Abscess of lungs

Description:

More or less limited cavity which is formed as a result of purulent fusion of pulmonary fabric is called. The activator — various microorganisms (most often golden staphylococcus). Decrease in the general and local protective functions of an organism because of hit in lungs and bronchial tubes of foreign bodys, slime, emetic masses — is characteristic at alcoholic intoxication, after a convulsive attack or in unconsciousness. Chronic diseases and infections (a diabetes mellitus, blood diseases), disturbance of drainage function of bronchial tubes, long reception of glucocorticoids, tsitostatik and immunodepressants promote.
At a X-ray analysis of lungs massive blackout, after break of abscess — a cavity with liquid level in it comes to light in an initial stage. Bronkhoskopiya most often shows inflammatory changes of a wall of the bronchial tube tied with abscess. In blood test — a leukocytosis, a deviation to the left, increase in SOE.

Abtsess's symptoms of lungs:

The symptomatology is various before break of an abscess in a bronchial tube. Before break of abscess the purulent process which is followed by accumulation of a purulent phlegm in the ograyonichenny site of a lung serves as the reason of a serious general condition of the patient. He complains of a strong nedoyomoganiye, appetite loss, weakness, perspiration; breath can be complicated, dry cough is noted, the tempeyoratura of a body reaches high figures. At percussion shortening of a sound over area of abscess opreyodelyatsya, at auscultation — the weakened breath or a small amount of dry rattles. The thickening of phalanxes — fingers in the form of "drum sticks" is often noted.

The blood analysis shows considerable uvelicheyony quantities of leukocytes, SOE. Radiological the roundish shadow — infiltrate of various sizes vyyavyolyatsya. Diagnosis is facilitated in the second period of abscess of a lung when the abscess breaks in the bringing bronchial tube.

Sometimes say that the first symptom is found in a spittoon as at once much (to 1 l) the phlegm is allocated. The break of abscess, allocation of a purulent phlegm outside, emptying of an abscess cavity at once affects the general condition of the patient: body temperature decreases, the health improves, it becomes easier for patient to breathe, appetite, a dream improves, perspiration decreases. Moyokrota departs several days, at this time there is cough. At auscultation the mnoyozhestvo of wet rattles is found. Over a big cavity, almost oporozhyonenny from a purulent phlegm, sometimes it is possible to reveal a tympanic percussion  sound perkutorno.

Radiological the roundish cavity is defined, the level of the remained phlegm is visible. The phlegm at abscess of a lung is characteristic; it is a dvukhsloyna (an upper layer more liquid, lower — dense, greenish color). In most cases after emptying the cavity cicatrizes.

Abtsess's reasons lungs:

Most often is the reason:

the pneumonia caused by staphylococcus, klebsielly, anaerobe bacterias and also contact infection at a pleura empyema, subphrenic abscess;
aspiyoration of foreign bodys, the infected contents of adnexal bosoms of a nose and almonds.
Treat the neyopryamy reasons:

the septic emboluses getting in the hematogenous way from the centers of an osyoteomiyelit, gahnite, prostatitis the lymphogenous way — a drift is less often noted at furuncles of a verkhyony lip, phlegmons of a mouth floor.
Multiple abscesses, are more often bilateral, arise in a septicopyemia reyozultata.
Abscess of a lung can be a lung heart attack complication
disintegration of a rakoyovy tumor in a lung.
Acute abscess with perifocal inflammatory infiltration of a pulmonary tkayona can pass into a chronic form with formation of a dense piogenic cover.

Meets at men of middle age more often, 2/3 patients abuse alcohol. The disease begins sharply: fever, temperature increase, stethalgias. After break of pus in a bronchial tube a large number of a purulent phlegm, sometimes with impurity of blood and an unpleasant smell is allocated. Over a zone of damage of lungs the weakened breath, after break of abscess - bronchial breath and wet rattles is listened in the beginning. Within 1-3 months there can come the happy end: a thin-walled cyst in a lung or a focal pneumosclerosis; the failure — abscess becomes chronic.

Abtsess's treatment lungs:

Improvement of the draining function of bronchial tubes (bronchial spasmolytics, expectorating, inhalations, repeated medical bronkhoskopiya). At an abscess arrangement in the lower shares carry out a drainage by situation, raising the foot end of a bed on 20-30 cm Antibiotics in high doses, stimulation of protective forces of an organism (high-calorific food, proteins, vitamins, levamisole, T-activin, anti-staphylococcal plasma and gamma globulin, hemosorption, a plasma exchange). At inefficiency in 2-3 months — surgical treatment. Timely begun treatment usually leads to recovery. At inefficiency of treatment during 6-8 weeks of the patient it is necessary to hospitalize in a surgical hospital for carrying out a bronchoscopic drainage or operation. Gangrene of lungs meets seldom, differs in a heavy current, the expressed intoxication, expectoration of chocolate color of a phlegm with a fetid smell. Appoint antibiotics of a broad spectrum of activity paranteralno; at their inefficiency operational treatment is shown. Operational lechnny abscesses consists in sanitation of an abscess cavity. Carrying out a transdermal puncture is possible. Rg - a research of lungs with imposing of a tag on area of an estimated puncture is made. Then the same way, as well as at a toraktsenteza the puncture is made, the drainage tube is brought to a cavity of an abstsees. Further complex antibacterial therapy is appointed. One more option of operational treatment is bronchoscopic sanitation of abscess (it is carried out at rather close arrangement of abscess to a primary bronchus).