Lung abscess detail text to style

1. Lung Abscess
Definition, Etiology, Clinical Features
& Physiotherapy Management

2. Definition
• Lung abscess: Localized, pus-filled cavity
within lung parenchyma.
• Forms due to necrosis of lung tissue from
severe infection.
• Characterized by cavity formation with air–
fluid level.

3. Etiology – Primary Causes
• Aspiration: Most common cause; poor gag
reflex, intoxication, dysphagia.
• Pneumonia-related: Anaerobes,
Staphylococcus aureus, Klebsiella.
• Bronchial obstruction: Tumor, foreign body,
bronchial stenosis.

4. Etiology – Secondary Causes
• Septic emboli: Infective endocarditis, IV drug
use.
• Hematogenous spread from distant
infections.
• Immunocompromised states: HIV, diabetes,
steroid therapy.
• Post-surgical or trauma-related.

5. Pathophysiology
• Initial infection → inflammation and necrosis
of lung tissue.
• Liquefactive necrosis creates pus-filled
cavity.
• Cavity drains into bronchi → forms air–fluid
level.
• Chronic abscess: Thick fibrotic wall
formation.

6. Clinical Features – General
• Fever with chills, night sweats.
• Fatigue, weight loss, malaise.

7. Clinical Features – Respiratory
• Productive cough with foul-smelling sputum
(hallmark).
• Possible hemoptysis.
• Dyspnea, tachypnea, pleuritic chest pain.
• Crackles, decreased breath sounds on
auscultation.

8. Investigations
• Chest X-ray: Cavity with air–fluid level.
• CT scan: Better visualization of abscess
margins.
• Sputum culture: Identifies causative
organism.
• Blood tests: Elevated WBC, ESR, CRP.

9. Physiotherapy Goals
• Improve airway clearance.
• Enhance ventilation and lung expansion.
• Prevent atelectasis and complications.
• Improve functional capacity.

10. Airway Clearance Techniques
• Postural drainage (avoid head-low if
aspiration risk).
• ACBT: Breathing control, thoracic expansion,
huffing.
• Percussion & vibration (if tolerated).
• Suctioning for poor expectoration.

11. Breathing & Expansion Exercises
• Diaphragmatic breathing.
• Lateral costal expansion.
• Segmental breathing.
• Incentive spirometry (if not excessive
coughing).

12. Positioning & Mobilization
• Upright or semi-Fowler’s for improved
ventilation.
• Avoid lying on affected side (risk of shunting).
• Early mobilization: sitting, standing,
ambulation.

13. Adjunct Treatments
• Nebulization with bronchodilators or saline.
• Humidification therapy.
• Pain management: splinted coughing,
relaxation.

14. Contraindications & Precautions
• Active hemoptysis.
• Severe uncontrolled pleuritic pain.
• Very high fever.
• Hemodynamic instability.

15. Summary
• Lung abscess: localized necrotic cavity with
pus.
• Commonly due to aspiration or pneumonia.
• Physiotherapy focuses on airway clearance,
breathing exercises, and mobilization.
• Early intervention prevents complications
and promotes recovery.