Lung abscess chest pain in the elderly is caused by inflammatory lesions involving the pleura, and the pain is aggravated during breathing. If the abscess breaks into the chest cavity, it can form an abscess chest, pneumothorax, or an encapsulated abscess chest due to fibrin wrapping, where the patient has restricted respiratory movements and increased shortness of breath. How to diagnose this symptom? 1.Symptoms (1)Patients with acute lung abscess may have foci of infection in the oropharynx and risk factors causing aspiration, or have a history of cold and exertion. The onset of the disease can be acute, with patients having chills and high fever, and the formation of cavities in the lungs after 8 to 14 days, with patients coughing up large amounts of purulent foul-smelling sputum and a significant drop in body temperature. In a few patients, the onset of the disease may be insidious, with malaise, cough, and low-grade fever lasting several weeks or even longer. Pulmonary abscess secondary to pneumonia may appear 2 to 3 weeks after the onset of the disease, when the pneumonia should be cured, but there is a reoccurrence of high fever, increased amount of purulent sputum, and often malaise. (2) Cough and large amount of purulent sputum: initially coughing mucus or mucopurulent sputum, after 8 to 14 days of cavity formation in the lung, 40% to 70% of cases cough up large amount of purulent and foul-smelling sputum, with foul-smelling sputum suggesting anaerobic bacterial infection. (3) Hemoptysis is not uncommon and may occasionally cause fatal hemoptysis. (4) Chest pain is caused by inflammatory lesions involving the pleura, and the pain is aggravated during breathing. If the abscess breaks into the chest cavity, it can form abscess chest and pneumothorax, or it can form encapsulated abscess chest due to fibrin wrapping, and the patient’s respiratory movement is restricted and shortness of breath is aggravated. (5) Others include weakness, wasting, loss of appetite, etc. Hematogenous lung abscesses are mostly preceded by symptoms caused by the primary disease. Wasting symptoms such as anemia are common in patients with chronic lung abscess and abscess chest. 2.Signs There are often no positive signs when the abscess is small and the site is deep; if the abscess is large, there may be local signs of pulmonary solidity, such as abscess near the chest wall may appear empty urn sound; abscess chest patients appear signs of pleural effusion on the affected side; pestle finger can appear within a few weeks of the onset, which is often seen in chronic lung abscesses, and sometimes also suggests the possibility of bronchopulmonary cancer. Hematogenous lung abscesses often have no positive pulmonary signs because the lesions are small and scattered.