Our Summary

This research paper discusses a type of lung infection known as a lung abscess, which is a pus-filled cavity in the lung. This condition can be seen on chest X-rays and CT scans. There are two types of lung abscesses: primary and secondary. Primary lung abscesses typically occur in people who are prone to inhaling (aspirating) their food or drink, or in otherwise healthy people. Secondary lung abscesses often develop in people with lung tumors, immune system disorders, or in those who have undergone organ transplantation.

The bacteria found in these abscesses usually come from the mouth or throat. Common bacteria include anaerobic bacteria, streptococci, Staphylococcus aureus, Streptococcus pyogenes, and Actinomyces, especially in people with alcoholism and poor oral hygiene.

To diagnose a lung abscess, doctors use chest radiography and CT scans. The main treatment for a lung abscess is antibiotics, which are chosen based on the type of bacteria causing the abscess. Primary abscesses are usually successfully treated with antibiotics and have a death rate of less than 10%. Secondary abscesses, despite appropriate antibiotics, have a poor prognosis with a death rate as high as 75%. Factors that contribute to a poor prognosis include old age, severe other illnesses, weak immune system, blocked airways, and tumors.

In rare cases (10%), surgery is needed when the abscess doesn’t improve with antibiotics. Surgery is successful in up to 90% of cases, but the death rate after surgery can range from 0% to 33%. Other treatments such as endoscopic or percutaneous drainage (removing fluid through a tube) are successful in 73% to 100% of cases, with a death rate of 0% to 9%.

FAQs

  1. What is a lung abscess and how is it diagnosed?
  2. What are the main treatments for a lung abscess and how effective are they?
  3. What factors contribute to a poor prognosis in cases of secondary lung abscesses?

Doctor’s Tip

After lung surgery, it is important to follow your doctor’s instructions for recovery. This may include taking pain medication as prescribed, doing breathing exercises to prevent pneumonia, avoiding heavy lifting, and attending follow-up appointments to monitor your progress. It is also important to maintain good oral hygiene to prevent future lung infections. If you experience any new or worsening symptoms, such as chest pain, shortness of breath, or fever, be sure to contact your doctor right away.

Suitable For

Patients who are typically recommended for lung surgery in cases of lung abscess include those who have not responded to antibiotic treatment, have a large abscess that is causing severe symptoms, or have complications such as a collapsed lung or an abscess that is pressing on nearby structures. Surgery may also be recommended for patients who are at a high risk of complications due to their age, underlying health conditions, or weakened immune system.

Overall, the decision to recommend lung surgery for a patient with a lung abscess is based on the individual’s specific circumstances and the severity of their condition. It is important for patients to work closely with their healthcare team to determine the most appropriate treatment plan for their unique situation.

Timeline

Before lung surgery, a patient will typically undergo a series of tests and evaluations to determine the best course of treatment. This may include chest X-rays, CT scans, blood tests, and possibly a bronchoscopy to examine the inside of the lungs. The patient will also meet with their surgical team to discuss the procedure, potential risks, and recovery process.

After lung surgery, the patient will be closely monitored in the hospital for any complications such as infection, bleeding, or difficulty breathing. Pain management will be a priority, and the patient will be encouraged to move around and perform breathing exercises to prevent complications such as pneumonia. Physical therapy may be recommended to help regain strength and lung function.

As the patient recovers, they will have follow-up appointments with their surgical team to monitor their progress and address any concerns. It may take several weeks to months for the patient to fully recover and return to normal activities. Pulmonary rehabilitation may be recommended to help improve lung function and overall quality of life. Ongoing monitoring and follow-up care will be important to ensure the best possible outcome for the patient.

What to Ask Your Doctor

  1. What type of lung abscess do I have (primary or secondary)?
  2. What type of bacteria is causing my lung abscess?
  3. How will you determine the best antibiotic treatment for my lung abscess?
  4. What are the potential side effects of the antibiotics I will be taking?
  5. What are the chances that my lung abscess will require surgery?
  6. What are the risks and benefits of surgery for my lung abscess?
  7. How long is the recovery process after surgery for a lung abscess?
  8. Are there any alternative treatments to surgery for my lung abscess?
  9. How will you monitor my progress during treatment for my lung abscess?
  10. What lifestyle changes can I make to prevent future lung abscesses?

Reference

Authors: Marra A, Hillejan L, Ukena D. Journal: Zentralbl Chir. 2015 Oct;140 Suppl 1:S47-53. doi: 10.1055/s-0035-1557883. Epub 2015 Sep 9. PMID: 26351764