OVERVIEW
OVERVIEW
Septic lung infections are chronic infectious diseases of the lungs caused by purulent bacteria that result in destruction of lung or bronchial tissue, with bronchiectasis and lung abscesses being the most common.
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Department
Respiratory Medicine
Clinical symptoms
Cough, hemoptysis, coughing up sputum, fever, sputum with foul odor, chest pain, etc.
Hazards
Lung tissue destruction is severe with dyspnea, and the infection can spread to other parts of the body through the bloodstream.
Complications
Bronchial dilatation, brain abscess, etc.
Examination
Bronchoscopy, CT, X-ray film, bronchial iodine oil imaging, etc.
Diagnosis
Bronchial dilatation: cough, fever, coughing up sputum, the most violent coughing up sputum in the morning, with foul smell. Lung abscess: high fever, chills, coughing up sputum, chest pain, pus and sputum with bad odor and blood in sputum. Diagnosis can be made by combining bronchoscopy and imaging.
Treatment principle
Postural drainage and antibiotic treatment. Ineffective internal medicine treatment can be surgical treatment.
Curability
Aggressive treatment can cure some patients.
Dietary advice
Diet should be light and nutritious, avoid spicy and stimulating food.
Etiology
Epidemiology
Bronchiectasis most often starts before the age of 20, with frequent attacks in winter.
Etiology
Bronchiectasis: congenital bronchial insufficiency, acquired infections of the lungs and bronchi. Lung abscess: common causative organisms are anaerobes, streptococci, staphylococci, pseudomonas, Escherichia coli, and clostridial spirochetes.
Symptoms and Diagnosis
Typical symptoms
1. Bronchiectasis is mainly characterized by cough, hemoptysis, sputum and fever. Coughing and sputum are the most intense in the morning when awake, and the sputum is large in volume and has a bad odor. Massive hemoptysis can cause asphyxia. Long-term patients may have emaciation, anemia, pestle-like fingers (toes) and pulmonary osteoarthropathy. If the lung tissue is severely damaged, there is dyspnea. The infection may spread to other parts of the body through the bloodstream and form localized abscesses.2. Typical symptoms of lung abscess are high fever, chills, coughing up sputum and chest pain. Pus cavity and bronchial communication after coughing up pus sputum, pus sputum often has a bad smell, and sputum with blood. At this time, there is often relief of systemic symptoms of poisoning. The long duration of the disease is characterized by lethargy and fatigue. There may be dyspnea, pestle-like fingers (toes). It may be complicated by branch expansion and brain abscess. After the abscess breaks down, it forms pneumothorax and bronchopleural fistula.
Diagnostic basis
1. Bronchial dilatation (1) mostly starts before the age of 20, with frequent attacks in winter. The main manifestations are cough, hemoptysis, sputum and fever. Cough and sputum in the morning when awake, the most intense, sputum volume, there is a bad smell. Long-term patients may have emaciation, anemia, pestle finger. (2) Bronchial iodine oil imaging can show the shape and location of bronchiectasis, and CT can also show bronchiectasis. Severe bronchiectasis may show bunches of small translucent areas, honeycombing, and multiple small fluid flats on radiographs. (3) Bronchoscopy can reveal which lung segment the hemoptysis is coming from.2. Lung abscess (1) Typical symptoms are high fever, chills, coughing up sputum, and chest pain. Pus and sputum often have a bad odor, and blood in the sputum. The long duration of the disease is characterized by lethargy and fatigue. There may be dyspnea, pestle-shaped fingers (toes). It may be complicated by branchial dilatation and brain abscess. (2) X-ray film can show pus cavity and fluid level, and there is inflammatory infiltration in the lung tissue around the abscess. The diagnosis can be made according to the typical manifestations and examination results.
Treatment
Treatment guidelines
Postural drainage and selection of sensitive antibiotic therapy. Bronchoscopic aspiration. Surgery is indicated when medical treatment is ineffective.
Drug treatment
1. Bronchodilatation postural drainage and selection of sensitive antibiotic therapy. 2. Lung abscess postural drainage of sputum, bronchoscopic sputum aspiration, combined with effective antibiotic treatment.
Surgical treatment
1. If the medical treatment of bronchiectasis is ineffective, and the bronchiectasis is confined to one side or one lobe of the lung, and it is expected that the function of the remaining lungs can be compensated, then lung resection should be performed. If the hemoptysis cannot be stopped, the source of the hemoptysis should be identified and pneumonectomy should be performed. 2. Surgical treatment should be considered for those who cannot be cured by medical methods for lung abscess, and the common method is pneumonectomy. If the general condition is poor and the patient cannot tolerate surgery, lung abscess drainage is feasible.
Prognosis
The prognosis is good with active treatment.
Nursing care
Daily care
1. Maintain indoor air circulation and control indoor temperature and humidity. 2. Turn over and pat the back more often to help discharge respiratory secretions.
Diet
Give easy-to-digest, multi-water, high-calorie and high-vitamin food.