ABSCESS LUNG

About Your Diagnosis

Lung abscess refers to a cavity in your lung filled with pus. Predisposing factors are stroke, excessive sleepiness, alcoholism, and poor oral hygiene. The diagnosis may be suspected from the history, although a chest x-ray and/or computed tomography (CT) scan of the chest, in addition to sputum and blood culture results are helpful. Most cases are not contagious. Successful treatment depends on the underlying cause and coexisting medical problems.

Productive cough is not always present but may be foul smelling and associated with a spiking fever, chills, and weight loss. Careful examination of the oral cavity including the teeth, the swallowing mechanism, and the heart (listening for heart murmurs) is also very useful. Complications from a lung abscess may include rupture of the abscess into the pleural space, respiratory failure and septic shock, increased shortness of breath, and chest or upper abdominal pain.

The best treatment is a prolonged course of appropriate antibiotic therapy, initially intravenously and then orally. Postural drainage, careful monitoring for any complicating events, and occasionally surgery is necessary. With prompt and adequate treatment, most lung abscesses collapse and heal over 4 to 6 weeks.

• It is very important to complete the full course of antibiotic therapy as outlined by your physician. Prompt notification for any relapse in terms of fever, hemoptysis (coughing up blood), adverse medication effects, or help with smoking cessation are also important. In individuals who have problems with recurrent aspiration, changes in the diet and consideration for feeding tube placement may be necessary. Regular performance of postural drainage especially over the affected lung segment is usually beneficial.

• Don't stop your antibiotics unless advised by your doctor. Do not expect a quick recovery or complete normalization of the chest x-ray within 3 to 4 weeks.

• Notify your doctor immediately if you develop a sudden worsening in chest pain associated with shortness of breath and copious sputum production or hemoptysis. See your doctor if your symptoms persist despite completing your course of antibiotics, or if you experience significant weight loss or tiredness.

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