What is Lung Abscess

Lung abscess is a space (cavity) that forms inside the lung and fills with dead tissue and pus. It results from an infection that gets into the lung. A lung abscess can cause symptoms such as fatigue, fever, and a cough that brings up fluid from the lungs (sputum).

A lung abscess usually occurs in just one lung. A person who has a lung abscess may need treatment for several weeks. A lung abscess that lasts longer than 6 weeks is considered chronic.

What are the causes?

This condition is usually caused by bacteria. In most cases, it is caused by more than one type of bacteria. Bacteria can get into the lungs by:

• Saliva, vomit, or liquid that is contaminated with bacteria being inhaled (aspirated) into the lungs.
• Spreading from a blood infection (sepsis). This can sometimes cause abscesses in both lungs.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Having a medical condition that weakens the body’s defense system (immune system).
• Having a dental, gum, or sinus infection.
• Having poor oral hygiene.
• Aspiration. You may be at risk for aspiration if you:
  • Have a nervous system condition that interferes with coughing or swallowing.
  • Have a tube in your airway for breathing (tracheal tube or endotracheal tube).
  • Are very drowsy or unconscious because of a medicine (sedative) or drinking too much alcohol.
• Chronic lung conditions, such as chronic obstructive pulmonary disease (COPD), cancer, or cystic fibrosis.
• Aging.

What are the signs or symptoms?

Early symptoms of this condition are similar to the symptoms of other lung infections, such as pneumonia. These include:

• Fever.
• Chills.
• Night sweats.
• A cough that brings up sputum.
• Shortness of breath.
• Fatigue.

Symptoms of a chronic lung abscess also include:

• Weight loss.
• Chest pain.
• Coughing up sputum that smells bad, is discolored, or is tinged with blood.

How is this diagnosed?

This condition may be diagnosed based on:

• A physical exam and medical history. During the exam, your health care provider will use a stethoscope to listen to your lungs and check for abnormal sounds in the abscess area.
• Medical tests, such as:
  • Chest X-rays to check for a cavity that is filled with fluid and air.
  • Blood tests to look for signs of infection.
  • Blood and sputum cultures to test for bacteria.
  • Blood tests to measure the oxygen level in your blood (arterial blood gases, or ABG).
  • A procedure to examine your lung and take samples of fluid or tissue using an endoscopic tube (bronchoscope).
  • Imaging studies of your lung, such as a CT scan or ultrasound.

How is this treated?

This condition may be treated with:

• Antibiotic medicines. This is usually the first treatment.
  • First, these medicines may be given directly into a vein through an IV. Treatment with antibiotics may start with an antibiotic that is known to work against many different kinds of bacteria (broad-spectrum antibiotic).
  • Second, your IV antibiotics may be changed if tests identify the germs and show that another type of antibiotic may be more effective. You may have to continue antibiotics in the hospital or at home for several weeks.
• Antifungal medicines. These may be given if a fungus is present in the abscess.
• Supportive care, such as:
  • IV fluids and nutrition.
  • Oxygen therapy.
• A procedure to drain the abscess using a bronchoscope or drainage tube.
• Open lung surgery to drain the abscess and remove dead lung tissue. This is rare.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Take your antibiotic medicine as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Lifestyle

• Do not abuse drugs or alcohol.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Brush your teeth every morning and night with fluoride toothpaste and floss once a day. See a dentist regularly.
• Eat a healthy diet. Ask your health care provider what foods are right for you.
• Rest at home until your health care provider says that you can return to your normal activities.

General instructions

• Drink enough fluids to keep your urine pale yellow.
• Do breathing exercises as told by your health care provider. This may include:
  • Changing positions to help drain the infected area (postural drainage).
  • Using a breathing device (incentive spirometer) to help you take very deep breaths.
• Keep all follow-up visits as told by your health care provider. This is important.

Get help right away if you:

• Have a fever.
• Have a cough that is not going away or is getting worse.
• Cough up blood.
• Have shortness of breath that is not going away or is getting worse.
• Have chest pain.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• A lung abscess is a cavity in the lung that fills with dead tissue and pus due to an infection.
• Antibiotic therapy is the main treatment for a lung abscess. Do not stop taking the antibiotic even if you start to feel better.
• As you heal, your health care provider may recommend special lung exercises to help improve your breathing and encourage drainage of the infection from your lung.
• Get help right away if you develop a fever or have a cough that is not going away or is getting worse.