Pneumonia symptoms

The first signs of pneumonia in children and adults

Pneumonia is a disease that has an infectious origin and is characterized by inflammation of the lung tissue in the event of provoking physical or chemical factors such as:

Complications after viral diseases (influenza, ARVI), atypical bacteria (chlamydia, mycoplasma, legionella)
Effects on the respiratory system of various chemical agents - poisonous fumes and gases (see. chlorine in household chemicals is hazardous to health)
Radioactive radiation, to which infection is attached
Allergic processes in the lungs - allergic cough, COPD, bronchial asthma
Thermal factors - hypothermia or burns of the respiratory tract
Inhalation of liquids, food or foreign bodies can cause aspiration pneumonia.

The cause of the development of pneumonia is the emergence of favorable conditions for the multiplication of various pathogenic bacteria in the lower respiratory tract. The original causative agent of pneumonia is the aspergillus mushroom, which was the culprit of the sudden and mysterious deaths of researchers of the Egyptian pyramids. Owners of domestic birds or lovers of urban pigeons can get chlamydial pneumonia.

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For today, all pneumonia is divided into:

out-of-hospital, arising under the influence of various infectious and non-infectious agents outside the walls of hospitals
hospital, which cause hospital-acquired microbes, often very resistant to traditional antibiotic treatment.

The frequency of detection of various infectious agents in community-acquired pneumonia is presented in the table.

Causative agent	Average% detection
Streptococcus is the most frequent pathogen. Pneumonia caused by this pathogen is the leader in the frequency of death from pneumonia.	3, %
Mycoplasma - affects most children, young people.	1, %
Chlamydia - chlamydial pneumonia is typical for people of young and middle age.	1, %
Legionellae - a rare pathogen, affects weakened people and is the leader after streptococcus by frequency of deaths (infection in rooms with artificial ventilation - shopping centers, airports)	, %
Hemophilus rod - causes pneumonia in patients with chronic bronchial and lung diseases, as well as in smokers.	, %
Enterobacteria are rare pathogens, affecting mainly patients with renal / hepatic, cardiac insufficiency, diabetes mellitus.	, %
Staphylococcus is a frequent pathogen of pneumonia in the elderly population, and complications in patients after the flu.	, %
Other pathogens	, %
The causative agent is not installed	3, %

When the diagnosis is confirmed, depending on the type of pathogen, the patient's age, the presence of concomitant diseases, a corresponding therapy, in severe cases, treatment should be performed in a hospital setting, with mild forms of inflammation, hospitalization of the patient is not is required.

Characteristic first signs of pneumonia, the vastness of the inflammatory process, acute development and danger of serious complications in untimely treatment - are the main reasons for the urgent circulation of the population for medical help. At present, a sufficiently high level of medical development, improved diagnostic methods, and a huge the list of antibacterials of a wide spectrum of action has considerably lowered a death rate from an inflammation of lungs (cm. antibiotics for bronchitis).

Typical first signs of pneumonia in adults

The main symptom of the development of pneumonia is a cough, usually it is first dry, obtrusive and persistent. protivokashlevye, expectorants with a dry cough), but in rare cases cough at the beginning of the disease can be rare and not strong. Then, as the inflammation develops, the cough becomes pneumatic with pneumonia, with a discharge of mucopurulent sputum (yellow-green color).

Any catarrhal virus disease should not last more than 7 days, and a sharp deterioration of the condition later 4-7 days after the onset of an acute respiratory viral infection or influenza indicates the onset of an inflammatory process in the lower respiratory ways.

Body temperature can be very high up to 39-40C, and can remain subfebrile 3, -3, C (with atypical pneumonia). Therefore, even with a low body temperature, coughing, weakness and other signs of malaise, you should definitely consult a doctor. Caution should be a repeated temperature jump after a light gap during the course of a viral infection.

If the patient has a very high temperature, one of the signs of inflammation in the lungs is the inefficiency of antipyretic drugs.

Pain with deep breath and cough. The lung itself does not hurt, as it is devoid of pain receptors, but involvement in the pleura process gives a pronounced pain syndrome.

In addition to cold symptoms, the patient has dyspnea and pale skin.
General weakness, increased sweating, chills, decreased appetite are also characteristic for intoxication and the onset of the inflammatory process in the lungs.

If such symptoms appear either in the midst of a cold, or a few days after the improvement, these may be the first signs of pneumonia. The patient should immediately consult a doctor to undergo a complete examination:

To pass blood tests - general and biochemical
To make a roentgenography of a thorax, if necessary and a computer tomography
Sputum for culture and sensitivity of the pathogen to antibiotics
Sputum for culture and microscopic determination of mycobacterium tuberculosis

The main first signs of pneumonia in children

Symptoms of pneumonia in children have several characteristics. Attentive parents may suspect the development of pneumonia with the following discomforts in the child:

Temperature

Body temperature above 38C, lasting for more than three days, not knocked down by antipyretics, there may also be a high temperature of up to 3, especially in young children. At the same time, all signs of intoxication are manifested - weakness, increased sweating, lack of appetite. Small children (as well as elderly people), can not give high temperature fluctuations with pneumonia. This is due to imperfect thermoregulation and immaturity of the immune system.

Breath

There is frequent shortness of breath: in children up to 2 months of age, 60 breaths per minute, up to 1 year, 50 breaths, after a year, 40 breaths per minute. Often the child spontaneously tries to lie down on one side. Parents may notice another sign of pneumonia in the child, if you undress the baby, then when breathing from the patient lung can be noticed the retraction of the skin in between the ribs and the lag in the process of breathing one side of the chest. There may be irregular breathing rhythm, with periodic stops of breathing, changes in the depth and frequency of breathing. In infants, shortness of breath is characterized by the fact that the child begins to nod his head in time with the breath, the baby can stretch his lips and inflate his cheeks, foamy discharge from the nose and mouth can appear.

Atypical pneumonia

Inflammation of the lungs caused by mycoplasma and chlamydia differ in that first the disease passes like a cold, there is a dry cough, runny nose, swelling in the throat, but the presence of dyspnea and a stably high temperature should alert parents to the development pneumonia.

Character of cough

Because of the perspiration in the throat, only coughing can appear first, then the cough becomes dry and painful, which is amplified by crying, feeding the baby. Later, the cough becomes wet.

