Lung abcess (Suppurative pneumonia)

Lung abcess is a circumscribed suppurative inflammation of lung caused by pyogenic organisms leading to cavitation and necrosis.
Causes:
1. Aspiration abscess -- Aspiration of infected material -- (a) From upper respiratory tract -- Oral or pharyngeal sepsis,oesophageal obstruction,tracheo-oesophageal fistula,drowning. (b) Vomit. (c) Bronchiectasis. (d)Iatrogenic following use of intermittent positive pressure breathing therapy and nebulisers.
2. Specific abscesses -- (a) Lobar pneumonia particularly Klebsiella,Staphylococcal pneumonia. (b)Tuberculosis. (c) Fungal infection, e.g. actionmycosis.
3. Bronchial obstruction or stenosis -- Benign tumours,or inspissated bronchial mucus or foreign body, mucovscidosis.
4. Metastatic lung abscess -- Suppurative thromboembolism involving lung parenchyma??pulmonary embolism from pelvic thrombophlebitis or right sided endocarditis,or during septicemia and pyemia.
5. Malignancy -- Necrosis within a large solitary nodular malignant neoplasm.
6. Infected cysts -- Congenital or acquired.
7. Extension from neighbouring organs -- Diaphragm e.g. amoebic infection,vertebral column.
Symptoms -- Groups:
1. Mild general toxaemia -- with slight fever. No symptoms referrable to respiratory tract.
2. Sudden onset -- with high fever,pleuritic chest pain, cough and later copious expectoration.
3. Symptoms of subacute or chronic respiratory disease -- cough, foetid breath, expectoration and general toxaemia. Hemoptysis may occur, or pain due to associated pleurisy.
In traditional Chinese medical studies, this disease is belongs to the category of fei yong (pus in lung), struggle between evil (abnormality) and good (body system), declination of positive Qi will resulted in sudden high fever, then protective Qi is not enough, besides, it will has excretion of fluid as sweat and improper Qi penetrate into lungs causing afraidness of cold. The attack of re du (bad substances of heat), causing accumulation of bad heat thus resulted in suffering of fluid balance or the heat will caused injury to the lung pathway (pathway in acupuncture studies), internal accumulation of heat will turn into pus and leads to disorders of shu ji (lungs function) which later causes cough, cough with mucus or with mucosal phlegm or with purulent phlegm or with bloody phlegm and hemoptysis (coughing with blood). The spleen regulates the gas and blood system, weakness of spleen will cause imbalance of fluid homeostasis and decreased in nutrition absorption which later will resulted in lowered of mental capacity, body weakness, loss of appetite and decreased in taste perception.