Lung Lesions

An Informative Guide About Lung Lesions

A lung abscess is an infection that is characterized by pus-filled lung lesions.  In the majority of individuals, they are almost always a result of aspiration of oral secretions that are associated with poor oral hygiene or gingivitis.  Typically, the individual has suffered altered consciousness because of alcohol intoxication, anesthesia, illicit drugs or sedatives.  Older people who have difficulty handling their oral secretions are at risk as are individuals with neurological diseases as well.

A less common cause of lung lesions is pneumonia which often develops out of a hematogenous seedling.  When this occurs, there are traditionally multiple abscesses rather that just one isolated one.

Pathogens that are usually responsible for these abscesses when they are due to aspiration are both aerobic and anaerobic organisms, most commonly staphylococci and streptococci.  Occasionally, cases can be due to bacteria that is gram-negative as well or tuberculosis in developing countries.

Other Causes

Induction of such pathogens into your lungs initially causes inflammation.  This then leads to tissue necrosis which results in abscess formation.  Generally, the abscess will rupture into a bronchus, expectorating its contents and leaving a fluid and air filled cavity.  In nearly one-third of all cases, indirect or direct extension into the pleural cavity will result in empyema.

However, lung lesions are not always a result of infection.  Other noninfectious causes also include lung cancer, pulmonary embolism, lung infarction, sarcoidosis, bronchiectasis, pulmonary sequestration and Wegener's granulomatosis.

Symptoms And Signs

Symptoms of lung lesions that are due to either aerobic or anaerobic bacteria include chronic cough, sweats, weight loss and fever.  Severe prostration may also occur.  In many cases the sputum may be blood-streaked or purulent and smell and taste foul.  Symptoms are often mistaken for bacterial pneumonia.

Signs of multiple lung abscesses may include decreased breathing sound, dangerous fever, egophony and even crackles over the area that is affected.  Most patients have a history of predisposing aspiration, a condition of impaired consciousness or signs of periodontal disease.

Diagnosis

Lung lesions are often suspected based on the patient's history and then the condition is confirmed with the chest X-ray.  The pattern portrayed in the X-ray will show the difference of pulmonary masses from an abscess.  A CT is not routinely performed unless necessary but it is useful if the X-ray happens to suggest an underlying pulmonary mass that is obstructing lung drainage.

 

Additionally, bronchial carcinoma will often lead to an obstruction that can cause abscess formation as well as pneumonia.  This should always be considered in smokers and individuals who have n fever and unexplained cavitary lesions.

Treatment

Although lung lesions do sound quite frightening, when they are caught early on, treatment is done with either oral or intravenous antibiotics.  If there is no positive response to the antibiotics in a designated amount of time or if empyema is present, drainage or surgery is necessary.

Common practice typically is to continue to treat the chest until a new X-ray shows no sign of abscess which can take six weeks or longer.  As a rule, the larger the abscess is, the longer it will take to treat.

Most experts do not recommend postural drainage or chest physical therapy because they can cause infection spillage into other bronchi.  If the individual is paralyzed or weak or has respiratory failure, suctioning and tracheostomy may be necessary and any empyema must be drained.  Surgical drainage in patients with lung lesions is usually only required about 10 percent of the time.