Behavior of the child

Children with pneumonia become capricious, whiny, sluggish, they are disturbed by sleep, sometimes can completely refuse to eat, and also to appear diarrhea and vomiting, in babies - regurgitation and rejection of breasts.

Blood test

In the general analysis of blood, changes are detected that indicate an acute inflammatory process - increased ESR, leukocytosis, neutrophilia. Shift of the leukoformula to the left with increasing stab and segmented leukocytes. In viral pneumonia, along with high ESR, there is an increase in leukocytes due to lymphocytes.

With timely access to a doctor, adequate therapy and proper care for a sick child or adult, pneumonia does not lead to serious complications. Therefore, at the slightest suspicion of pneumonia, the patient should be given medical care as soon as possible.

zdravotvet.ru

Symptoms of pneumonia in adults

Pneumonia is an infectious disease. It remains one of the most common in the world. It is the leader among nosocomial infections leading to death. It is important to know the symptoms of pneumonia in adults in order to take timely action. Treatment of pneumonia and the prognosis of the development of the disease depends on the nature of the infection, age and general condition of the patient.

What is pneumonia and how dangerous it is

Inflammation of the lungs in an acute form is called pneumonia. It is caused by infections that can be transmitted in various ways, affecting the lung tissue. In the list of diseases that caused death, she is in fifth place, and medicine does not always help. Lethal outcome among adults from pneumonia is 10-33%. Intrahospital and atypical form of the disease takes even more lives - the risk of dying increases to 50%. In elderly people, people with weakened immunity, the prognosis of pneumonia is often disappointing.

From usual pneumonia, 1-3% of young patients who do not have diseases that die, can die. Among elderly patients, the mortality rate is up to 40-50%. Causes of death from pneumonia:

Concomitant diseases, such as cardiac pathologies, existing respiratory diseases (such as bronchitis), diabetes mellitus, problems in the genitourinary system;
bad habits (smoking, especially lengthy experience, drug addiction, alcoholism);
dysfunctional living conditions;
weakened immunity.

A special risk of inflammation of the lungs is for pregnant women. The disease itself is heavy due to dangerous pathologies. For a woman who carries a child, she is doubly dangerous - for the future mother and fetus. In early terms, pneumonia is threatened by an embryo, the tissues and organs of which are not yet formed. In the last trimester for a child, pneumonia is less dangerous than for a mother. Prevention is simple: strengthening the immune system of the mother.

The first signs of pneumonia

Symptoms of pneumonia in adults depend on the type of infection that caused the disease. There are several types of pneumonia, and each has its own clinical picture. The provoking factor for the onset of pneumonia is hypothermia affecting the upper respiratory tract. In the elderly, it often goes into a pathological form. Symptoms of pneumonia in adults are several: they are divided into varieties of insidious disease. The common form of pneumonia is viral, occurs in half the cases. Other reasons:

bacteria;
mycoplasma;
fungus;
parasites;
chlamydia;
streptococcus.

Atypical

A disease that occurs without symptoms characteristic of pneumonia is called atypical. The latent inflammation of the lungs is dangerous because it is delayed for its treatment, when many complications appear. Pulmonary manifestations fade into the background, the patient is more concerned about general intoxication. The X-ray does not show changes in the airway. Signs of atypical inflammation:

dry cough;
sore throat;
muscle pain;
headache;
weakness.

Aseptic atypical pneumonia is caused by Legionella, viruses, chlamydia, mycoplasmas, therefore, it is treated with antimicrobials. After infection, the symptoms of the disease manifest themselves in a period of 2 to 10 days. Changes in the lungs begin later than with a typical pneumonia. The temperature rises, the patient starts to suffocate, he does not have enough air. A large percentage of patients can be cured at home, but sometimes the ailment is difficult. The mortality from this type of disease is 3-5%, the cause is cardiopulmonary insufficiency.

Viral

This type of disease is caused by several viruses. In the first place - the flu. At the onset of pneumonia, triggered by the influenza virus, malaise is noticeable during 3-5 days. Then the condition worsens, shortness of breath starts, chest pains appear. Pneumonia is treated with rimantadine, zanamivir, oseltamivir. Viral pneumonia is caused by cytomegalovirus.

Serious complication of viral pneumonia is SARS, respiratory syndrome. It is caused by the viruses of Paramyxoviridae (they are also the cause of measles and mumps). The syndrome poses a great danger. Symptoms of pneumonia in adults with viral pneumonia are:

very high temperature accompanied by chills;
dry cough (unproductive);
headache and muscle pain;
fatigue without reason.

Bacterial

The cause of pneumonia in this case are bacteria: pneumococcus, staphylococcus, streptococcus. Bacterial pneumonia begins with a sharp temperature jump to a mark of 41 degrees. It lasts up to 3 days, and this symptom is considered a clear sign of bacterial infection. If the temperature then falls, then rises - this is a viral picture. Pneumococcal pneumonia is accompanied by the escape of "rusty" sputum, cardiac contractions become more frequent (tachycardia), breathing becomes more difficult. Treat the disease with antibiotics.

Grybkovoy

The most dangerous variant of pulmonary inflammation is fungal infection. It is due to the fact that fungal pneumonia is not manifested at first, and people do not know that they are sick. The disease is diagnosed late. The onset of the process of inflammation of the lung tissue is like atypical pneumonia, but with the exacerbation of symptoms, the nature of lung damage changes, cavities are formed. A frequent causative agent of such pneumonia is Candida albicans, a fungus. Initially, the patient has catarrhal symptoms: fever, cough, fatigue and shortness of breath. Then, when pussy is pus, then the correct diagnosis is made.

The main symptoms of pneumonia in an adult

The cold, the flu, should not last more than 7 days, if in 4-7 days after the onset of an acute respiratory infection the condition of the patient worsened, this signal starts in the lower respiratory tract of a dangerous inflammation. Symptoms of pneumonia in adults include pallor and dyspnea. If they have a cold, they are accompanied by weakness, sweating, decreased appetite - this is typical for intoxication in the beginning of pneumonia.

Temperature with pneumonia

With atypical pneumonia, body temperature is not always greater than 3,. In the usual cases, a sharp increase to 40 degrees is typical. With pneumonia, antipyretic drugs do not work. If you can not bring down the temperature - it's a sign of pneumonia. The temperature begins to drop when antibiotics work. It is dangerous if the disease runs without temperature: the patients sometimes do not take measures until the condition worsens. How much the temperature lasts depends on the pathogen: a fungus, a bacterium or a virus.

