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Measures to diagnose and treat lung abscess
Lung abscess is an acute necrotizing inflammatory condition that creates pus-filled foci in the lung parenchyma, which after embolism will form caverns in the lungs. To treat lung abscess effectively, it is necessary to choose appropriate antibiotics along with actively draining the lung abscess for the patient.
1. What is a lung abscess?
Lung abscess is an acute inflammation of the lung parenchyma not due to tuberculosis, causing necrosis, destruction of alveolar membranes, capillaries, and formation of a pus-filled cavity.
Patients with lung abscess often have impaired airway defense mechanisms. Normally, mucus in the nasopharynx containing bacteria can be sucked into the lungs during sleep, but a local lung defense mechanism will eliminate the bacteria. When this protective mechanism is reduced, lung abscess has conditions to develop. The reduced lung protection mechanism is common in immunocompromised people, alcohol abusers, to***co users, exhaustion, etc.
2. Methods of diagnosing lung abscess
To diagnose a patient with a lung abscess, the doctor will rely on the following factors:
2.1 Clinical symptoms of patients with lung abscess
Patients with lung abscess have the following clinical symptoms:
- Fever 38.5oC, sometimes higher, may or may not be accompanied by chills.
- Chest pain on the affected side, patients with lower lobe lung abscess may present with abdominal pain.
- The patient coughs up purulent sputum. The sputum often has a stench, can spit a lot of pus, sometimes it can spit up pus and blood, and even cough a lot of blood.
However, there are cases of only a dry cough.
- The patient has difficulty breathing, may show respiratory failure such as rapid breathing, purple in the lips, the tip of the extremities. On lung examination, crackles, moist rales, snoring rales can be seen, sometimes cavernous syndrome, condensate syndrome are seen.
2.2 Subclinical diagnosis
The test results, subclinical imaging of the patient with abscessed pneumonia gave the following results:
- Complete blood count: white blood cell count increased, usually > 10 giga/liter, erythrocyte sedimentation rate increased.
- Chest X-ray: The chest radiograph shows that the abscess cavity usually has a relatively even wall with air-fluid levels, one or more abscesses can be seen, unilaterally or bilaterally. It is necessary to take a lateral chest X-ray to determine the exact location of the abscess to help choose an appropriate method of drainage.
- Direct endoscopic staining and bacterial culture from sputum, bronchial fluid or abscess pus. Blood culture when fever > 38.5oC, do antibiotics if bacteria are found.
2.3 Diagnosing the cause
Determining the cause is based on the results of microbiological examination of sputum, bronchial fluid, blood or other specimens.
The causative agents of lung abscess are usually anaerobic bacteria, staphylococcus aureus, Klebsiella pneumonia, Pseudomonas aeruginosa, parasites (amoeba),... Favorable factors of the disease are immunocompromised patients due to HIV or due to the use of immunosuppressive drugs, alcoholics, smokers, ...
2.4 Differential diagnosis of lung abscess with other lung diseases
- Distinguish from pneumothorax: in pneumothorax, the water-air level images on straight and slanted chest x-ray have different lengths. In a lung abscess, these two dimensions are approximately equal.
- Differentiate from abscessed lung cancer: besides lung abscess symptoms, abscessed lung cancer may have other symptoms such as choking, hoarseness, clubbing, cupped nails, coat edema , pain in the joints,... The chest X-ray film shows that the cave has thick walls, often eccentric, surrounded by thorns, with little image of water v***r level. The disease usually occurs in patients over 45 years of age, history of smoking, pipe to***co, ...
- Differentiate from cavernous pulmonary tuberculosis: pulmonary tuberculosis usually progresses slowly with general emaciation, collapse, cough, expectoration of sputum or blood, and fever in the afternoon. Acid-resistant bacilli (AFB) were found in the sputum, and the erythrocyte sedimentation rate increased. X-ray images are seen against the background of infiltrative or fibrotic lesions with one or more caverns, usually located at the apex of the lung.
- Differentiate from pulmonary hematoma: patients with pulmonary hematoma have a history of trauma, cough less, no sputum, if sputum is present, sputum is not purulent. In the early stages, there may be coughing up blood.
