If a lung abscess is not completed within two months, it becomes chronic.
Etilogiya chronic lung abscess
The reasons for the transition of acute to chronic abscess can be divided into two groups:
Caused by features of the pathological process:
very large, diameter greater than 6 cm, a cavity in the lung
the presence of seizures in the cavity
poor drainage conditions (narrow curved draining bronchus; the course of the cavity, starting in the upper part thereof), the localization of an abscess in the lower lobe
sluggish reaction to the inflammatory process
Caused by errors in the treatment of the patient:
antibiotic therapy started late
small doses of antibiotics, antibiotic sensitivity without flora
insufficient use of measures aimed at improving conditions for the drainage of abscess
insufficient use of restorative treatment
Against the background of the common symptoms of acute and chronic abscesses, such as tachycardia, asymmetric breathing motion of the chest, the weakening of respiratory sounds, big and small moist rales, respiratory amforicheskogo with good drainage of the abscess cavity, a three-layer sputum: yellow mucus, pus, watery layer, and (bottom) for Chronic lung abscess is characterized by:
Periodic exacerbation of purulent process. In remission: barking cough paroxysms, increasing the amount of purulent sputum with a change in body position, possibly coughing up blood, severe fatigue, weight loss, increased sweating.
The disease runs in cycles, with periodic exacerbations of acute fever, a typical three-level increase in the number of sputum. Duration of stages depends on how the functions are preserved and the draining bronchus oporozhnyaemosti abscess cavity.
In the long possible complications, cachexia, bronchiectasis (bronchiectasis with regard to inflammation), pneumosclerosis (overgrowth of scar connective tissue), emphysema (increased lightness of lung tissue), pulmonary hemorrhage, respiratory failure, amyloidosis (deposition of amyloid protein) of the internal organs, brain abscess, etc.
Clinic and diagnostics: There are two main types of chronic abscesses.
The first type. The acute stage is completed the clinical recovery or significant improvement of the patient. The patient was discharged from hospital with a normal body temperature. After being discharged condition remains satisfactory and the patient often begins to work. However, after a 'period again increased body temperature, increased cough. After 7-12 days is draining the abscess, the body temperature decreases. Subsequently, the deterioration becomes longer and more frequent. Evolving phenomena of purulent bronchitis, there is increasing intoxication and its associated degenerative changes in the organs.
The second type. The acute period of remission without severe changes in the chronic stage. The disease occurs with hectic fever. Patients produce a large number of purulent sputum, dividing at a distance of three layers. Rapidly growing evolving and severe intoxication, leading to total exhaustion and degeneration of parenchymal organs. Most often this type of disease occurs when multiple abscesses of the lung. In patients with a characteristic appearance: they are pale, sallow skin tone, cyanotic mucous membranes, there is puffiness face, swelling of the feet there and back, the protein associated with starvation and impaired renal function. Rapidly growing pulmonary heart disease, from which patients die.
In chronic abscess may develop the same complications that are inherent in the acute period of illness.