What a cough with pneumonia

At the beginning of the disease, a cough is dry, this is called unproductive. He becomes obtrusive, constant, exhausting. Inflammation develops - this symptom also changes. The sputum departs, the color of which depends on the nature of the infection: yellow-green, purulent, "rusty." Nasal cough, which does not pass for 7-10 days, is a clear sign of the inflammatory process in the lungs.

Voice tremor

The doctor can recognize the symptoms of the disease, assessing the patient's jittery response. The patient says words where there are several "p" sounds, and the doctor puts his hands on his chest, and determines the voice trembling. With pneumonia, part of the lung, or it is whole, becomes denser. This will be noticed by the medical doctor who conducts the diagnostics, by the fact that the voice tremor is amplified.

Diagnosis of the disease

If there is a suspicion of an inflammatory process in the lungs, a comprehensive diagnosis is performed. Sometimes already at the primary admission the doctor can determine the disease by conducting an auscultation, that is, having listened to the chest with a phonendoscope. But the main method of diagnosis in an adult is an X-ray. Necessarily the patient will take blood for general and biochemical analysis. If the patient is in the hospital, examine the culture of sputum, urine, check blood for antibodies to viruses.

Types of pneumonia

The mild forms of pneumonia, found in the initial stage, are treated at home. Remember that even mild pneumonia will complicate with improper care. It is necessary to adhere to the doctor's recommendations how to treat pneumonia in the home:

antipyretic drugs, anti-inflammatory;
an abundant drink is prescribed;
an important component of the treatment is a diet: the body is poisoned by toxins, light foods, more fluids are required.

How to treat pneumonia, how long the process will last depends on the severity and variety of the disease. Infection is sometimes found in the lung tissue for years, leading to a chronic illness. Fibers and connective tissues are damaged, they press on the pulmonary vesicles, which leads to hardening of the lungs, pneumosclerosis. The patient feels discomfort, constantly coughs. It is a slow, prolonged illness, which gradually leads to complications.

Conventional pneumonia is divided into mild, moderate, severe and extremely severe in severity, it depends on how the disease proceeds. Severe acute forms include pleuropneumonia, when one or more of the lungs are inflamed. There is pneumonia in the localization:

Focal (concentrated in the focus of inflammation);
segmental or polysegmentary, depending on whether one or more segments are located;
share - does not exceed one share;
total - covers all the lungs.

One-sided and two-sided

The inflammatory process is concentrated either on one side or it is bilateral. Unilateral pneumonia is divided into two types:

Right-sided - occurs more often, the right bronchus is wider than the left and shorter than it, the infection penetrates there freer.
Left-sided - develops less often, with it there are stagnant processes in the lung.

Two-sided covers both lungs: all lung tissue becomes inflamed, and the disease is provoked by bacteria (pneumococcus, hemophilic rod). Against the background of one infection, other harmful microorganisms are multiplied, mixed-infection develops. In the fight against a person enter several pathogens, to select antibacterial drugs for treatment is difficult.

Basal

The focus of inflammation, located along the root of the lung, is difficult to diagnose. Such cases are called basal pneumonia. In the diagnosis of computed tomography. The doctor should exclude tuberculosis and lung cancer, the focus of inflammation is similar to a picture on a tumor. Tuberculin tests are carried out. If you mistakenly prescribe drugs against tuberculosis, but they do not give an effect - this is considered a diagnostic sign.

Bronchopneumonia

Bronchial pneumonia characterizes the lesion of small branches of the bronchial tree of the patient. Bronchopneumonia refers to focal. The process of recovery will take a long time. Sometimes the disease is secondary, develops against the background of bronchitis. A person tries to cure bronchitis, that is prolonged, the condition worsens, weakness appears, temperature jumps. The cough that accompanies bronchitis intensifies, unpleasant purulent sputum is separated, at times - with veins of blood.

Important symptoms of this disease: shortness of breath, increased heart rate to 110 strokes for a minute, chest pain. To the development of bronchopneumonia leads not only bronchitis, but also ARVI. Often this type of pneumonia and viruses cause this kind of pneumonia, in order to treat the disease correctly, establish a pathogen, prescribe antiviral drugs or antibacterial. How much the disease is treated depends on the type of pathogen.

Hospital

In addition to community-acquired pneumonia, which develops under normal conditions, there is a serious form of illness - hospital, it is also hospital-acquired. The diagnosis is made when the inflammation appears after two days and more after placing a person in a hospital clinic with a completely different diagnosis. This is the most ruthless species, killing 50% of patients. The disease is caused by microorganisms. Types of nosocomial pneumonia:

associated with artificial ventilation;
postoperative;
Hospital-acquired pneumonia in hospitalized in serious condition.

Immunity of patients is weakened, the body struggled with another disease, was not ready to invade new microbes. To save the situation, patients are placed with droppers, use intravenous nutrition to maintain the vital forces of the body, use drugs of a new generation, potent drugs. Cure nosocomial pneumonia can not always. Treatment of pneumonia in this case is excluded.

The equity

Fracture pneumonia affects the lobe of the lung and the pleura. With this type of pneumonia, it is important to schedule injections of antibiotics, the duration of which is determined by the doctor. Applied physiotherapy, detoxification. Partial pneumonia begins suddenly and sharply. There are three forms of the disease:

Upper-lobar - it is difficult, with neurological disorders;
lower-lobed - gives a pseudo-picture of the "acute abdomen which confuses during diagnosis, chills and "rusty" sputum are characteristic;
central - inflammation develops deep in the lung, symptomatology is poorly defined, difficult to define.

Croupous

Croupous pneumonia proceeds acutely. The nature of the defeat of the lungs is bilateral. If the pathology is not recognized and the treatment is not started quickly, the patient will die from cerebral hypoxia and cardiovascular insufficiency. The first day the patient has a dry cough. The next day, sputum is rusty, vomiting occurs. On the third day, it becomes worse, dyspnea appears, tachycardia develops. The patient is not able to climb to one floor. Treat croupous pneumonia in pulmonology, in a hospital or resuscitation. Pulmonary lobes of the patient are totally affected on both sides.