3. Treatment of lung abscess
3.1 Medical treatment of lung abscess
3.1.1 Antibiotic treatment
Patients will be treated with a combination of two or more antibiotics, administered intravenously or intramuscularly and using high doses from the start. Antibiotics are used as soon as the microbiological specimens are obtained and the antibiotics are changed based on the clinical course or the results of the antibiogram. The duration of antibiotic use is at least 4 weeks, can be extended to 6 weeks depending on the clinical and radiographic findings of lung abscess.
The antibiotics that can be used are:
- Penicillin G is used from 10-50 million units depending on the patient's condition and weight, intravenous phase injection 3-4 times/day. Use Penicillin in combination with an aminoglycoside antibiotic such as gentamycin (3-5mg/kg/day IM once) or amikacin (15mg/kg/day IM once or IV phase in 250ml NaCl 0.9 solution. %).
- Use Amoxicillin + clavuanic acid or ampicillin + sulbactam instead of penicillin G if beta-lactamase-producing bacteria are suspected, the dose is 3-6g/day.
- If anaerobic lung abscess is suspected, one of the following combinations can be selected:
- Group beta lactam + clavuanic acid 3-6g/day in combination with metronidazol dose 1-1.5g/day, intravenous infusion 2-3 times/day or
- Penicillin G from 10-50 million units combined with metronidazole 1-1.5g/day intravenous infusion
- Penicillin G 10-50 million units combined with clindamycin 1.8g/day intravenously.
- If staphylococcal abscess is suspected, use Oxacillin 6-12g/day or vancomycin 1-2g/day. If drug-resistant staphylococci are suspected, combine the above drugs with amikacin.
- If Pseudomonas aeruginosa lung abscess is suspected: use Ceftazidim 3-6g/day in combination with quinolone antibiotics such as ciprofloxacin 1g/day, levofloxacin 750mg/day.
- If lung abscess is caused by amoeba, use Metronidazole 1.5g/day intravenously 3 times/day in combination with other antibiotics.
3.1.2 Drainage of lung abscess
The patient will be drained to make the amount of pus in the abscess drain out as much as possible. Methods of draining a lung abscess include:
- Postural drainage, thoracic flutter: choose the most appropriate drainage position for the patient based on the chest x-ray or computed tomography image. Conduct postural drainage several times a day, at first, drain for a short time, then gradually lengthen depending on the patient's tolerance, the drainage time can be up to 15-20 minutes/time .
- Flexible bronchoscopy to aspirate pus in the bronchi to help drain the abscess.
- Puncture drainage of pus through the chest wall when the lung abscess is in the periphery without communicating with the bronchi, the abscess is close to the chest wall, or is attached to the pleura. A 7-14F catheter is inserted into the abscess to drain the pus through a continuous suction system.
3.2 Surgical treatment of lung abscess
Patients will be surgically removed lung segments or lobes of the lung or a whole lung, depending on the extent of the spread with the patient's condition or the respiratory function within the allowable limits. Surgery is performed in the following cases:
- Abscess socket >10cm
- Chronic treatment is ineffective.
- Patients with recurrent hemoptysis or severe, life-threatening hemoptysis.
- Abscess associated with severe focal bronchiectasis, with complications of bronchopleural fistula.
During treatment, it is necessary to strengthen the diet so that the patient has enough health to fight the disease. To prevent disease, it is necessary to pay attention to oral hygiene, nose and throat. When there are infections of the teeth, mouth, nose and throat, they must be treated thoroughly. In particular, for patients who eat with a nasogastric tube, caregivers when feeding patients must closely monitor, to avoid the patient choking on food.

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Measures to diagnose and treat lung abscess
Lung abscess is an acute necrotizing inflammatory condition that creates pus-filled foci in the lung parenchyma, which after embolism will form caverns in the lungs. To treat lung abscess effectively, it is necessary to choose appropriate antibiotics along with actively draining the lung abscess for the patient.
