Acute lung abscess is a limited cavity formed as a result of purulent fusion of lung tissue. The causative agent is various microorganisms (most often Staphylococcus aureus). A decrease in the general and local protective functions of the body is characteristic due to the ingress of foreign bodies, mucus, and vomit into the lungs and bronchi – with alcohol intoxication, as a result of a convulsive seizure or in an unconscious state. Contribute to chronic diseases and infections (diabetes mellitus, blood diseases), violation of the drainage function of the bronchi, long-term use of glucocorticoids, cytostatics and immunosuppressants.
Symptoms and course. Acute lung abscess is more common in middle-aged men, 2/3 of the patients abuse alcohol. The disease begins acutely: chills, fever, chest pain. After a breakthrough of pus, a large amount of purulent sputum is released into the bronchus, sometimes with an admixture of blood and an unpleasant odor. First, weakened breathing is heard over the zone of lung damage, after the breakthrough of the abscess – bronchial breathing and moist rales. Within 1-3 months, a favorable outcome may occur: a thin-walled cyst in the lung or focal pneumosclerosis; unfavorable outcome – the abscess becomes chronic.
Recognition. X-ray of the lungs reveals a massive darkening in the initial stage, after the breakthrough of the abscess – a cavity with a liquid level in it. Bronchoscopy most often shows inflammatory changes in the bronchus wall associated with an abscess. In the blood test – leukocytosis, a shift of the leukocyte formula to the left, an increase in ESR.
Treatment. Improvement of the draining function of the bronchi (bronchodilators, expectorants, inhalations, repeated therapeutic bronchoscopy). When the abscess is located in the lower lobes, drainage is carried out by position, raising the foot end of the bed by 20-30 cm. Antibiotics in large doses, stimulating the body’s defenses (high-calorie nutrition, proteins, vitamins, levomisole, T-activin, antistaphylococcal plasma and gamma globulin, hemosorption, plasmapheresis). With inefficiency after 2-3 months – surgical treatment.