According to a 2015 review by Dr. Ivan Kuhajda and others published in the Annals of Translational Medicine, a lung abscess is a condition in which lung tissue cells die, becoming a viscous, liquid mass and eventually form cavities larger than 2cm full of fluid from a microbial infection or debris resulting from prematurely deceased cells. Individuals with alcoholism are those who are most predisposed to developing lung abscesses.
Lung abscesses are categorized in three ways:
Based on duration:
- acute (6 weeks or less)
- chronic (more than 6 weeks)
How they spread:
- hematogenic (blood-borne)
- brochogenic (bronchial-related)
- primary (60% of cases, if the patient was healthy before)
- secondary (if the patient had another bronchogenic or immunocompromising disease)
Early signs of lung abscesses can be difficult to spot, because they’re impossible to separate from those associated with pneumonia: fever with accompanying night sweats, shivering, cough, weight loss, chest pain, fatigue, and occasional anemia. Those with lung abscesses will sometimes experience hemoptysis, a condition in which patients cough up blood or mucus-filled blood. Furthermore, individuals with chronic lung abscesses can also exhibit clubbed–or swollen–fingers. Specialists often have to do a variety of tests to definitively differentiate lung abscesses from other, similar-presenting illnesses; it’s recommended by Kuhajda et al that bronchoscopies are used in every step of diagnosing and treating lung abscesses.
The Ancient Greek physician Hippocrates was the first to describe both the clinical signs and treatment of lung abscesses. In pre-antibiotic times, ⅓ of patients suffering from the condition would succumb to it. Another ⅓ would survive the ordeal with lifelong complications like chronic lung abscesses and other illnesses, while the last ⅓ would recover completely. During that period, surgery was deemed the only worthwhile therapy.
In fact, only 100 years ago, about 75% of patients with a lung abscess would die from the condition. Once physicians began practicing open drainage of lung abscesses, mortality dropped by between 20 and 35%; antibiotic therapy helped mortality decrease by about 8.7% more.
Luckily, between 80 and 90% of today’s patients can survive with just a course of antibiotics–no open drainage needed. Patients generally tend to respond to therapy after 3-4 days, with their general conditions improving within 3 days to a week. However total healing, complete with normal radiographic results, takes about two full months.