Causes and treatment lung abscess
Lung abscess is characterized by nonspecific or specific purulent-destructive inflammatory process with the formation in tissues of the lung cavity filled with pus. This cavity formation in the lung may be limited. Here there is an active reproduction of pathogens. Especially dangerous is the disease in children.
The reasons for the development of pathology
To the development of purulent inflammation of tissue of a certain division of the lung results in the following:
- In most cases the disease develops after pneumonia.
- As a result of entering into the alveoli, the bronchi of liquid and solid particles occurs aspiration pneumonia. Aspiration - penetration of pus, of blood in the tissue following surgery or injury.
- Lobar pneumonia is an inflammatory-allergic in nature.
- Influenza pneumonia is called pathogenic germs and develops downstream by the background of tracheobronchitis.
- The bronchial obstruction.
- The introduction into the patient's organism to pathogenic germs which cause the development of infectious process.
- Violation of the General immunity.
In 60% of cases there is a loss of the right lung. Most often the disease affects men of working age. Bilateral involvement is seen in each of the sixth ill. Usually dangerous pathological process develops in the right lung.
Pathogenesis of lung abscess
The process of formation of the symptoms of the disease process:
- In a limited area of the lung under the influence of pathogenic factors is developing inflammation response. Occurs purulent infiltration of the lung.
- Vessels breathing on trombicula. As a result of healthy lung tissue is separated from the abscess.
- At some point, the abscess is drained, the person coughs. The wall of the branches of the windpipe collapses. Purulent contents flows through the bronchi in the upper respiratory tract, then with the efforts of the expectorated in putrid sputum.
Varieties of chronic obstructive pulmonary disease
There are the following types:
- Acute abscess of the lung. His another name - abscessed pneumonia. Develops putrefactive lose or melting of the painful tissue of the respiratory organ.
- Gangrenous abscess is a border state between pulmonary gangrene and abscess of the respiratory organ.
- If the illness lasts more than two months, the patient's state of health deteriorates. Formed chronic lung abscess. This disease with abundant expectoration, sharp pains in my side,the febrile exacerbations.
- As a result of introduction of an amoeba with the lymph, the blood from other organs develops amoebiasis organ of respiration.
- Purulent form of disease, cavitary lesions in his lungs - this is gangrene of the respiratory organ.
Clinical signs of abscess
The symptoms of the disease have different degrees of severity. The initial stage of purulent inflammation of the tissues lasts up to 10 days.
Characteristics of the clinical picture:
- The blood was rapidly growing, excessively high content of leukocytes, neutrophils - white blood cells. Syndrome accelerated ESR indicates the presence of the disease.
- Weakened bronchial breathing.
- Serious condition of the patient. Develops a fever. Temperature rises to 39-40°C and above. Characterized by significant daily fluctuations in body temperature, accompanied by torrential then.
- Dyspnea - respiratory failure. The dullness of percussion sound. Periodically escalating long-lasting cough.
- Severe headache. Loss of body weight.
- Pain in the chest. In the affected parts of the body - severe pain when breathing.
- Purulent sputum. The discharge may be blood. Discomfort during coughing.
- The feeling of exhaustion, fatigue. Nausea, disturbances of appetite. Shortness of breath due to intoxication.
A transition to the second phase of the disease is characterized by manifestations:
- There is a spontaneous break of the abscess into the bronchi.
- With a cough produces a large quantity of stinking putrid sputum.
- After the discharge of pus are two possible course of the pathological process. The outcome of the unfavorable course of the disease can become a chronic abscess. In the case of competent treatment of the pathology is the transition to the third phase of the disease is gradual and a cure.
Greater complexity is differential diagnosis of this disease because its signs can be confused with symptoms of bronchopneumonia.
Clinical picture helps to confirm a set of diagnostic procedures:
- Assessment of respiratory sounds during auscultation, percussion helps the physician determine the dangerous pathology of the lungs.
- Chest x-ray. See purulent inflammation of the lung tissue on a radiograph. Pathology looks like a rounded shadow, bounded by a fluid - pus.
- Often there are cases when the abscess is detected on the radiograph in a patient who has no complaints. This happensbecause of purulent inflammation of the tissues limited by dense fibrous connective tissue that has formed for a long time. For precise localization of the pathological process is carried out x-rays in three projections.
- After opening the abscess, abundant ejection of the mucus, diagnosis is facilitated.
- Differential diagnosis allows to exclude other dangerous diseases: chronic abscessing pneumonia, bronchiectasis, cavernous tuberculosis.
- The CT gives the opportunity to clarify the nature of the pathology of the chest.
Treatment of necrosis of lung tissue
The doctor makes appointments depending on the severity of a purulent process. Shown intensive conservative therapy or surgical treatment.
A set of conservative medical measures:
- For the active evacuation of sputum lung abscess is bronchofibroscopy. This effective procedure allows to evaluate the state of the mucous membranes of the bronchi.
- Is allocated purulent of the substrate is sent for bacteriological examination to detect and identify the pathogen.
- Determined by antibiogram.
- The doctor is guided by these data and prescribes antibacterial, restorative therapy aimed at normalization of the status of the protective properties of the organism.
- The main drugs for the treatment of lung diseases are the modern antibiotics that the doctor selects individually.
- Diagnosis of immunological disorders because of a lung abscess is usually hiding some immunopathology. Apply methods of active immunotherapy. Positive result give autovaccine, staphylococcal toxoid.
- With the aim of strengthening the protective forces of the body receive blood transfusions.
- Assigned to steroids.
- In most cases, the patient with purulent pathology of lungs showing intense inpatient treatment.
- The effectiveness of therapeutic interventions is the main indication for surgical intervention.
- When abscessing pneumonia is shown opening the abscess and draining. This effective manipulation is performed according to the rules of surgery.
- In the period of remission is performed lobectomy - removal of the affected segment of the lung. Subsequently is a powerful antibacterial therapy.
- The most radical type of surgery is pneumonectomy- removal of the entire lung. This operation is performed very rarely.
- Full normalization of the functions of the main respiratory organ, the lung abscess cure is possible only through radical surgery.
The most frequent complications of purulent diseases of the respiratory system
Abscess and gangrene of the lung - stage of the same disease process. Acute lung abscess frequently breaks into the pleural cavity. There is an accumulation of air. There is an acute pneumothorax, a collapsed lung. This condition is life-threatening.
Since the lungs are well krovosnabjaemah, agents quickly enter the blood. Often develops acute respiratory distress syndrome. This is a very serious condition. If the lung abscess symptoms are ignored, do not take the necessary measures, further develop sepsis, septic shock, multiple organ failure and death. It is therefore necessary to treat lung abscess with special attention and treat it as quickly as possible.
If the first symptoms of lung abscess, should apply to the doctor for the diagnosis of bronchopulmonary pathology.
It is crucial to identify the disease correctly establish the causes of the disease and prescribe adequate treatment.
Satisfactory condition of the patients can be maintained for many years using restorative treatment, postural drainage, breathing exercises.