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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Lung Abscess

What is it?

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 It?

  • 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 (see Periodontitis for more information).
  • A lung tumor may block bronchial passages (see Lung Cancer for more information).
  • Immunocompromised patients, such as those with AIDS or those undergoing treatment for cancer, are prone to lung abscesses.

Prevention

  • Thorough dental hygiene should be pursued.
  • Upper respiratory infections should be treated.

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 to Treat It

  • 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.