Video: types and symptoms of pneumonia

Pneumonia is a dangerous disease, it is important to determine it in the early stages, when the treatment is effective even with folk remedies at home. In the video offered below, experts will tell in detail about the symptoms of pneumonia, teach what to look for if pneumonia occurs without the typical symptoms. Timely detection will avoid irreversible consequences.

sovets.net

Inflammation of the lungs symptoms and signs | How to identify pneumonia

Inflammation of the lungs in most cases refers to infectious diseases and is caused by various pathogens (pneumococci, Staphylococci, streptococci, mycoplasma, legionella, chlamydia, anaerobic microorganisms, Klebsiella, E. coli, viruses and other). Characteristic symptoms of the disease can successfully diagnose and treat this disease. Although in recent decades, due to the success of antibacterial therapy, mortality from pneumonia has decreased significantly.

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The high prevalence of the disease, the severity of development and the severity of symptoms in the initial period diseases, the possibility of serious complications make pneumonia a frequent reason for applying for emergency help. There are inflammations of croupous (lobar) and focal (bronchopneumonia). How to determine the inflammation of the lungs, everyone should know, who appreciates health.

Symptoms and signs of various forms of pneumonia

Symptoms of croupous pneumonia

1. The clinical picture of croupous pneumonia is characterized by a sharp onset with a sharp increase in temperature to 39-40 ° C, combined with chills and sweating.

2. Simultaneously, the symptoms of pneumonia are associated with headache, considerable weakness, lethargy.

3. With severe hyperthermia and intoxication, there may be cerebral symptoms - severe headache, vomiting, deafness of the patient or confusion and even meningeal symptoms.

4. Very early in the chest on the side of the inflammation there is pain. Often with pneumonia, the pleural reaction is so severe that the pain in the chest is the main complaint and requires emergency care.

5. A distinctive feature of pleural pain in pneumonia is its connection with breathing and coughing: a sharp increase in inspiration and coughing. In the first days, a cough may appear with the release of rusty sputum from red blood cells, sometimes unhealthy hemoptysis.

On examination, the patient's involuntary position often attracts attention: more often he lies on the side of inflammation. The face is usually hyperemic, sometimes a feverish blush is more pronounced on the cheek according to the side of the lesion. A characteristic symptom of pneumonia is shortness of breath to 30-40 breaths per minute, combined with cyanosis of the lips, swelling of the wings of the nose. Often in the early period of the disease, bubble rashes appear on the lips (herpes labialis). When examining the chest usually shows a lag in the affected side during breathing. Because of severe pleural pain, the patient, as it were, spares the side of inflammation. Over the zone of inflammation with percussion of the lungs, shortening of the percussion sound is determined, breathing acquires a bronchial hue, early appear small bubbly moist crepitic wheezing. Characterized by tachycardia up to 100 beats per minute and a slight decrease in blood pressure. The pronounced pleural reaction is sometimes combined with reflex pain in the corresponding half of the abdomen, painfulness upon palpation in its upper parts. Ictericity of the skin and mucous membranes can appear due to the destruction of red blood cells in the affected lobe of the lung and, possibly, the formation of focal necrosis in the liver.

How to identify inflammation of the lung focal shape?

With focal pneumonia, which often occurs in patients with chronic inflammation of the upper respiratory tract and bronchi or with heart failure and other serious diseases, Symptoms, as a rule, are less pronounced: fever up to 38-3, ° C, dry cough or with separation of mucopurulent sputum, possible pain on coughing and deep breathing, objectively detected the symptoms of inflammation of the lung tissue, expressed to varying degrees depending on the extent and location (deep or superficial) of the inflammation focus, the focus is most often detected crepitating wheezing.

How to identify the symptoms of pneumonia in the elderly?

Particularly unfavorable prognosis is when combined with acute vascular insufficiency with increasing cardiac weakness leading to pulmonary edema. In the origin of pulmonary edema in pneumonia, in addition to heart failure, toxic damage to pulmonary capillaries with increased vascular permeability is important.

1. The threat of lung edema is evidenced by the appearance of dry and especially wet wheezing above the healthy lung against the background of increased dyspnoea and worsening of the patient's condition.

2. The development of pneumonia in elderly people with concomitant diseases of the cardiovascular system, emphysema of the lungs, pneumosclerosis often requires the provision of emergency care, but the recognition of pneumonia in the early stages of the disease in these patients is often is difficult due to the absence of an acute onset, a weak pleural reaction with pain in the chest during breathing, insignificant increase in temperature.

3. The thought of pneumonia in the elderly and weakened patients should arise in those cases when, for obvious reasons, activity of the patient, weakness grows, he stops moving, lies all the time, becomes indifferent, often sleepy, refuses from eating.

4. A close examination reveals sometimes a one-sided cheeks blush, a dry tongue and always considerable shortness of breath and tachycardia.

5. Auscultation of the lungs usually reveals the focus of sonorous wet rales.

Manifestations of pneumonia in people with alcohol dependence

Very acute acute form of pneumonia in patients with chronic alcoholism and generally abusing alcohol. Usually, the inflammation of the lungs is severe, with severe intoxication and is often complicated by the development of alcoholic psychosis - "white fever". Psychosis is accompanied by visual and auditory hallucinations, mental and motor excitement, misconduct, disorientation in time and space. Often, patients try to escape and even throw themselves out of the window, do not allow themselves to be examined and injected. Meanwhile, very often pneumonia in patients in the state of "white fever" is complicated by the development of severe shock.

Signs and symptoms of complications of pneumonia

Signs of pneumonia that threaten life both in the case of croupous and focal forms may be due to the development of complications - septic shock, pulmonary edema, psychosis. Usually, shock and pulmonary edema are observed when pneumonia develops in elderly, weakened patients with severe concomitant cardiac pathology and often with circulatory failure. A harbinger of shock for pneumonia should be considered the emergence of persistent tachycardia, especially over 120 strokes per minute with low pulse filling. The development of shock is accompanied by a significant deterioration in the state, the appearance of a sharp weakness, sometimes a decrease in temperature. The skin acquires a gray shade, facial features sharpen, cyanosis increases, dyspnea increases significantly, the pulse becomes frequent and small, the BP drops below 90/60 mm Hg. v., stops urinating.

How to detect pulmonary complications of pneumonia?

