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Abscess In The Chest: What To Know

A chest abscess tends to refer to an abscess in the lungs. This also includes abscesses in the muscles of the chest wall, between the lung tissue and the lining of the chest cavity.

An abscess is a painful collection of pus.

Abscesses can occur almost anywhere in the body, for example, the skin or mouth. Treatment typically involves antibiotics and draining them.

Left untreated, chest abscesses can cause serious health conditions.

This article will explain what a chest abscess is, what causes it, and the typical symptoms. It will also look at diagnosis, treatment, and possible complications.

The location of the abscess in the body can determine what symptoms a person might experience.

Some people with a lung abscess will have no symptoms at all. Others may experience:

Abscesses can develop when bacteria, viruses, or foreign objects trigger the body's natural defense mechanism.

When the immune system detects a threat, it sends white blood cells to the affected area. These cells cause inflammation to protect the tissue while it regenerates.

During this process, living and dead white blood cells mix with dead tissue and germs, forming pus. When this collects in the body, it can create a pocket. This pus-filled pocket is an abscess.

Infection is the main cause of lung abscesses. Not all lung infections will lead to a lung abscess. However, some things can make it more likely. Doctors call these risk factors.

Risk factors for developing a lung abscess include the following:

Having a compromised immune system

People who are immunocompromised are more likely to develop a lung abscess following infection than people who are not. That includes:

  • people who are living with HIV or AIDS
  • people have had an organ transplant
  • people who take immunosuppressive medication — for example, to treat an autoimmune condition
  • Diabetes and smoking are also risk factors for chest abscesses too.

    Being at risk of aspiration

    Aspiration can happen when particles of food and fluids enter the lungs rather than the stomach. This can lead to infections and chest abscesses.

    Some factors can increase the risk of experiencing aspiration. These can include:

  • having trouble chewing or swallowing
  • having certain medical conditions — for example, severe dental issues, seizure disorder, muscular dystrophies, and cerebral palsy, among others
  • misusing alcohol
  • To diagnose a lung abscess, doctors will usually recommend a chest X-ray. They may also suggest a computerized tomography (CT) scan. Both scans allow healthcare professionals to look for any changes inside the chest.

    Doctors may also take a sputum (or phlegm) sample, which can help determine the type of lung infection a person has.

    The location of the abscess may determine the treatment approach.

    In most cases, doctors will recommend antibiotics to clear the abscess-causing infection.

    If the abscess is large or does not go away with antibiotics, doctors may recommend draining the abscess, which involves cutting into the abscess to let the pus out. This will typically involve surgery.

    Another way to drain the abscess is through endoscopy. This procedure uses a long flexible tube with a camera and a cutting tool at its end.

    If doctors do not diagnose and treat lung abscesses, it can lead to complications, such as:

  • abscess bursting, which can lead to pus leaking into the lungs
  • scarring of the lungs
  • trapped lung, meaning the lung is unable to expand for breathing
  • respiratory failure
  • Complications such as trapped lung and respiratory failure can be life threatening.

    Doctors typically classify lung abscesses as primary or secondary. Primary lung abscesses occur in people who otherwise have no other lung problems. Secondary lung abscesses occur in people who have underlying lung problems.

    Doctors cure around 90% of primary lung abscesses. Whereas secondary lung abscesses are more likely to lead to complications. Key factors to improving the outlook are early diagnosis and treatment.

    Abscesses can form anywhere in the body. They are pockets of pus that can develop as the body fights an infection. A chest abscess usually refers to an abscess in the lungs.

    Diagnosis will usually involve a mix of scans and physical exams, as well as sputum or blood tests. Doctors will usually recommend antibiotics to clear the infection. In some cases of lung abscess, doctors typically drain it.

    Most cases of chest abscesses can be successfully treated, though they may sometimes reappear.


    What Is Empyema?

    Empyema is a condition where you have pus between your lung and the membrane surrounding it. It's caused by an infection and can cause symptoms such as pain and shortness of breath.‌

    You're more likely to develop empyema if you have conditions like chest trauma or pneumonia. Read on to learn more about empyema, what it is, what causes it, and how it can be treated.

    Empyema occurs when pus starts building up in the cavity that's between your lung and the pleural space, which is the membrane surrounding your lung.

    This condition is the result of an infection that spreads to the lung. As the pus builds up in the pleural space, you will experience a lot of pressure on your lungs, causing pain and shortness of breath.

