Lung abscess - Symptoms, causes and treatment

A lung abscess is a bacterial infection of the lungs that causes the appearance of pus. The main symptom of a lung abscess is a cough with phlegm. Sputum that is issued often contains blood or pus, and smells bad.

Lung abscesses are treated with antibiotics. Patients are required to take antibiotics for several weeks until the infection subsides. Patients who are well treated have a high cure rate. On the other hand, if not treated properly, this disease can lead to complications or even death.

Causes of Lung Abscess

The main cause of lung abscess is the emergence of infection in the lung tissue due to liquid or food containing bacteria directly into the lungs. This event occurs when a person is unconscious due to the influence of alcohol or drugs, especially tranquilizers.

In addition to being caused by foreign fluid entering the lungs, lung abscesses can be a complication of other diseases, both inside and outside the lungs, namely:

  • The presence of blockage of the airways in the lungs, due to tumors or enlarged glands in the lungs
  • Pneumonia, specifically pneumonia caused by bacteria
  • Bronchiectasis, namely widening, thickening, and damage to the respiratory tract tissue before the lungs (bronchus)
  • cystic fibrosis, which is a respiratory disease that causes respiratory tract mucus or phlegm to become thicker. The thicker mucus fluid will block the flow of breath from or to the lungs, so that it can trigger an infection that forms phlegm
  • Peritonitis, which is an infection of the lining of the abdominal cavity (peritoneum)
  • Endocarditis, which is an infection of the inner wall of the heart

Lung Abscess Risk Factors

Alcoholics are the group of people who are most susceptible to lung abscess, due to reduced consciousness and frequent vomiting. This condition causes fluid from the stomach or from outside containing bacteria to enter the lungs more easily and cause infection and abscesses.

Alcoholics also have a weaker immune system, making it easier for infections to occur. Alcoholics who are or have recently had pneumonia have a high risk of developing a lung abscess. In addition to alcoholics, some factors that can increase the risk of developing a lung abscess are:

  • Weak immune systems, such as people with cancer and HIV, and taking drugs that lower the body's resistance.
  • Loss of consciousness for a long time.
  • Being under the influence of drugs or sedatives.

Lung Abscess Symptoms

The main symptom of a lung abscess is a cough. Coughing that occurs is accompanied by phlegm that contains blood or pus. In addition, other symptoms that can appear in sufferers are:

  • Chest pain
  • Hard to breathe
  • Losing weight
  • Weak
  • High fever
  • Smelly breath
  • Sweating (especially at night)

Lung Abscess Diagnosis

Doctors will suspect a patient has a lung abscess if there are symptoms, which are confirmed by a physical examination. To confirm the diagnosis, supporting examinations need to be carried out, one of which is a sputum test. Sputum samples taken will be examined in the laboratory to confirm the presence of infection or not, as well as the type of bacteria causing the infection.

In addition to the sputum test, the doctor may also ask the patient to undergo supporting examinations in the form of:

  • X-ray's photo. The patient's chest is examined using X-rays which will provide visual information if there is an abscess in the lung.
  • CT scans. CT scans provide better results visually than X-rays, so lung abscesses are easier to identify.
  • Ultrasound (USG). The doctor will check for the presence of a lung abscess through the use of ultrasonic waves.
  • Bronchoscopy. The lung doctor will examine the inside of the lungs with the help of a special tube equipped with a camera at the end. In addition to visually examining the condition of the lungs, bronchoscopy can also be done to take a sample of lung tissue.

Lung Abscess Treatment

The main treatment for lung abscess is antibiotics. The doctor will prescribe antibiotics according to the results of the bacterial sensitivity test so that the drug given is in accordance with the type of bacteria, so that it works 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 will be undertaken by patients varies, depending on the severity of the abscess. Treatment of lung abscess is relatively long, which can reach 3 weeks to 6 months. In secondary lung abscess patients will usually be recommended to undergo treatment in the hospital to help treat the disease that triggers the abscess.

In some cases, patients can undergo treatment through surgery to remove the abscess. The surgeon will insert a tube into the inside of the lung, then the pus contained in the abscess is sucked out. Lung tissue damaged by the abscess is then removed.

To help the healing process of the abscess, the patient will be asked to stop drinking alcohol and not to smoke. Patients will also be advised to drink more water.

Complications of Lung Abscess

Complications in cases of lung abscess often occur due to rupture of the 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 within the lungs can flow out of the lungs. This complication can be corrected with surgery.
  • Lung bleeding. Rupture of a lung abscess can be followed by a rupture of a blood vessel in that organ. This condition can cause the patient to lose blood due to bleeding. If the bleeding is severe enough, it can endanger the patient's life due to blood loss.
  • Spread iinfection. A ruptured abscess will cause bacteria to spread from the site of infection to other parts of the body.