Gangrene of the lungs: causes, symptoms, diagnosis, treatment

Gangrene of the lungs is a severe pathological condition characterized by extensive necrosis and ichorous decay of the affected lung tissue, not prone to clear demarcation and rapid purulent melting.

Symptoms of gangrene of the lungs

1. The general severe condition of the patient: hectic body temperature, chills, severe intoxication, weight loss, lack of appetite, shortness of breath, tachycardia.
2. Chest pain on the affected side, worse when coughing.
3. When percussing the affected area, there is a dull sound and pain (Kryukov-Sauerbruch symptom), when pressing with a stethoscope on the intercostal space in this area, a cough appears (Kiessling symptom). With rapid decay of necrotic tissue, the dullness zone increases, and areas of higher sound appear against its background.
4. On auscultation, breathing over the affected area is weakened or bronchial.
5. After a breakthrough into the bronchus, a cough appears with the discharge of foul-smelling sputum of a dirty gray color in large quantities (up to 1 liter or more), moist rales are heard over the lesion. The course of gangrene of the lung is always severe. Complications often develop that can lead to death.

Laboratory data

1. Complete blood count: signs of anemia, leukocytosis, band shift, toxic granularity of neutrophils, marked increase in ESR.
2. General urine analysis: proteinuria, cylindruria.
3. Biochemical blood test: increased levels of sialic acids, fibrin, seromucoid, haptoglobin, alpha2- and gamma-globulins, transaminases, decreased levels of albumin.
4. General analysis of sputum: color - dirty gray, when left to stand, three layers are formed: the upper one is liquid, foamy, whitish in color, the middle one is serous, the lower one consists of purulent detritus and scraps of melting lung tissue; elastic fibers and many neutrophils are determined.

Instrumental research

X-ray examination: before breaking through into the bronchus - massive infiltration without clear boundaries, occupying one or two lobes, and sometimes the entire lung; after breaking through into the bronchus, against the background of massive darkening, multiple, often small, irregularly shaped enlightenments are determined, sometimes with fluid levels.

Lung Gangrene Screening Program

1. General urine and blood tests.
2. Blood biochemistry: total protein, protein fractions, transaminases, aldolase, bilirubin, urea, seromucoid, fibrin, haptoglobin, sialic acids.
3. General clinical examination of sputum: total, elastic fibers, atypical cells, BK.
4. Bronchoscopy with sputum examination for flora and sensitivity to antibiotics.
5. ECG.
6. Fluoroscopy and radiography of the lungs.
7. Fiberoptic bronchoscopy.

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