Pulmonary complications of pneumonia (exudative pleurisy, abscess and especially breakthrough abscess in the pleural cavity with the development of pyopneumothorax) also require the provision of emergency care patient. Exudative pleurisy is manifested by lagging of the lower part of the chest on the affected side during breathing, expressed by stupidity and weakening of breathing on the affected side. About abscessing should be thought in the event that the intoxication grows, there is an abundant night sweat, the temperature acquires a hectic character with daily swings to 2 ° C or more.

Breakthrough abscess in the bronchus with pneumonia and the departure of a large amount of purulent foul sputum make the diagnosis of lung abscess obvious. Sharp deterioration of the condition, increased pain in the side with breathing, a significant, rapid increase in dyspnea, tachycardia, fall arterial pressure may indicate the breakthrough of the abscess into the pleural cavity and the complication of pneumonia by development pyopneuromotorax. The condition of patients with pyopneumotorax is always severe. Usually because of pain they are forced to occupy a semi-sitting position. Breathing, coughing and movement dramatically increase pain. Dyspnoea (more than 40 in 1 min) is characteristic. Above the patient side, the breathing is relaxed. Percussion reveals a boxed sound over the top and dullness over the lower sections of the lung. Pulse is frequent, small. Blood pressure is low. Such a formidable picture of pleural shock requires the provision of emergency care.

Diagnostic signs and signs of pneumonia

Usually pneumonia is successfully recognized on the basis of a characteristic clinical picture of the disease - a combination of pulmonary, extrapulmonary manifestations and an x-ray picture. Symptoms of pneumonia allow you to diagnose a prehospital stage:

1. Pulmonary symptoms - shortness of breath, cough, sputum (mucous, mucopurulent, etc.), pain in breathing, local clinical signs (dullness of percussion sound, bronchial breathing, crepitating rales, friction noise pleura).

2. Extrathoracic symptoms of pneumonia-fever, chills and sweating, myalgia, headache, cyanosis, tachycardia, herpes labialis, skin rash, lesions of mucous membranes (conjunctivitis), confusion, diarrhea, jaundice, toxic changes in peripheral blood.

Some features of the clinic of pneumonia allow conducting etiological diagnostics of pneumonia before obtaining the results of a microbiological study. The most common pathogens of "home" pneumonia in people younger than 60 years without severe concomitant pathologies become pneumococci, with the corresponding epidemiological situation - mycoplasma and viruses (Table. 7). Older patients with severe physical illnesses and chronic alcoholism are particularly prone to pneumonia caused by Gram negative microorganisms (klebsiella, E. coli, proteus, enterobacter), with frequent development of destruction of lung tissue and the formation of abscesses lung.

Diagnostic signs of pneumonia in old age

In elderly patients with severe physical illnesses or severe immunodeficiency, pneumonia can occur atypically. In such patients, fever is often absent, extrapulmonary symptoms predominate (disorders from the central nervous system system, etc.), there are little or no physical signs of pulmonary inflammation, it is difficult to identify the pathogen pneumonia.

The most important method, confirming the diagnosis of pneumonia and clarifying the localization of the focus of inflammation, is an x-ray examination of the thoracic organs. X-ray signs of pneumonia appear later than clinical, which, along with the characteristics of the pathogen and the localization of the process, causes cases of "x-ray negative" pneumonia.

Differential symptoms of pneumonia

The spread of pain to the upper abdomen, a combination of pain and pain during palpation, especially the right the upper quadrant of the abdomen, the intensification of pain during flicking on the right costal arch often make diagnosis difficult pneumonia. All these symptoms of pneumonia are caused by involvement in the inflammatory process of the pleura and irritation of the endings of the right diaphragmatic and inferior intercostal nerves, participating, in addition, in the innervation of the upper divisions of the anterior abdominal wall and of the abdominal organs cavity. This explains the frequent occurrence of various symptoms from the abdomen (abdominal) with acute diseases of the chest.

The severity of abdominal pain, combined with other gastrointestinal disorders, often leads to erroneous diagnosis of acute diseases of the abdominal cavity in patients with croupous pneumonia, as well as pleurisy, pericarditis, infarction myocardium. Often, these patients are sent to the surgical department with a diagnosis of acute cholecystitis, appendicitis, perforated stomach ulcer; There are cases when they were subjected to prompt intervention. In such cases, the diagnosis of pneumonia is facilitated by the absence in most patients of abdominal muscle tension and peritoneal irritation symptoms, although this symptom is not absolute.

Treatment of beginning inflammation of the lungs

Emergency care for pneumonia

The volume of emergency care for pneumonia depends, of course, on the prevailing symptoms. In the presence of severe respiratory failure, oxygen therapy is indicated, with persistent debilitating cough - antitussive drugs, with pleural pain - non-narcotic analgesics, with severe intoxication - detoxification therapy, with infectious-toxic shock - anti-shock therapy.

The development of mental disorders in alcoholics in pneumonia requires the use of psychotropic drugs: Seduxen (10 mg intravenously or intramuscular, the drug is contraindicated in chronic obstructive pulmonary diseases), Haloperidol (1-2 ml,% solution), Aminazine (2 ml, % solution). It should take into account the hypotensive effect of Aminazine, so its use in arterial hypotension is contraindicated. In addition, the use of psychotropic drugs is contraindicated in patients with acute alcohol intoxication.

Hospitalization with pneumonia

The diagnosis of pneumonia leads to the need for hospitalization of the patient in the therapeutic department hospitals, because only in a hospital can a clinical examination be completed and a sufficiently intensive therapy. Treatment of pneumonia at home is justified only in cases of its easy uncomplicated course, in the absence of any doubt in the diagnosis.

With pneumonia, complicated by cardiac and vascular insufficiency, development of an abscess or pyopneumothorax, immediate hospitalization of the patient is required. Patients with abnormal behavior, mental and motor excitement should be under the unremitting supervision of medical personnel.

