OM VERMA ASSISTANT PROFESSOR GRACIOUS COLLEGE OF NURSING ABHANPUR (C.G.)

1. PRESENTED BY
MR .OM VERMA
ASSISTANT PROFESSOR
RELIANCE INSTITUTE
OF NURSING

3. 1.Localized suppurative (Suppuration is the
process of pus forming.) Inflammation of the
lung.
According to Luckmann and Sorensen's
2. Necrosis of the pulmonary tissue (lungs) &
formation of cavities containing necrotic debris or
fluid caused by microbial infection.
 According to Brunner & Suddarth's
3. A localized area of destruction of lung parenchyma in which
infection by pyogenic organisms results in tissue necrosis &
suppuration .
According toBrenda G. Bare

4. 4.Lung Abscess is a localized necrotic lesion
of the lung parenchyma containing purulent
material that collapses and forms a cavity. It
is generally caused by aspiration of
anaerobic bacteria.
 According to Lippincott
5. Lung abscess is a type of liquefactive
necrosis of the lung tissue and formation of
cavities (more than 2 cm) containing necrotic
debris or fluid caused by microbial infection.
This pus-filled cavity is often caused by
aspiration, which may occur during
anesthesia, sedation, or unconsciousness
from injury.
 According to Lewis's

5. Lung abscess
Inhalation
lung abscess
Pneumonic
abscess
Embolic
abscesses

6. Location:
 Dependent areas (posterior segments of upper & lower lobes).
Stages:
 Pneumonic stage: patch of consolidation Is a region of normally compressible
lung tissue that has filled with liquid instead of air. The condition is marked by in
duration (swelling or hardening of normally soft tissue) of a normally lung.
 Rupture: central necrosis, communication with a bronchus & expectoration
(mucus ) of the liquid centre.
 Acute cavitations: irregular thick wall, shaggy ( shaggy means branches ) inner
margin & surrounding consolidation (collection).
 Chronic cavitation: thin wall, smooth inner margin & subsidence of surrounding
inflammatory reaction.

7. Complication of pneumonia:
 Staph pneumonia.
 Klebsiella pneumonia.
 T.B.
 Necrosis of pulmonary tissue and formation of
cavities containing necrotic derbies or fluid causes
microbial infection. the formation of multiple
small abscesses is occasionally referred to as
necrotizing pneumonia or lung gangrene.

8. Lung abscess
with bulging
fissure ( a
long narrow
opening or
line of
breakage )
sign.

9. 3.EMBOLIC
ABSCESSES
 an abscess arising distal to the point of arrest of a
septic embolus.
 A septic embolism is a type of embolism that is
infected with bacteria, resulting in the formation of
pus. a clot or other plug, usually part or all of a
THROMBUS

10. Embolic
abscesses
primary
Due to
impaction(pressure)
of septic embolus(a b/d
clot air bubble )
in pulmonary artery
secondary
Due to infection
of infracted lung

11.  Infected catheters.
 Infected pacemakers.
 Tricuspid endocarditic ( IV drug abusers).

12.  ETOLOGY

13.  HEMATOGENOUS
 metastases of tumors or in infections; blood-
borne. spread from a distal site)
originating in the blood. 2. producing blood or
components of blood. 3. distributed or
spread by way of the bloodstream,
• SEPTIC THROMBOPHLEBITIS
• venous thrombosis, inflammation, and
bacteremia.

14.  Metabolism of alcohol reduces glutathione
anti-oxidant levels in the lungs.
 Oxidation damage to the cells impairs the
ability of the lungs to remove fluid.
 Oxidative damage to cells reduces immune
response.
IMMUNE SYSTEM ISN’T WORKING WELL:
 This can let in germs found in your mouth or
throat, like fungi or the bacteria that
cause tuberculosis, strep throat, lead to lungs
abscess.

15.  Blood-borne causes: It’s rare, but bacteria or
infected blood clots from an infected part of
your body can travel through your
bloodstream and into your lung, where they
cause an abscess.
POOR ORAL HEALTH:
 People with gum disease are more likely to
get an abscess

16.  infective endocarditis
 (IE) caused by Staphylococcus aureus has been ...
Our patient presented with metastatic abscesses in
the lungs that led to

17.  Lung Abscess pyogenic lung
infection/pneumonia, necrotizing pneumonia.
... The most frequent cause is aspiration of
anaerobic organisms from the mouth in those
predisposed to ... Penetrating
pulmonary trauma - eg, a stab wound.