1. What is a lung abscess?
Lung abscess is an acute inflammation of the lung parenchyma not due to tuberculosis, causing necrosis, destruction of alveolar membranes, capillaries, and formation of a pus-filled cavity.
Patients with lung abscess often have impaired airway defense mechanisms. Normally, mucus in the nasopharynx containing bacteria can be sucked into the lungs during sleep, but a local lung defense mechanism will eliminate the bacteria. When this protective mechanism is reduced, lung abscess has conditions to develop. The reduced lung protection mechanism is common in immunocompromised people, alcohol abusers, to***co users, exhaustion, etc.
2. Methods of diagnosing lung abscess
To diagnose a patient with a lung abscess, the doctor will rely on the following factors:
2.1 Clinical symptoms of patients with lung abscess
Patients with lung abscess have the following clinical symptoms:
- Fever 38.5oC, sometimes higher, may or may not be accompanied by chills.
- Chest pain on the affected side, patients with lower lobe lung abscess may present with abdominal pain.
- The patient coughs up purulent sputum. The sputum often has a stench, can spit a lot of pus, sometimes it can spit up pus and blood, and even cough a lot of blood.
However, there are cases of only a dry cough.
- The patient has difficulty breathing, may show respiratory failure such as rapid breathing, purple in the lips, the tip of the extremities. On lung examination, crackles, moist rales, snoring rales can be seen, sometimes cavernous syndrome, condensate syndrome are seen.
2.2 Subclinical diagnosis
The test results, subclinical imaging of the patient with abscessed pneumonia gave the following results:
- Complete blood count: white blood cell count increased, usually > 10 giga/liter, erythrocyte sedimentation rate increased.
- Chest X-ray: The chest radiograph shows that the abscess cavity usually has a relatively even wall with air-fluid levels, one or more abscesses can be seen, unilaterally or bilaterally. It is necessary to take a lateral chest X-ray to determine the exact location of the abscess to help choose an appropriate method of drainage.
- Direct endoscopic staining and bacterial culture from sputum, bronchial fluid or abscess pus. Blood culture when fever > 38.5oC, do antibiotics if bacteria are found.
2.3 Diagnosing the cause
Determining the cause is based on the results of microbiological examination of sputum, bronchial fluid, blood or other specimens.
The causative agents of lung abscess are usually anaerobic bacteria, staphylococcus aureus, Klebsiella pneumonia, Pseudomonas aeruginosa, parasites (amoeba),... Favorable factors of the disease are immunocompromised patients due to HIV or due to the use of immunosuppressive drugs, alcoholics, smokers, ...
2.4 Differential diagnosis of lung abscess with other lung diseases
- Distinguish from pneumothorax: in pneumothorax, the water-air level images on straight and slanted chest x-ray have different lengths. In a lung abscess, these two dimensions are approximately equal.
- Differentiate from abscessed lung cancer: besides lung abscess symptoms, abscessed lung cancer may have other symptoms such as choking, hoarseness, clubbing, cupped nails, coat edema , pain in the joints,... The chest X-ray film shows that the cave has thick walls, often eccentric, surrounded by thorns, with little image of water v***r level. The disease usually occurs in patients over 45 years of age, history of smoking, pipe to***co, ...
- Differentiate from cavernous pulmonary tuberculosis: pulmonary tuberculosis usually progresses slowly with general emaciation, collapse, cough, expectoration of sputum or blood, and fever in the afternoon. Acid-resistant bacilli (AFB) were found in the sputum, and the erythrocyte sedimentation rate increased. X-ray images are seen against the background of infiltrative or fibrotic lesions with one or more caverns, usually located at the apex of the lung.
- Differentiate from pulmonary hematoma: patients with pulmonary hematoma have a history of trauma, cough less, no sputum, if sputum is present, sputum is not purulent. In the early stages, there may be coughing up blood.
3. Treatment of lung abscess
3.1 Medical treatment of lung abscess
3.1.1 Antibiotic treatment
Patients will be treated with a combination of two or more antibiotics, administered intravenously or intramuscularly and using high doses from the start. Antibiotics are used as soon as the microbiological specimens are obtained and the antibiotics are changed based on the clinical course or the results of the antibiogram. The duration of antibiotic use is at least 4 weeks, can be extended to 6 weeks depending on the clinical and radiographic findings of lung abscess.