Inpatient treatment for pneumonia

In an inpatient setting, before the susceptibility of the causative agent is established, antibiotic therapy is provided with empirical antibiotic therapy. In severe pulmonary inflammation with severe physical signs of pulmonary inflammation, pneumonia are regarded as pneumococcal and penicillin is administered intramuscularly or intravenously from 6 to 30 million units in day. In patients with chronic nonspecific lung diseases, Ampicillin is preferred in a daily dose of 4-8 g. In patients with chronic alcoholism and severe physical illnesses, as well as in patients with advanced the age of therapy begins with cephalosporins of the second generation or with a combination of Ampicillin with inhibitors betalactamases. With bilobar (bilobed) pneumonia, severe flow with severe intoxication phenomena and an unidentified pathogen, a combination antibiotics (semisynthetic Penicillins or Cephalosporins with Aminoglycoside - Gentamicin or Netromycin), use Fluoroquinolones, Carbapenems.

Along with inflammation of the lungs, inflammatory processes are observed, the characteristic feature of which is focal infectious destruction all elements of the lung tissue - either delimited (single or multiple abscesses), or not having clear boundaries (gangrene lungs).

Many types of pneumonia, as well as abscess and gangrene of the lungs, develop as a result of microaspiration of microflora from the oropharynx - aspiration pneumonia. The term was introduced to refer to a disease associated with aspiration into the lungs of not only the contents of the oropharynx, but also the contents of the stomach by patients unconscious at the time of vomiting. Primary lung response to aspiration is not infectious in nature, but is an inflammatory process in the bronchi in response to the irritating effect of hydrochloric acid in gastric juice. This reaction creates favorable conditions for the subsequent development of infection, aspirated together with the contents of the oropharynx and stomach. Slime from the oropharynx and gastric juice contain only a small amount of microflora, which is normally represented by a wide range of anaerobic and aerobic bacteria. Anaerobes, the number of which significantly exceeds the number of aerobes (ratio 1:), interact with each other as a mixed an infection capable of inducing not only inflammation of the lung parenchyma but also necrosis of the lung tissue followed by abscess formation.

Complications after treatment of pneumonia

Causes of destruction of pulmonary tissue after inflammation

Usually the causative agents of infectious destruction of lung tissue are necrotizing infections:

1. pyogenic bacteria (Staphylococcus aureus, Klebsiella, group A streptococci, bacteroides, fusobacteria, anaerobic streptococci, etc.);

2. mycobacteria (tuberculosis, etc.);

3. fungi (aspergillus, Histoplasma, Coccidioides);

4. parasites (amoebae, pulmonary flukes).

The most frequent forms of infectious destruction of the lungs are abscesses (single and multiple), gangrene, tuberculous caverns, fungal and parasitic abscesses.

Causes of abscess and gangrene after pneumonia

Abscess and gangrene of the lung are characterized by such signs of pneumonia as pulmonary necrosis arising in the central part of the inflammatory infiltrate, almost identical to the infiltrate observed with pneumonia, infarct-pneumonia or aspiration pneumonia. The necrotic tissue undergoes purulent fusion with the subsequent formation of purulent cavities.

The development of necrosis is facilitated by several factors:

1. violation of bronchial patency (narrowing of the lumen of small bronchi due to edema of the mucous membrane);

2. thrombosis of small vessels with subsequent disturbance of microcirculation;

3. necrotizing mixed anaerobic and aerobic infection.

Necrotizing lung tissue favors the rapid development of pathogenic microflora, the progression of purulent or putrefactive process, the melting of lung tissue with the formation of purulent cavities.

Abscess and gangrene have a common origin and uniformity of the initial phase of the development of the disease, identical to that of the after-inflammation of the lungs. Some authors disagree with this and tend to treat abscess and gangrene as qualitatively different pathological processes.

AstroMeridian.ru

Symptoms of pneumonia of the lungs

Before discussing the symptoms of pneumonia, it is necessary to understand a little the nature of the disease and clarify the meaning of terms describing the inflammatory processes in the lungs.

The nature of the disease and its causes

Until the beginning of the 21st century, Soviet medicine extended the expanded interpretation of the term "pneumonia." It was used to describe any acute focal inflammation of the lung tissue regardless of the cause. In the Russian classification of the disease "acute pneumonia" there were isolated such forms as "pneumonia from exposure chemical and physical factors allergic pneumonia infectious-allergic pneumonia "and others options.

Currently, in accordance with international standards, the term "pneumonia" refers to acute infectious diseases of the pulmonary tissue of predominantly bacterial nature. It is characterized by a local (focal) lesion of the respiratory tissue of the lung with the swelling of the inflammatory fluid into the pulmonary vesicles. Symptoms of inflammation in the lung tissue are revealed when the patient is examined by a doctor and an x-ray examination of the chest organs. For inflammation of the lungs are characterized by: acute febrile reaction (fever) and severe intoxication.

Since this disease by definition is an acute infectious disease, the definition of "acute" before the word "pneumonia" in the diagnosis became redundant and out of use.

Is there a chronic pneumonia?

The term "chronic pneumonia" in modern medicine is also not used, as it lost a real clinical basis. "Chronic pneumonia" of the 20th century was divided into several diseases of different nature. To distinguish them was made possible by improving the methods of examination and the progress of medical science. Chronic inflammatory reaction in the pulmonary ways takes place with all these diseases, which have received separate names and special methods of treatment. The most common of these is chronic obstructive pulmonary disease - a constant companion of tobacco smokers. Chronic bacterial infection is also characteristic of bronchiectasis.

What external signs does pneumonia have?

The first symptoms of inflammation of the lungs, which tell patients:

sudden onset of the disease;
acute fever (body temperature increase 8 8 ° C);
tremendous chills;
acute chest pain, worse with coughing and breathing;
cough dry or unproductive;
expectoration of a rusty color in a small amount;
dyspnea;
pronounced general weakness, fatigue;
sweating at night and with minimal physical exertion.

The thought of pneumonia should occur when a combination of body temperature increases with complaints of coughing, sputum separation, dyspnea, chest pain. Also, patients with pneumonia, complain of unmotivated weakness, fatigue, increased sweating at night.

How to recognize the latent form of the disease?

Almost in all age categories - in children, adolescents and adults, inflammation of the lungs has a similar clinical picture. But it is possible and hidden, sluggish form of the disease. Symptoms such as chest pain with coughing, fever and other signs may not be present in weakened adolescents or adults.

The latent symptomatology of pneumonia can be observed in the elderly. In 25% of patients aged> 65 there is no increase in body temperature, and the disease can manifest as fatigue, weakness, nausea, lack of appetite, abdominal pain, impaired consciousness.

