Pus in the lungs
What is pus in the lungs?
If there is pus in the lungs, there can be a number of reasons.
With bronchitis or pneumonia, pus can develop in the lungs, which can be coughed up in the form of yellowish sputum. It is also possible that pus develops as part of a necrotic form of pneumonia and collects in an encapsulated cavity in the lung tissue in the form of a lung abscess.
Causes- What causes pus in the lungs?
Pus, also known medically as pus, is a biological breakdown product. Most pus formation is caused by a bacterial infection.
It is caused by the destruction of white blood cells (leukocytes), which play an important role in the immune system, and autolysis (melting of tissue). Leukocytes play an important role in the human immune system in that they can differentiate the body's own and foreign structures, if necessary form antibodies, or they can take up (phagocytize) foreign structures. This also initiates a more specific immune response in the body.
Depending on the situation, the number of white blood cells may be increased or decreased. Because of this important task, the number of leukocytes is an important indicator of the presence of inflammation or infection. Autolysis is the melting down of tissue, i.e. the destruction of cells that have either already died or are no longer needed by the body. Because of this way of formation, pus consists mainly of proteins and so-called cell waste.
In addition to the already mentioned inflammatory diseases of the lungs and airways such as bronchitis, pneumonia and also the lung abscess, other clinical pictures can be the cause of pus in the lungs. It is also possible that a lung abscess could develop without the presence of pneumonia.
Furthermore, accumulations of pus in the lungs often occur in patients with bronchiectasis in these irreversible sacs of the large bronchi. Pus can also accumulate in the existing cavity between the lungs and chest (so-called pleural space) - this is then referred to as pleural empyema and although it is not located directly in the lungs, it can also lead to lung-associated and generally serious symptoms.
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The diagnosis of “pus in the lungs” is usually based on a combination of a detailed medical history and a general physical examination, including listening to and tapping the lungs.
Imaging in the sense of ultrasound examinations, chest x-rays or computed tomography (CT) with determination of the configuration, size and location of the corresponding area are also made if a pus accumulation in the lungs is suspected. If necessary, bronchoscopy (reflection of the lungs) can also be performed.
Once there is pus in the lungs, affected patients often suffer from an additional cough and fever. The cough is usually productive, which means that an often viscous, yellowish to greenish secretion is coughed up. In addition, patients often complain of general symptoms such as general exhaustion, headaches and / or body aches. In addition to this strong feeling of illness, affected patients often complain of a feeling of shortness of breath and an increased breathing rate.
If the lung membrane, the so-called pleura, is also affected by the infection, there is also pain when breathing. In older patients in particular, however, it is quite possible that they suffer less from the symptoms mentioned above, but are rather clouded in consciousness or appear disoriented or confused. This is because the immune system "ages" and a physical immune response decreases or becomes less specific with age.
As well as cough, possibly with sputum, headache and aching limbs, fever is often one of the symptoms associated with pus in the lungs.
When the body temperature rises (one speaks of fever from 38 ° C) it is a defense mechanism of the body against pathogens. If the cause is unclear, or if the symptoms do not improve for a few days despite therapy, the fever does not decrease or even increases again, a doctor should definitely be consulted again.
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Often times, with the presence of pus in the lungs, patients feel an urge to cough. Often mucus, which is also known as sputum, is coughed up.
An inflammation in the airways produces mucus there. If possible, the mucus should be coughed up - even if the cough is sometimes painful. During the day, the mucus can be liquefied through fluid intake and expectorant and mobilized with the help of inhalation or certain breathing exercises to make it easier to cough up.
The pus can also be encapsulated in the form of an abscess, which makes it impossible to cough up. If the urge to cough reduces the quality of sleep too much, it is also possible to take cough suppressants at night.
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Therapy for pus in the lungs has several approaches, often used simultaneously, and depends very much on the individual situation and the course of the disease.
It includes approaches to positively influence the healing process with and without medication, as well as targeted and efficient antibiotic therapy. Initially, in most cases, a broad spectrum of pathogens is covered with antibiotics and the therapy is continued in a more targeted manner as soon as the causative pathogen can be identified with the help of laboratory diagnostics. Depending on factors such as age, general state of health and consciousness and the antibiotic chosen, inpatient admission and treatment may also be necessary, since many drugs can only be administered directly into the vein in hospital.
Patients are also encouraged to take physical care, take sufficient fluids in the form of water or unsweetened tea, may be given oxygen through a nasal cannula and are prescribed medication to lower fever and dissolve mucus. Depending on the individual initial and general situation, breathing training or a wet inhalation to dissolve mucus may also be used.
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Which antibiotic should be used for pus in the lungs must always be carefully weighed and decided by the doctor.
Antibiotics from the aminopenicillin class are often used. If necessary, these must be combined with another group of drugs, the so-called beta-lactamase inhibitors, in order to make the mode of action even more potent.
If there is an allergy or intolerance to penicillins, antibiotics such as macrolides or fluoroquinolones can be used. In the case of severe disease progression, broad-spectrum and / or reserve antibiotics must be used in order to specifically combat the inflammation and avoid the formation of resistance.
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Is surgical removal possible?
If there is mucus in the lungs, i.e. in the airways, the aim should be to dissolve the mucus and then cough it up. If that is not possible at all, a doctor can also perform a lung specimen (bronchoscopy).
As part of this, the doctor can get an overview of the circumstances and suction off any tough, stuck mucus. If there is a lung abscess associated with pneumonia, the abscess can be drained as part of a bronchoscopy, if necessary. However, if the abscess is due to another primary cause (such as a foreign body or another tumor), surgical treatment of this cause may also have to be performed.
Duration and forecast
Since pus can develop in the lungs due to various causes, it is difficult to give an indication of the duration and prognosis of the disease.
If there is an acute purulent bronchitis, it is usually over after about two weeks. Like other diseases, pneumonia can be complicated or uncomplicated and therefore last different lengths. If the pus has another cause, such as a tumor disease, it is also difficult to make a statement about the prognosis and duration.
In general, however, it can be said that factors such as the age of the patient, general health, comorbidities and lifestyle play an important role in relation to the duration of an illness and its prognosis.
Lung abscess as a complication
A lung abscess can be a health complication in the lungs.
An abscess is the melting of tissue and accumulation of pus as a result of inflammation in an encapsulated cavity. It is usually caused when pathogens enter the lungs on the airway and cause inflammation there. As a result of primary diseases such as tumor diseases, irreversible bulging of the large bronchi or foreign bodies in the lungs, lung abscesses can develop. Timely drainage of the abscess is therapeutically important.
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Blood poisoning as a complication
Blood poisoning can result as a potentially life-threatening complication of pus in the lungs. This is also known medically as sepsis and is a sign that the body's own immune system is no longer able to contain the existing inflammation and fight it locally, but rather that the inflammation spreads further in the body via the bloodstream.
In this dangerous situation, the body reacts extremely and sets off a chain reaction that can extremely damage the body and organs. Typical symptoms are very high or low body temperature, a high heart rate, very fast or very slow breathing, changes in the blood count and signs of malfunctioning at least one organ system.
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