    You're more likely to have empyema if you have or recently had conditions such as:

    Other risk factors include:

  • Intravenous drug abuse
  • Gastric acid reflex
  • Alcohol abuse
  • Diabetes mellitus
  • Immunosuppression, which is when your immune system isn't working the way it should. This can be caused by diseases as well as medications.
  • Generally, empyema won't result in permanent damage to your lungs. But it can be fatal if not treated, particularly if you developed empyema through a fungal infection. ‌

    In general, 20% to 30% of patients with empyema will require surgery or will pass away in the first year after getting empyema.

    If you have empyema, you may experience the following symptoms:

  • Feeling unwell in general
  • Feeling uneasy
  • Weight loss
  • Chest pain that gets worse if you inhale deeply
  • Chills and fever
  • Dry cough
  • The symptoms of empyema are similar to those of pneumonia, but those with empyema may have these symptoms for a longer time.

    Your doctor will use the following methods to see if you have empyema:

  • CT scans
  • X-rays
  • Thoracentesis, which is when your doctor removes air or fluid around the lungs using a needle to look at the pus in your pleural space
  • Pleural fluid Gram stain and culture, which will help your doctor to figure out what kind of fungal or bacterial infections are causing your empyema
  • Doctors may also use the RAPID system to determine how to treat your empyema. The RAPID system looks at the following:

  • Renal or kidney function (0-2 points. The worse the kidney function, the higher the number)
  • Pus, specifically how much of it there is and how white it is (or albescence) (1 point if not white)
  • Infection, whether you got it at the hospital or outside of it  (1 point if you got the infection in the hospital where there are typically more dangerous bacteria and fungus)
  • Diet, which specifically looks at your albumin levels. Albumin is a protein your liver creates. Higher levels of albumin indicate that your body is fighting against more inflammation (1 point if albumin is low)
  • Age (0-2 points) the older you are the higher the number)
  • Low-risk patients have zero to two points, while medium-risk patients have three to four points. Finally, high-risk patients have five to seven points. The higher your score, the longer your hospital stay may be.

    You can get empyema through bacterial or fungal infections.‌

    Bacterial infections. You can get empyema by being exposed to various types of bacteria, such as Streptococcus aureus and Pseudomonas, which are particularly common if you got an infection at the hospital. Getting empyema through Streptococcus aureus is particularly common if you've had surgery or trauma.

    The bacteria cause inflammation, which causes more fluid to be produced in the pleural cavity. As time goes on, bacteria and other microorganisms create an empyema by taking over the fluid. The fluid is made of the following:

  • Dead cells
  • Proteins
  • Neutrophils, which are a type of immune cell that's sent to infection sites throughout the body to destroy microorganisms causing the infection
  • After the infection goes away, your lung tissue may stiffen and become hard in a process known as fibrosis. This will make it more difficult for your lungs to work properly. That's why empyema needs to be diagnosed and treated as soon as possible.‌

    Fungal infections. Fungal empyema is rare and associated with higher mortality. The most common type of fungus associated with this kind of infection is the Candida species.

    Like bacteria, fungal infections cause fluid to be produced in the pleural cavity.

    The goal of treating empyema is to remove the pus from the lung and cure the infection.

    Your doctor will prescribe antibiotics to get rid of the infection and use a chest tube to drain the pus.

    If you got your bacterial infection outside the hospital, you may be prescribed cephalosporin combined with metronidazole or ampicillin with a beta-lactamase inhibitor. The beta-lactamase inhibitor boosts the effectiveness of the antibiotics by interrupting bacterial cell wall formation. This makes it easier for the antibiotics to wipe out the bacteria.

    If needed, a surgeon will perform decortication, or removal of the lung lining, if your lung isn't expanding properly.‌

    In any case, make sure to talk to your doctor about your medical history and current health to determine the best way to treat your empyema. Your doctor will determine what might work best for you given your circumstances.


    Medications And Their Potential To Cause Increase 'Lung Abscess'

    Last Updated on Nov 16, 2023

    This page lists all known medications that could potentially lead to 'Lung abscess' as a side effect. It's important to note that mild side effects are quite common with medications. The medication(s) listed here may be used individually or as part of a broader combination therapy. The information provided is intended as a helpful resource; however, it should not replace professional medical advice. If you're concerned about 'Lung abscess', it is advisable to consult a healthcare professional. In addition to 'Lung abscess', there may be other similar symptoms or signs that better match your side effect. These have also been listed below for your convenience. If you find a symptom that more closely resembles your experience, you can use this information to identify potential medications that might be the cause. Find drugs that can cause other symptoms like 'Lung abscess' References
  • https://www.Fda.Gov/drugs/information-consumers-and-patients-drugs/finding-and-learning-about-side-effects-adverse-reactions
  • https://nctr-crs.Fda.Gov/fdalabel/ui/search
  • https://dailymed.Nlm.Nih.Gov/dailymed/
  • Last Updated on Nov 16, 2023

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