The antibiotics that can be used are:
- Penicillin G is used from 10-50 million units depending on the patient's condition and weight, intravenous phase injection 3-4 times/day. Use Penicillin in combination with an aminoglycoside antibiotic such as gentamycin (3-5mg/kg/day IM once) or amikacin (15mg/kg/day IM once or IV phase in 250ml NaCl 0.9 solution. %).
- Use Amoxicillin + clavuanic acid or ampicillin + sulbactam instead of penicillin G if beta-lactamase-producing bacteria are suspected, the dose is 3-6g/day.
- If anaerobic lung abscess is suspected, one of the following combinations can be selected:
- Group beta lactam + clavuanic acid 3-6g/day in combination with metronidazol dose 1-1.5g/day, intravenous infusion 2-3 times/day or
- Penicillin G from 10-50 million units combined with metronidazole 1-1.5g/day intravenous infusion
- Penicillin G 10-50 million units combined with clindamycin 1.8g/day intravenously.
- If staphylococcal abscess is suspected, use Oxacillin 6-12g/day or vancomycin 1-2g/day. If drug-resistant staphylococci are suspected, combine the above drugs with amikacin.
- If Pseudomonas aeruginosa lung abscess is suspected: use Ceftazidim 3-6g/day in combination with quinolone antibiotics such as ciprofloxacin 1g/day, levofloxacin 750mg/day.
- If lung abscess is caused by amoeba, use Metronidazole 1.5g/day intravenously 3 times/day in combination with other antibiotics.
3.1.2 Drainage of lung abscess
The patient will be drained to make the amount of pus in the abscess drain out as much as possible. Methods of draining a lung abscess include:
- Postural drainage, thoracic flutter: choose the most appropriate drainage position for the patient based on the chest x-ray or computed tomography image. Conduct postural drainage several times a day, at first, drain for a short time, then gradually lengthen depending on the patient's tolerance, the drainage time can be up to 15-20 minutes/time .
- Flexible bronchoscopy to aspirate pus in the bronchi to help drain the abscess.
- Puncture drainage of pus through the chest wall when the lung abscess is in the periphery without communicating with the bronchi, the abscess is close to the chest wall, or is attached to the pleura. A 7-14F catheter is inserted into the abscess to drain the pus through a continuous suction system.
3.2 Surgical treatment of lung abscess
Patients will be surgically removed lung segments or lobes of the lung or a whole lung, depending on the extent of the spread with the patient's condition or the respiratory function within the allowable limits. Surgery is performed in the following cases:
- Abscess socket >10cm
- Chronic treatment is ineffective.
- Patients with recurrent hemoptysis or severe, life-threatening hemoptysis.
- Abscess associated with severe focal bronchiectasis, with complications of bronchopleural fistula.
During treatment, it is necessary to strengthen the diet so that the patient has enough health to fight the disease. To prevent disease, it is necessary to pay attention to oral hygiene, nose and throat. When there are infections of the teeth, mouth, nose and throat, they must be treated thoroughly. In particular, for patients who eat with a nasogastric tube, caregivers when feeding patients must closely monitor, to avoid the patient choking on food.

and
Men need more protein than women to build muscle. Men also require a large amount of zinc to increase the secretion of testosterone, the main hormone that controls libido and s*x drive.
Diet plays an important role in health
Poor nutrition is like "su***de"
Easy to get into trouble because of lack of Magne
How to cook to preserve nutrients?
Nutritionist: "Obesity children still need to add fat!"
The protein
Men have greater muscle mass and less body fat than women. So they need more protein to maintain muscle mass. Protein provides about 22 standard amino acids and 9 of them are indispensable for a healthy body. You can get protein that contains all the essential amino acids through foods like lean pork, poultry thighs, low-fat dairy, fish, shellfish, egg whites, and beans.