18. • BRONCHIAL OBSTRUCTION
: tumour, foreign body,
Blocked airway: Mucus can form behind a tumor
or foreign object in your windpipe and lead to an
abscess. If bacteria get into the mucus, the
blockage stops you from coughing it out.
 IMMUNODEFICIENCY
immunodeficiency disease characterized by
eczema, recurrent staphylococcal skin abscesses,
recurrent lung infections, eosinophilia (a high
number of eosinophils in the blood) and high
serum levels of IgE.

19.  lung disease: Lung conditions such
as bronchiectasis, cystic
fibrosis, lung contusions (bruises), and
infected infarcts may lead to a lung abscess

20.  Tuberculosis & non tuberculous mycobacterial
infection – fluid filled cavities – upper lobes / apical
segments of lower lobes
 Fungal infection – Histoplasma capsulatum
Blastomyces dermatitidis
Coccidiodes immitis
Aspergillus
Cryptococcus neoformans
Candida

21.  Aspiration of oropharyngeal or gastric secretion.
 2) Septic emboli.
 Necrotizing pneumonia
 Necrotizing tumors
 Gram negative organisms. (klebsiella)
 Anaerobic bacilli (Bacterorides
 Carcinoma of the lung
 Parasitic and fungal diseases of the lung.
 TB

22.  Lung abscess starts as an area of pneumonia
 Small zones of necrosis
 Coalesce together to from one or more large
cavities of 1-2 c.m
 Progressive and enlargement to from the
abscess cavity
 The abscess cavity well erode( increase) a
bronchus

23.  Expec-toration of purulent sputum with air
fluid formation in the cavity
 Fate
 1. infection of the other lung
 2. Open into pleura –pyopneumothorax
 3. Hematogenous spread

24.  The presenting features of lung abscess
vary considerably .
1. Symptoms progress over weeks to months
2. Fever, cough, and sputum production
3. Night sweats, weight loss & anemia
4. Hemoptysis, is the coughing up of blood or
blood-stained mucus from the bronchi,
larynx, trachea, or lungs.

25.  Digital clubbing – develop within a few weeks
if treatment is inadequate.
 Dullness to percussion
 Diminished breath sounds if abscess is too
large and situated near the surface of lung.
 Amphoric / cavernous breath sounds
 Cough with foul smelling purulent sputum.
 Fever with shivering
 Night sweats
 Chest pain
 Shortness of breath
 Lethargy
 ) Finger clubbing

26.  Leukocytosis refers to an increase in the total
number of WBCs
 Anorexia
 Weight loss
 Weakness
 Dyspnea

27. Lung abscess
Acute
< 6 weeks.
Chronic
> 6 weeks

28.  HISTORY TAKING
 PHYSICAL EXAMINATION
 During a physical exam, doctor will listen for
abnormal sounds in your lungs and heart
using a stethoscope.And detect any lungs fluid
accumulation .
 BRONCHOSCOPY
 TO Identification of proximal airway
obstruction by a tumour or foreign body
 CHEST X-RAYS = nearly Identifying the lung
abscess as a cavity filled with fluid and air.

29.  Sputum Gram Stain:
May occasionally be helpful if
there is a large number of
white blood cells and bacteria
consistent with oropharyngeal
flora.
-

30. 
 Arterial Blood Gas Test
 The arterial blood gas
 test is a test used to check the level of oxygen
and carbon dioxide in your blood. A doctor or
nurse will take blood from the artery in your
wrist. Then, they will send the blood to a lab
for testing. The results of this test indicate the
amount of oxygen and carbon dioxide in your
blood.

31.  Pulse Oximetry Test
 The doctor will measure your oxygen level
using a small sensor that’s placed on the tip
of your finger to see if you are getting
enough oxygen. This is called the pulse
oximetry test .
 CT SCAN = thick-walled, usually round cavity
with irregular margins forming an acute angle
with chest wall, no signs of compression of
surrounding lung .

33.  Drainage: You may need this if abscess is 6
centimeters or more in diameter. doctor will
use a CT scan to guide him as he inserts the
drain through your chest wall into the
abscess.

35.  COMPLICATION

36.  Caused by spread of infection into the pleural
space or by contamination of the pleural
cavity after percutaneous drainage.
 2.Amyloidosis
 is a group of diseases in which abnormal
protein, known as amyloid fibrils, builds up in
tissue.
 3. Hemoptysis is the coughing up of blood or
blood-stained mucus from the bronchi,
larynx, trachea, or lungs.