Objective signs of inflammation of the lungs

The next stage of diagnosis of the disease after questioning is examination of the patient, revealing the objective symptoms of pneumonia. These are signs of a disease that the doctor finds in the patient when examining, tapping the chest (percussion) and listening to the lungs (auscultation).

Classical objective symptoms are:

Stupidity of percussion sound when tapping over inflamed areas of the lungs.
Listening to hard breathing over a limited area of the lung tissue at the site of inflammation.
Local listening to sonorous small bubbling rales over the inflamed area of the lung.

The main criterion that confirms pneumonia is the asymmetry of the lesion, that is, the presence of objective signs of inflammation of the lungs only on one side of the chest.

In almost 20% of cases, objective signs of pneumonia in patients may differ from the classical ones or absent. In these cases, latent symptoms can lead to diagnostic errors. Fortunately, in the arsenal of doctors there is a way to detect the inflammation of the lungs with the help of X-rays.

X-ray signs of pneumonia

The main x-ray symptom of pneumonia is a local compaction (infiltration) of lung tissue found in a patient with external signs of acute inflammation of the respiratory system.

The consolidation of the pulmonary tissue in pneumonia usually has a one-sided nature. Two-sided infiltration is rare. This symptom is more typical for swelling of the lungs, metastases of malignant tumors, systemic connective tissue diseases with respiratory organs.

An x-ray study with suspicion of pneumonia is conducted in all patients without exception: newborns, adolescents, adults, pregnant and lactating women, elderly people. This rule is associated with the danger of a diagnostic error, high mortality when delayed in prescribing antibiotics for patients with pneumonia.

Symptoms of viral pneumonia

Acute viral respiratory infection and pneumonia itself are various diseases. Viral infection, of course, is a leading risk factor for inflammation of the lungs. However, painful changes in the lung tissue caused by respiratory viruses should be clearly delimited from pneumonia. After all, the treatment of these conditions is fundamentally different. True microbial pneumonia is qualitatively different from that of lungs by viruses, which is characterized by bilateral infiltration along the way of the pulmonary vessels.

Viral infection, especially highly pathogenic influenza ("pork "avian"), can occur in the form of bilateral lung damage with inflammation in the course of the pulmonary vessels. At laboratory confirmation of the presence of highly pathogenic influenza virus in the patient's sputum and the absence of other pathogens in it, the diagnosis of viral pneumonia is justified.

The first significant symptoms of viral influenza pneumonia are rapidly increasing dyspnoea, an increase in temperature bodies to very high figures (9 9 ° C), a painful cough with bloody frothy sputum, a sharp general weakness. Influenza pneumonia is a very dangerous condition requiring treatment in the intensive care unit.

What is croupous pneumonia?

The term "croup pneumonia" is a traditional name for pneumococcal pneumonia, which has all the classic symptoms of lung inflammation in its entirety. Croup pneumonia is practically the only of all forms of this disease, in which a preliminary diagnosis corresponds to an aetiological (pneumococcal infection).

Croupous pneumonia develops sharply, beginning with a tremendous chill and a swift rise in body temperature to 39-40 ° C. An early sign is the appearance of chest pain on the side of the lesion, which is sharply aggravated by deep inhalation or coughing. First, the cough is dry, then on the second or third day of the disease, rusty or brown sputum appears. Characteristic signs are reddening of the face, especially on the side of the lesion, frequent shallow breathing to 30 per minute and more. Croup pneumonia usually affects one lung (usually the right one) and can capture 1, 2 or 3 lobes.

Atypical pneumonia in adolescents

The term "atypical pneumonia" means the belonging of the causative agent to microbes, called "atypical flora". Atypical flora are intracellular infectious agents - mycoplasma, chlamydia, legionella. Inflammation of the lungs, caused by mycoplasmas, most often affects young people in organized collectives - military service personnel, students, children, adolescents (20-30% of all pneumonia). And, on the contrary, at patients of the senior ages atypical pneumonia is diagnosed extremely seldom.

Atypical mycoplasmal or chlamydial infection is accompanied by muscle and headaches, chills, symptoms of ARI. Hemoptysis and chest pain are uncharacteristic of pneumonia caused by atypical flora.

Treat such a disease as atypical pneumonia, special drugs - antibiotics from a group of new macrolides (josamycin, rovamycin, spiramycin, klatsid). These drugs are approved for use in children and adolescents and do not cause intestinal dysbiosis.

ingalin.ru

Pneumonia in adults

Pneumonia is an acute inflammation of the lungs caused by infection. The initial diagnosis is usually based on the chest x-ray.

Causes, symptoms, treatment, prevention and prognosis depend on whether the infection is bacterial, viral, fungal or parasitic; hospital, or hospitalized in a nursing home; develops in an immunocompetent patient or against a background weakened immunity.

Code for the ICD-10 J18 Pneumonia without specifying the pathogen

Epidemiology

Pneumonia is one of the most common infectious diseases. In Europe, the annual number of patients with this diagnosis is between 2 and 15 per 1000 population. In Russia, the incidence of community-acquired pneumonia reaches 10-15 per 1000 population, and in older age groups (over 60 years) - 25-44 cases per 1000 people per year. Approximately 2-3 million people in the US are ill with pneumonia every year, about 4, 00 of them die. This is the most common hospital-acquired infection that has a lethal outcome, and is the most common of the common causes of death in developing countries.

Despite significant progress in diagnosis and treatment, mortality in this disease is increasing. Community-acquired pneumonia is the most common cause of death among all infectious diseases. In the general structure of causes of death, this disease ranks fifth after cardiovascular, oncological, cerebrovascular diseases and COPD, and in the older age group, lethality reaches 10-33%, and among children under 5 years - 25%. Even more high mortality (up to 50%) is characterized by the so-called hospital (hospital or nosocomial) and some "atypical" and aspiration pneumonia, which is due to the highly virulent flora that causes the listed forms of the disease, as well as the rapidly developing resistance to traditional antibacterial medicinal drugs.

The presence of a large number of patients with severe concomitant diseases and certain risk factors, including number of primary and secondary immunodeficiency, has a significant effect on the course and prognosis pneumonia.

Causes of pneumonia

In adults over 30 years, the most frequent pathogens of pneumonia are bacteria, and in all age groups, under all socio-economic conditions and in all geographic areas, Streptococcus pneumoniae. However, pneumonia can cause any pathogens, from viruses to parasites.