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7 interesting myths about erectile dysfunction7 interesting myths about erectile dysfunction hot flashes in men: Did you know? Hot flashes in men: did you know? SHOULD READ
70% of the human body is water, drinking enough 8 glasses of water (about 2 liters) a day helps protect your overall health. In particular, adding water is a way to lose weight and maintain a healthy weight.
Zinc
Testosterone is responsible for s*xual function, muscle growth and bone mineral mass. Zinc is an essential mineral for the body to produce testosterone. Men can supplement zinc by eating oysters, cereals, dark chocolate, mushrooms...
Potassium
Potassium is an essential mineral that lowers blood pressure and stabilizes the heart rate. The fruits and vegetables that are rich in potassium are bananas, apricots, oranges, grapefruits, potatoes, sweet potatoes, carrots, green leafy vegetables, etc.
Vitamin D
Vitamin D helps the body absorb calcium and improves the immune system. Vitamin D deficiency has been shown to be associated with many chronic diseases. Men can supplement vitamin D by exposing their skin to direct sunlight, eating fish, milk or egg yolks...
Fiber
There are many types of fiber and each type has different effects. Certain types of fiber contribute to blood sugar regulation by affecting the absorption of carbohydrates in the gut. Another group may help with weight control by making you feel fuller longer and have better bowel movements. Moreover, adequate fiber intake helps reduce the risk of cardiovascular disease. Fiber is found in whole grains, fruits, and green leafy vegetables.
Men should drink enough water every day
Omega-3 fatty acids
Omega-3s work to reduce inflammation, protect the heart and brain against disease risks. Omega-3 fatty acids are often found in fish such as salmon, mackerel, herring, tuna, sardines... If you do not like to eat fish, you can consider supplementing with fish oil, nuts like walnuts, etc. flaxseed or seaweed.
Besides, men also need to limit:
Saturated fat and trans fat
These "bad" fats can increase inflammation and LDL "bad" cholesterol levels, which are bad for heart health. Saturated and trans fats are commonly found in whole milk, high-fat cheeses, butter, fried or grilled foods, fatty meats...
Sugar and starch
Eating a lot of sugar and starch is absolutely not good for health. It will increase the risk of obesity, heart disease, cancer ...
Caffeine and alcohol
Too much caffeine can increase heart rate and blood pressure. According to recommendations, men should not consume more than 300mg of caffeine per day by limiting coffee, energy drinks, tea...Alcohol is also a drink to limit because it affects the liver, heart and increases the risk. Erectile dysfunction for men.

Strong healthy eating habits ask people to eat more fruits, vegetables, whole grains, good quality… Remember that healthy eaters ask you to pay attention to what you eat and drink. as well as how you prepare your food.
To have good results, all the people should go to make up or the variable, as well as the food that are many lines and well-add-in. Here are the top 5 benefits of healthy eating.
Balance
Being overweight or obese will increase the risk of serious diseases such as handling type 2 sugar, cardiovascular disease and some cancers… To lose weight, many people just focus on dieting to regain the nutrients. style . This is an important mistake. It is eating healthy and cold that is the key to losing weight and maintaining a healthy weight.
Good for a healthy heart
Even when you are young, you still need to think about how to protect the health of your blood vessels. Especially when cardiovascular disease is increasing, and the chip is on young people.
Healthy eating habits can improve your blood vessel health and prevent common diseases.
Helps strengthen bones and teeth
If you pay close attention, you can notice that many elderly people use dentures to eat and talk. A healthy diet can help people ensure that they have strong teeth and bones now and in the future, thereby preventing bone and tooth decay.
Improves mood and energy
If you eat a healthy, balanced diet, you'll feel better. You will get all the nutrients you need to function properly, which will improve your energy levels. Sugary foods and drinks to prevent high intakes and related events.
Improve memory and brain health
Eating healthy increases blood flow to the brain, which helps prevent brain diseases like Alzheimer's, dementia and cognitive decline.
Certain foods contain nutrients that help keep the brain healthy, including fats, fiber, protein, vitamins, and antioxidants. These nutrients can boost memory, focus and even prevent brain diseases.

