiotic to treat the infection.
What causes lung abscess
Lung abscess is caused when microorganisms, usually bacteria, settle in the lung and cause tissue necrosis. The penetration of microorganisms can happen through the following mechanisms:
- Aspiration of infectious material (most frequent cause): more common in cases of alcoholism, drug use, coma or anesthesia, in which the loss of consciousness facilitates the aspiration of contents from the mouth or stomach, as well as in cases of sinusitis, infections in the gums, tooth decay or even when an effective cough cannot be achieved; lung infection; cancer; direct traumatic penetrations into the lungs; spread of infections from a neighboring organ; embolism or pulmonary infarction.
When lung abscess arises from direct infection of the lung, it is characterized as primary. In cases where it arises due to complications of pulmonary changes, such as the spread of infection from other organs or pulmonary embolism, it is called secondary.
Some of the most frequent microorganisms as a cause of lung abscess are Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa or Streptococcus pyogenes, or anaerobic bacteria, such as Peptostreptococcus, Prevotella or Bacteroides sp , for example. Fungal or mycobacterial abscesses are rarer and occur more frequently in people with very weak immunity.
How the treatment is done
The treatment for lung abscess is made with the use of antibiotics such as Clindamycin, Moxifloxacin or Ampicillin / Sulbactam, for example, for an average of 4 to 6 weeks, depending on the causing microorganism and the patient's clinical conditions.
During the acute phase, nutritional support and respiratory physiotherapy are also indicated. If the initial treatment is not effective, surgery should be performed to drain the abscess, and ultimately, remove the part of the necrotic lung.
Physiotherapy for lung abscess
Physiotherapy is important to aid recovery, and is done through:
- Postural Drainage: after localization of the lung abscess, the individual is positioned in the direction of the source bronchus for subsequent elimination of secretions through cough; Respiratory kinesiotherapy: breathing exercises are directed in order to increase chest expansion and normalize lung volumes; incentive: the person is instructed to take a deep breath (pull the air into the lungs) and keep it for a few seconds. It can be done through devices like Respiron; Aspiration of secretions if the person is unable to cough.
Physical therapy for lung abscess is most effective in collaborative people who respond to requests for coughing and breathing exercises. Learn more about how respiratory physiotherapy is done and what it is for.
