Both of these diseases are very similar expression pattern and pathogenetic. Lack of timely diagnosis and treatment of lung abscess is associated with a poor clinical outcome, most of all - the patient's death.
Causes of
What it is? The main cause of lung abscess is a situation in which the lung tissue loses oxygen. patients with focal pneumonia They are at risk. Pyo-necrotic processes in pulmonary tissues can arise due to contact with the cavity upper airway foreign bodies, vomitus. Foreign objects getting into the lungs, bronchi completely closed, preventing the flow of air to it in proper quantity. It is in this space ulcers develop rapidly.
Lung abscess may be a consequence of the transferred bronchiectasis, reduced immunity. These reasons are quite essential for the development of the disease and the occurrence of subsequent relapses. Purulent inflammation can occur when the bloodstream enter certain microbes from existing foci of inflammation.
lung abscess may be caused by painful microflora in people suffering from gum disease. Pathogenic bacteria from the oral cavity fall into the airway, which provokes a transient infection and inflammation of the lung tissue. Subsequently, without proper examination and doctor's medication necrosis progresses and leads to the formation of an abscess.
The symptoms of lung abscess
Lung abscess in the acute form of statistics often affects the stronger sex aged 20-50 years. The right lung, due to its large parameters, often inflamed. In this case, abscesses occur in different parts of the body, while the upper lobe of the lung susceptible to the disease more.
Symptoms elicited in one period:
- The pain from the affected lung, worse when taking a deep breath and coughing.
- Dry cough.
- Increased respiratory rate 30 breaths per minute or more.
- Increasing the temperature to 39 ° C and above.
- Headache.
- The sharp decrease in appetite.
- Nausea.
- General weakness.
Symptoms, appearing in the 2nd period:
- Moist cough.
- Sputum by coughing, "mouth full".
- Offensive odor separated (if the infectious agent has acted putrefactive microflora).
- From 1000 mL of purulent or more per day (more recessed process, the higher the amount of discharge).
- Decrease in body temperature and general toxicity.
Depending on the progress of the disease and relapse opportunities can be divided abscess on chronic and acute.
the disease
In the case where the pus burst into the bronchi, but the infectious process was stopped, then the person begins the recovery phase. If the patient is not sought medical help, his condition is much worse and complications occur abscess. They are expressed in the form:
- painful shock;
- sepsis;
- empyema;
- inflammatory and necrotic focus;
- pneumoempyema;
- pulmonary hemorrhage.
As a rule, pulmonary hemorrhage is the most common complication of lung abscess.
Chronic lung abscess
It occurs when the acute process is not completed within 2 months. This is facilitated by features of the abscess - large size (more than 6 cm in diameter), poor drainage of sputum, to localize the seat in the lower part of the lung; weakening of the body - a violation of the immune system, chronic diseases and so on; Errors in the treatment of acute abscess - incorrectly selected antibiotic or too small dose begun late or insufficient treatment.
When the patient suffers chronic abscess dyspnea, cough with sputum stinking, and deterioration of interleaving normalization condition, fatigue, weakness, exhaustion, sweating. Gradually, due to lack of oxygen and constant intoxication, developed bronchiectasis, pulmonary fibrosis, emphysema, respiratory failure and other complications. Changing the appearance of the patient - the thorax increases in size, skin pale, cyanotic, end phalanges thicken, take the form of "drumsticks."
Diagnostics
Diagnosis is based on the results of the patient survey. There are several methods of examination of the patient. One is the portion of the patient palpation. When this is detected soreness.
- In carrying out X-ray and CT can see the formation of the inflammatory infiltrate, which is characterized by a homogeneous dimming. If the abscess bursts into the region of the bronchial tree, the purulent sputum is found in large quantities, which has an unpleasant smell, sometimes there is an admixture of blood.
- Most often relieved the patient's condition is observed in breaking the abscess, the temperature begins to drop. At the same time on the X-ray can be seen that the light produced enlightenment. Of great importance is the patient, the development of the disease, as well as data that has been obtained through laboratory, functional, immunological and radiological studies.
- Chronic lung abscess often has similar symptoms of gangrene of the lungs, therefore, to distinguish between them can be difficult. Therefore, most often diagnosed after the X-ray examination. Of great importance is the implementation of CT, which allows you to determine the degree of damage to the lung tissue. In addition, in cases of suspected abdominal form of cancer, it is necessary to pass needle biopsy.
right lung abscess often resembles tuberculosis.
In this case, to clarify the need to hand over a sputum on crop sticks and immunological examination. There are similar symptoms to emphysema and pneumothorax, lung cysts fester.
How to treat a lung abscess?
If there lung abscess initiation of treatment depends on its cause, nature of the flow (acute, chronic), microorganism-pathogen and its sensitivity to antibiotics, concomitant pulmonary diseases.
- Standard treatment is initiated with penicillin purpose of 500000-1000000 U better intravenously 6-8 times per day (up to 8000000-10000000 units per day). If no effect after determining the sensitivity to antibiotics of bacterial flora prescribe the most effective drug. The therapeutic effect can give morfotsiklin, erythromycin, methicillin, chloramphenicol, sigmamitsin, oleadomitsin and other antibiotics.
- Bronchoscopy is very effective suction pus abscess and subsequent introduction into the cavity of the antibiotic chosen according antibiotikogramme. In this case, penicillin is administered at 300 000-800 000 IU every 2-3 days (total of 15 injections), streptomycin - at 500,000 units.
- Often there is a highly effective combination of antibiotics with sulfonamides (sulfadimetoksin to 1 g per day, or norsulfazol sulfadimezin - 1 g 6-8 times a day). Appoint expectorant. Of great importance is providing drainage, which the patient (depending on the location of the abscess) confer certain position.
- When multiple bilateral or centrally located abscesses, as well as abscesses, bleeding complications, along with other treatments used infusion of antibiotics pulmonary artery. As a basis for the preparation of mixtures of drugs commonly used sodium chloride solution (1 L) in wherein the daily dose is dissolved one of antibiotics, 5000-10000 IU heparin, 1000 mg vitamin C, 25 to 30 mg hydrocortisone. The solution is introduced dropwise continuously at a rate of 12-15 drops per minute.
- Requires restorative therapy: repeated blood transfusions (100-200 mL every 4-5 days), vitamins A, C, G and group B, high-calorie diet (3000-4000 calories) with a high protein content.
If for 1 1/2 - 2 months of conservative therapy is ineffective, patients are referred for surgery.
surgical treatment methods
Surgical treatment of lung abscess carried out by several methods:
- By abscess drainage (thoracentesis, thoracotomy and pneumonopathy).
- With the help of easy resection.
It is aimed at the most rapid and complete removal of pus and dead areas of lung tissue.
prevention
Specific prevention of lung abscess there. Nonspecific prevention is early treatment of pneumonia and bronchitis, readjustment of foci of chronic infection and prevention of airway aspiration.
It is also an important aspect in reducing the incidence of a struggle with alcoholism.
