LUNG ABSCESS

LUNG ABSCESS

DEFINITION:-

It is defined as collection of pus or Purulent material in a localized area of lung.
It makes cavity formed by necrosis of lung tissue.


CAUSES/AETIOLOGY:-

  1. Bacterial infection:
    • Gram +ve:
      • Strep. Pneumonia
      • Strep. aurious.
    • Gram -ve:
      • H. influenza
      • Pseudomonas
      • Anaerobic bacteria
  2. Viral infection:
    • Influenza virus
    • Para influenza virus
    • Adenovirus
  3. Fungus infection:
    • Candidiasis
    • Histoplasmosis
  4. Mycoplasma and protozoa in AIDS.

RISK FACTORS:-

Aspiration of material into lung,
Risk factor for aspiration are:

  • Alcoholism
  • Seizure disorders
  • Drug overdose
  • General anaesthesia
  • Cerebrovascular accidents
  • Infectious agents
  • S.areus
  • Anaerobic bacilli.

OTHER CAUSES:-

  • Pulmonary embolism
  • Malignant growth
  • T.B.

TYPES:-

It is of two types:
  1. Extrinsic (Allergic): Commonly occur in cildhood.
  2. Intrinsic (Non-allergic): Commonly occur about 35 years of age.

CLINICAL MANIFESTATION (SIGNS/SYMPTOMS):-

  • Sweating
  • Increase pulse rate
  • Cough
  • Purulent sputum (including food smelling)
  • Haemoptysis
  • Fever
  • Chills
  • Pleuritic pain
  • Dyspnoea
  • Weight loss
  • Clubbing

DIAGNOSTIC EVALUATION:-

  • History collection
  • Chest X-ray
  • Chest Auscultation
  • Physical examination
  • Bronchoscopy
  • Sputum examination.

COMPLICATIONS:-

  • Empyema
  • Bronchopleural fistula.

MEDICAL MANAGEMENT:-

  • Antimicrobial therapy (6-8 weeks)
  • Chest Physiotherapy
  • Postural drainages should be given
  • Bronchodilators (for dilate bronchi)
  • Mucolytics (to liquify the secretion)

    • Note:Mostly penicillin with metronidazole are used.


SURGICAL MANAGEMENT:-

If the medical management is unsuccessful then there is surgical management

  • Segmentectomy (Surgical removal of segment
  • Lobectomy (Surgical removal of lobe)

NURSING MANAGEMENT:-

  • Provide frequent mouth care.
  • Provide good nutrition and adequate fluid intake.
  • Provide adequate comfort and rest.
  • Monitor chest tube functioning
  • Encourage rest and limitation of physical activity durinmg febrile periods.
  • Postural drainage may be recommended. Positions to be assumed depend on location of abscess.
  • Carry out coughing and breathing exercise.

NURSING DIAGNOSIS:-

  • Impaired gas exchange related to decreased ventilation and mucous plugs.
  • Anxiety related to breathing difficulty
  • Altered nutrition less than body requirements related to reduced appetite, dyspnoea and decrease energy level.
  • Sleep pattern disturbance related to dyspnoea and external stimuli
  • Airway clearance, Ineffective related to coughing and mucous production.

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