Health of patients 'post-COVID-19'
Although most people with COVID-19 get better within a few weeks of being infected, some people experience post-COVID-19 conditions. Post-COVID-19 harms are a range of new, recurrent, or ongoing health problems that a person may experience about four weeks or more after first being infected with SARS-CoV- 2 causes the disease COVID-19.
Even people infected with SARS-CoV-2 who do not have symptoms of COVID-19 disease for days or weeks after infection can develop post-COVID-19 illnesses.
Illnesses following COVID-19 may be known as: COVID sequelae, persistent COVID syndrome, post-acute COVID-19 or the long-term effects of COVID or chronic COVID.
They are different symptoms such as low-grade fever, slight shortness of breath or shortness of breath, fatigue or dizziness, cough, headache, chest tightness, heart palpitations or palpitations, muscle and joint pain may be present. Or there are cases of digestive disorders (loss of appetite, loss of appetite, stomach pain, diarrhea...), taste or smell disorders.
A rash may be seen on the skin. Neurologically, there may be sleep disturbances or difficulty concentrating, or mood swings.
Some people who recover from severe COVID-19 may experience long-term adverse effects of multiple organs or autoimmune disease with symptoms lasting weeks or months.
Also, although very rare, some people (mainly children) experience multisystem inflammatory syndrome (a condition in which different parts of the body can become inflamed) during or shortly after infection with COVID-19. -19.
How is healthcare after COVID-19?
After being sick with COVID-19, the patient needs continued support or the patient tries to serve himself (if possible) in living, eating and exercising, which is extremely necessary and very important. It is important to help post-COVID-19 patients recover better and faster.
First of all, people who have recovered from the disease need to take some measures (do it themselves or have someone support) to maintain a reasonable sleep time, mainly sleep a lot at night, limit sleeping a lot during the day to do this. Other health rehabilitation activities such as light exercise (slow walking, light exercise, cycling very slowly (if possible), exercise...).
It is necessary to pay attention to breathing exercises (inhale, exhale slowly, inhale deeply gradually and exhale gently without haste and the pace increases day by day). Besides, it is necessary to be exposed to the sun for at least 30 minutes/day (it can be in the early morning or afternoon sun, divided into 3-4 times, 5-10 minutes each time is moderate), this will help for regulating the body's circadian rhythms.
For those who have completed the self-isolation period, encourage them to participate in activities with their loved ones such as preparing meals, cleaning the house to return to normal activities soon.
Patients need to be exposed to the sun for at least 30 minutes a day.
Especially for the elderly, talking with family members and being encouraged and supported by relatives will help reduce anxiety and stimulate brain activity after recovering from COVID-19. Family members should encourage the person who has recovered from COVID-19 to participate in spiritual activities such as reading books/newspapers, participating in discussions about the day's news, etc., which also contribute significantly to the recovery of health. .
Even if the patient has recovered and is negative for SARS-CoV-2, the patient should still pay attention to strictly follow the doctor's advice before leaving the hospital to go home (for example, it is necessary to regularly wear a mask). , dispose of masks in designated places, keep a distance from all family members, wash hands often with soap and clean water, etc.) to prevent illness for other family members and neighbors (plus) copper), because, even though they are cured, they can still carry the SARCOV-2 virus). It is necessary to limit looking at the phone / electronic device screen continuously during the day
About the diet
In the early stage of hospital discharge, family members should note that they should divide meals into 3-5 meals per day depending on the patient's ability to eat and combine a variety of foods in the diet (depending on the conditions of each family). , should eat a lot of vegetables, drink enough water daily, in addition should drink more fruit juice, drink more milk (if people with diabetes should drink sugar-free milk, do not eat candy, soft drinks). have sugar).
To supplement micronutrients due to the damage of COVID-19 disease, it is recommended to eat foods rich in micronutrients such as shrimp, crab, and fish. To supplement potassium should eat more ripe bananas, supplement zinc should eat oysters, shellfish, fish ...
People who later recover from COVID-19 should note that if they know how to combine nutrition and exercise, they will surely recover quickly.