You’ve developed a character and nursed them into being in the pages of your story, now they need to die and a lung abscess is your choice of killer. How do you keep the writing convincing? What is a lung abscess? What are the symptoms? What does it do and how does it kill? Will you have to adjust the way you have written your character?

This article will answer these questions and help you kill your character with confidence.

For similar answers regarding the dying process see – ‘Killing your character convincingly- Staring Death in the Face’

What is a lung abscess?

A lung abscess is an area of infected lung that kills part of the lung and creates a cavity filled with dead tissue and infected pus.

Fact: Alcoholism is the most common cause of Lung Abscesses

Why your character dies

If the infection isn’t treated it can spread causing gangrene of the lung (necrotizing pneumonia) leading to blood poisoning (sepsis), multiple organ failure and death. A century ago 75% of sufferers died.

Causes of a lung abscess

  • As a complication of Bacterial or Fungal Pneumonia.
  • From foreign objects or infected matter introduced into the lung foreign and infected matter can be inhaled when under sedation, anaesthesia, or when unconscious,or from mouth infections (tooth abscesses or gum infection). Alcoholics often suffer from lung abscesses from inhaling vomit and periods of unconsciousness..Because the lungs process blood, anything that potentially infects the blood (dirty syringes or infected cannula) can pass the infection to the lungs and cause an abscess.
  • From an obstruction in the bronchial passage. This can include stuck food or vomit that has allowed infection to build up, but also any condition that causes the bronchial passage to become constricted ie difficulty swallowing (Dysphagia) or nervous recurrent paralysis or a condition that causes swelling.
  • From Gastro-oesophageal reflux disease, that allows the stomach juice to damage tissues high in the digestive tract can cause infection that could be inhaled.
  • After a stab wound to the lung
The symptoms are:

A phlegmy cough. The phlegm may be pus like, bloody or bad smelling.

Bad breath

Fever and chills

Chest pain

Shortness of breath (Dysphagia)

Sweating and night sweats

Weight loss


The risk is greater for anyone with a poor immune system (due to diabetes or old age)  or is already weakened by other illnessess such as cancer or AIDS. It is most commonly attributed to pneumonia, especially fungal pneumonia, but it can occur from something as simple as choking.or as dramatic as near drowning.

  “100 years ago Lung Abscesses killed 75% of sufferers”

Your fated character is likely to be an alcoholic or drug addict living on the streets, or not looking for medical help.

Alternatively, they will already have a chronic condition that requires assisted breathing.


The treatment for lung abscesses is mainly via antibiotic drugs either by IV or pills for 4-6 weeks. Medics may first carry out   a CT scan to rule out non bacterial causes and the abscess then drained before starting antibiotics.

If the antibiotics don’t work after 7 days and there are signs of sepsis (fever, irregular heart rate, increase in white blood cells), increased infection or respiratory failure or uncontrolled coughing up blood, then surgery would be considered. The surgery would be to insert a drainage catheter or remove the infected part of the lung. Endoscopic drainage via the airway may be considered, but it is risky.



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By Christaras A – Own work from anonmyized dicom image, CC BY 2.5,