What Is Lung Abscess?
A lung abscess is a cavity within the lungs partially filled with pus. Now uncommon, lung abscesses usually result from a severe infection such as pneumonia or tuberculosis or from the aspiration of infectious material into the lungs from the mouth.
An abscess may also develop if a bronchial passage becomes blocked by vomit, food or some other foreign matter that has trapped lung secretions, allowing them to accumulate and become infected. Generally, coughing expels material that may potentially block the lungs, preventing the formation of abscesses.
However, loss of consciousness, for example, owing to a head injury, anesthesia for surgery, certain medications, or the abuse of drugs or alcohol, may allow infectious material to be aspirated into the lungs and remain there. A tumor may also block bronchial passages and lead to an abscess.
An embolus (blood clot) in the blood vessels of the lungs can lead to death of lung tissue. The dead tissue acts as fertile soil for germs, which may enable an abscess to form. Symptoms may develop over a period of days or weeks.
The incidence of lung abscesses has decreased substantially since the advent of antibiotics. Lung abscesses are not contagious and generally respond well to a prolonged course of antibiotics.
What Causes Lung Abscess?
- Lung abscess may occur as a complication of a bacterial infection, such as pneumonia or tuberculosis (although this has become less common).
- Fungal infection of the lungs may lead to abscess.
- Inhalation of foreign matter into the lungs may lead to an abscess, especially in the presence of a tooth abscess or an infection of the gums (Periodontitis).
- A lung tumor may block bronchial passages.
- Immunocompromised patients, such as those with AIDS or those undergoing treatment for cancer, are prone to lung abscesses.
- Those who experience choking, near-drowning or aspiration are at risk of developing a lung abscess.
- Lung abscess may occur secondary to carcinoma of the bronchus.
Symptoms of Lung Abscess
- Fever and chills
- Being sick for several weeks or months
- Rapid heart rate
- Profuse sweating
- General feeling of poor health
- Loss of appetite and weight loss
- Chest pain
- Deep cough that may produce foul-tasting or bloody sputum
- Clubbing of the fingers
- Bluish discoloration of the skin
Lung Abscess Prevention
- Thorough dental hygiene should be pursued.
- Upper respiratory infections should be treated.
- Avoid excessive use of alcohol.
- Be aware of the risk of aspiration.
Lung Abscess Diagnosis
- Patient history and physical examination
- Blood and sputum cultures
- CT (computed tomography) scans
- At times, bronchoscopy (passage of a thin, hollow, flexible tube through the mouth into the windpipe to allow the main bronchial passages to be viewed)
- Chest x-rays. If a lung abscess is found, x-rays will be taken throughout treatment to monitor progress.
How Lung Abscess Is Treated
- Antibiotics are prescribed to treat a lung abscess involving a bacterial infection (including tuberculosis or bacterial pneumonia). These should be taken for the full term prescribed (often six weeks or more), even if fever and cough subside in less time.
- Antifungal drugs may be prescribed to treat an underlying fungal infection.
- Your doctor may show you how to drain mucus from your lungs by assuming various positions that lower your head below your torso (a technique known as postural drainage).
- Bronchoscopy may be used to aid drainage in some cases, depending upon the location and size of the abscess. Pus may be drawn out through the scope.
- Surgery may be performed to drain the abscess or, more often, to remove the infected lobe of the lung if the abscess does not respond to antibiotics.
When to Call a Doctor
- Call a doctor for shortness of breath, wheezing, high fever with chills, or fainting spells, or if a respiratory infection worsens despite treatment.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media