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Lung abscess

Overview
Lung abscess is a bacterial infection of the lungs that causes pus to appear. The main symptom of lung abscess is coughing up phlegm. Sputum that is released often contains blood or pus, and smells.
Lung abscesses are treated with antibiotics. Patients are required to take antibiotics for several weeks until the infection subsides. Patients who undergo treatment well have a high cure rate. Conversely, if not handled properly, this disease can cause complications or even death.
Overview of Lung Abscess Radiology
Symptoms
The main symptom of lung abscess is coughing. Coughing that occurs is accompanied by phlegm containing blood or pus. In addition, other symptoms that can appear in patients are:
  • Chest pain
  • Hard to breathe
  • Losing weight
  • Limp
  • High fever
  • Breath smells
  • Sweating (especially at night)
Cause
The main cause of lung abscess is the appearance of infection in the lung tissue due to liquid or food containing bacteria that directly enters the lungs. This event occurs when a person is unconscious due to the influence of alcohol or drugs, especially sedatives.
Besides being caused by foreign fluids that enter the lungs, lung abscesses can be a complication of other diseases, both diseases in the lungs themselves and outside the lungs, namely:
  • There is blockage of the airways in the lungs, due to tumors or enlargement of the glands in the lungs.
  • Bronchiectasis, namely widening, thickening, and damage to the respiratory tract tissue before the lungs (bronchi).
  • Cystis fibrosis, which is a respiratory tract disease that causes mucus in the respiratory tract or phlegm to become thicker. The thicker mucous fluid will block the flow of breath from or to the lungs, so that it can trigger infections that form
  • Peritonitis, which is an infection of the lining of the abdominal cavity (peritoneum).
  • Endocarditis, which is an infection of the inner heart wall.
Risk factors
Alcoholics are a group of people who are most susceptible to lung abscesses, due to reduced awareness and frequent vomiting. This condition causes fluid from the stomach or from outside which contains bacteria easier to enter into the lungs and cause infections and abscesses. Alcoholics also have a weaker immune system so that infections occur more easily. Alcoholics who are currently or recently suffering from pneumonia have a high risk of developing a lung abscess. In addition to alcoholics, several factors that can increase the risk of developing lung abscesses are:
  • Weakened immune system, such as cancer patients and HIV, and taking drugs that reduce endurance.
  • Long loss of consciousness.
  • Being under the influence of drugs or sedatives.
Diagnosis
The doctor will suspect a patient has a lung abscess if there are symptoms, which are strengthened by a physical examination. To ensure a diagnosis, an examiner needs to be done, one of which is a sputum test. Sputum samples taken will be examined in the laboratory to ensure the presence of infection or not, and the type of bacteria that causes the infection.
In addition to sputum tests, the doctor may also ask the patient to undergo a supporting examination in the form of:
  • X-ray The patient's chest is examined using an X-ray beam that will provide visual information if there is an abscess in the lungs.
  • CT scan. CT scans provide better visual results compared to X-ray photos, so that lung abscesses are more easily identified.
  • Ultrasound (USG). The doctor will examine the presence of lung abscesses through the use of ultrasonic waves.
  • The lung doctor will examine the inside of the lungs with the help of a special hose equipped with a camera at the end. In addition to checking the condition of the lungs visually, bronchoscopy can also be done to take samples of lung tissue.

Treatment
The main treatment taken to treat lung abscesses is antibiotics. The doctor will prescribe antibiotics according to the results of the bacterial sensitivity test so that the drugs given are in accordance with the type of bacteria, so that they work effectively. Some types of antibiotics that can be given to people with lung abscess are:
  • Penicillin, Clindamycin, Piperacillin, Amoxicillin-clavulanate, Metronidazole, Ciprofloxacin, Vancomycin, Amikacin, Meropenem, Levofloxacin
The duration of antibiotic treatment that the patient will undergo will vary depending on the severity of the abscess. Treatment for lung abscess is quite long, which can reach 3 weeks to 6 months. In patients with secondary lung abscess it is usually recommended to undergo treatment in a hospital to help treat diseases that trigger abscesses.

In some cases, patients can undergo treatment through surgery to eliminate abscesses. The surgeon will insert a tube into the inside of the lungs, then the pus contained in the abscess is sucked out. Lung tissue that is damaged by abscess is then removed.
To help with the healing process of an abscess, patients will be asked to stop drinking alcohol and not smoking. Patients will also be encouraged to drink more water.

Complications
Complications in cases of lung abscess often occur due to rupture of an abscess. Some of them are:
  • Bronchopleural fistula. This condition can occur if an abscess in the lung ruptures and causes a leak. As a result, air from inside the lungs can flow out of the lungs. This complication can be corrected by surgery.
  • Lung bleeding. Rupture of a lung abscess can be followed by rupture of a blood vessel in the organ. This condition can cause patients to lose blood due to bleeding. If the bleeding occurs badly enough, it can endanger the lives of patients due to blood loss.
  • Spread of infection. A ruptured abscess will cause bacteria to spread from the site of infection to other parts of the body.

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