Complications

Complicated courses of a pulmonary abscess consist in a permanent fistula formation (especially in chronic abscesses) and in a breakthrough into the lung tissue. Severe cases can develop septically, i.e. with life-threatening accompanying symptoms that can lead to death. Another serious complication is the gangrene of the lung tissue, i.e. the death of entire lung sections.

This occurs particularly when abscesses are discovered late and treated surgically or when recurring abscesses occur in the lung. A pleural empyema is an accumulation of pus between the two leaves of the pleura. The pleura consists of a leaf that directly envelops the lung and a leaf that is attached to the inside of the thorax.

In this space there is a negative pressure, as well as small amounts of a lubricating fluid to facilitate rubbing of the leaves during breathing. In the course of pneumonia and lung abscesses, inflammation and involvement of the pleural leaves can occur. As a result, liquid pus can get between the pleural leaves and cause empyema, a form of pleural effusion.

This can be very painful and hinder breathing. As a rule, the pus must be drained until the inflammation has subsided. More about this:

Pleural empyema – What is behind it?
Pleurisy

Is a lung abscess curable?

A lung abscess is basically curable and the lethality rate is low. How quickly or how well the abscess heals depends not only on the method of treatment but also on the size of the focus of inflammation and the number of abscesses. The treatment is done with antibiotics, whereby the development of antibiotic resistance is a possible complication. If the antibiotic therapy does not work, the abscess can also be drained. In severe cases it is also possible to remove part of the affected lung (segment resection or lobectomy).

Prognosis

Lung abscesses have a very different prognosis depending on their cause, the underlying pathogen, the physical condition and the course of the disease. If a small abscess occurs as a result of pneumonia in an immunocompromised person, the disease can usually be cured without any problems by a short course of antibiotic therapy.Aggressive pathogens, large abscesses, immune deficiencies and concomitant diseases increase the risk of complications and dangerous courses. Even if the abscess heals, permanent fistula formation in the lung, adhesions of the pleural leaves, as well as damage to parts of the lung tissue can occur under certain circumstances. Before this happens, a small part of the lung can be surgically removed as a last therapeutic measure. Overall, the prognosis can be improved, especially by timely and adequate treatment of the pneumonia and its accompanying symptoms.