A lung abscess is a bacterial infection that occurs in the lung tissue. The infection causes tissue to die, and pus collects in that space. A lung abscess can be challenging to treat, and it can be life-threatening.
Lung abscesses can be classified as primary or secondary. They develop from different strains of bacteria and have different causes.
Primary abscesses often develop from lung infections such as pneumonia. Secondary abscesses often develop because of other issues, such as obstructions, abnormalities of the lungs, inhaling foreign materials, or other infections.
Inhaling foreign matter while sedated or unconscious, either through intoxication or anesthesia, can cause a lung abscess. The inhaled material is often damaging to lung tissue. It is also typically filled with bacteria, either from an infection or from normal bacteria found in the mouth, respiratory tract, or stomach. People with alcoholism are strongly predisposed to developing lung abscesses because they often experience bouts of vomiting and altered levels of consciousness. These conditions increase the likelihood of inhaling stomach contents and bacteria into the lungs, which can cause an infection. An additional risk factor is that people with alcoholism often have weakened immune systems due to poor overall health and nutrition.
The most noticeable symptom of a lung abscess is a productive cough. The contents that are coughed up may be bloody or pus-like, with a foul odor.
Other symptoms include:
- bad breath
- fever of 101°F or higher
- chest pain
- shortness of breath
- sweating or night sweats
- weight loss
Who’s at risk?
People who have alcoholism or have recently been ill (especially with pneumonia) have a high risk of developing a lung abscess. Other people with weakened immune systems who have conditions such as cancer, HIV, organ transplants, and autoimmune disease are also at risk. The risk is high for people who have recently been under anesthesia, sedation, or unconsciousness from injury as well.
To diagnose a lung abscess, your doctor will first look at your health history. Your doctor will review recent operations where anesthesia was used. If an abscess is suspected, your doctor will analyze the sputum or pus. Your doctor might also use imaging tools, such as an X-ray or CT scan, to look at where the infection is in the lungs and rule out other conditions, such as cancer or emphysema. For more serious infections, your doctor might perform a procedure to take a sample from the abscess.
If your doctor thinks foreign material has entered the lungs, he or she might insert an instrument called a bronchoscope into the windpipe to locate it.
The primary treatment for a lung abscess is antibiotics. Long-term use of medication might be necessary, for up to six months. In addition, your doctor might suggest at-home treatments including deep breathing and mucus and sputum clearing techniques known as chest physiotherapy treatments (CPT). Lifestyle changes such as not smoking and drinking more fluids may also be suggested.
In some cases, more invasive procedures or surgery may be necessary. A tube can be inserted into the lungs to drain pus from the abscess or a surgical procedure may be required to remove infected or damaged lung tissue.
In rare cases, a lung abscess can rupture. This is a serious medical concern. Another potential complication is infection spreading to other parts of the body.
Chronic abscess or an abscess left untreated could lead to:
- chronic lung disease
- weight loss
- other lung issues
It is also possible for the abscess to rupture, which can cause significant bleeding into the lungs, a collapsed lung, and further spread of the infection. This condition can be fatal if left untreated.
A lung abscess treated with antibiotics can heal without complications. People with suppressed immune systems, underlying health conditions, or without access to healthcare are more susceptible to adverse outcomes.