The respiratory tract and lungs are constantly exposed to the pathogenic organisms of the environment; upper respiratory tract and the oropharynx are especially colonized by the so-called normal flora, which is safe due to immune defense organism. If pathogens overcome numerous protective barriers, an infection develops.

Symptoms of pneumonia

Symptoms of pneumonia include malaise, coughing, shortness of breath, and chest pain.

Cough is usually productive in older children and adults and dry in infants, young children and the elderly. Dyspnoea is usually mild and occurs with physical activity and is rarely present at rest. Pain in the chest is pleural and localized next to the affected area. Inflammation of the lung tissue can be manifested by pain in the upper abdomen, when the infection of the lower lobe irritates the diaphragm. Symptoms vary in extreme age groups; Infection in infants can manifest as vague irritability and restlessness; in the elderly - as a violation of orientation and consciousness.

Manifestations include fever, tachypnea, tachycardia, wheezing, bronchial breathing, euphony and dullness with percussion. Symptoms of pleural effusion may also be present. Inflammation of the nostrils, the use of extra muscles and cyanosis are frequent in infants.

Signs of pneumonia, as previously thought, differ depending on the type of pathogen, but there are a lot of common manifestations. In addition, none of the symptoms or symptoms are sufficiently sensitive or specific to be able to determine the etiology on its basis. Symptoms may even resemble non-infectious lung diseases, such as pulmonary embolism, neoplasms and other inflammatory processes in the lungs.

Where does it hurt?

Chest pain Chest pain after pneumonia Chest pain with inspiration Chest pain when coughing

What's bothering you?

Shortness of breath Body temperature Chrypses in lungs Cough

Diagnosis of pneumonia

The diagnosis is suspected on the basis of the symptoms of the disease and is confirmed by chest radiography. The most serious condition, mistakenly diagnosed as an inflammation of the pulmonary tissue, is pulmonary embolism, which is more is likely in patients with minimal sputum production, absence of concomitant ARVI or systemic symptoms and risk factors thromboembolism.

When chest radiography is almost always found infiltration of a certain degree of severity; rarely infiltration is absent in the first 24-48 hours of the disease. In general, no definite results of the study distinguish one type of infection from another, although multi-dose infiltrates suggest infection of S. pneumoniae or Legionella pneumophila, and interstitial pneumonia involves viral etiology or mycoplasma.

A generalized blood and electrolyte test, urea and creatinine should be performed by a hospitalized person to determine the degree of hydration and risk. Two blood cultures are done to detect pneumococcal bacteremia and sepsis, as approximately 12% of all patients hospitalized with pneumonia have bacteremia; S. pneumoniae accounts for two thirds of these cases.

Studies are continuing to help determine whether the results of blood cultures are so important for treatment to justify the costs of these analyzes. Pulse oximetry or analysis of arterial blood gases should also be performed.

Usually, there is no evidence to conduct research, including the analysis of sputum, identifying a pathogenic microorganism; exceptions can be made for critically ill patients, suspected drug resistant or unusual microorganism (eg, tuberculosis), and patients whose condition worsens or who do not respond to treatment in for 72 hours. The feasibility of Gram staining and bacteriological examination remains questionable, since samples are often contaminated and their overall diagnostic effectiveness is low. In patients who do not produce sputum, samples can be obtained non-invasively by simple cough or after inhalation of hypertonic saline, or the patient may undergo bronchoscopy or endotracheal suction, which can be easily performed through the endotracheal tube in patients on IVL. In patients with a worsening condition and not responding to broad-spectrum antibiotics, the study should include staining for mycobacteria and for fungi and crops.

Additional studies are appointed under certain circumstances. People with a risk of legionellosis pneumonia (for example, patients who smoke have chronic lung diseases, the age is older 40 years old, receive chemotherapy or take immunosuppressants for organ transplantation) should carry out a urine test for Legionella antigens, which remains positive for a long time after the initiation of treatment, but allows the identification of only L pneumophila serogroup 1 (70% of cases).

A fourfold increase in antibody titers up to>: 28 (or in a single serum upon recovery>: 56) is also considered diagnostic. These tests are specific (95-100%), but not very sensitive (40-60%); Thus, a positive test indicates an infection, but a negative test does not exclude it.

Babies and small children with a possible RSV infection should be promptly examined for antigens in swabs from the nose or throat. There are no other tests for viral pneumonia; Viral culture and serological tests are rarely available at the clinic.

The PCR test (for mycoplasma and chlamydia) is not yet available, but it has good prospects due to its high sensitivity and specificity, as well as speed of execution.

The SARS-associated coronavirus test exists, but its role in clinical practice is unknown, and its use is limited beyond known outbreaks. In rare situations it is necessary to consider the possibility of anthrax.

What it is necessary to survey?

Lungs

How to inspect?

X-ray of the lungs Examination of the respiratory (lung) organs Computed tomography of the chest Study of bronchi and trachea

What tests are needed?

Sputum analysis General blood analysis Antibodies to pneumococcus in serum Antistreptolysin O in serum Antibodies to streptococcus A, B, C, D, F, G in the blood Staphylococcal infections: antibodies to staphylococci in the blood serum Respiratory mycoplasmosis: detection of the Mycoplasma pneumoniae antigen in the direct immunofluorescence Mycoplasma infection: detection of mycoplasmas Chlamydia: detection of Chlamydia trachomatis Influenza A: antibodies to the influenza A and B virus in the blood Antibodies to cytomegalovirus class IgM and IgG in the blood Cytomegalovirus infection: detection of cytomegalovirus HIV / AIDS test HIV infection: detection of the immunodeficiency virus human (PCR vich)

Who to contact?

Pulmonologist

Treatment of pneumonia

Risk assessment is carried out to identify those patients who can safely be treated on an outpatient basis and those who require hospitalization because of a high risk of complications. Prediction should reinforce, not replace, clinical data, as the choice of location of treatment is affected a host of invaluable factors - compliance, ability to self-service and the desire to avoid hospitalization. Hospitalization in OITR is required for patients who need artificial ventilation, and patients with arterial hypotension (systolic blood pressure <90 mm Hg. st.). Other hospitalization criteria in PIT include a respiratory rate of more than 30 / min, PaO2 / on inhaled O2 (PO2) less than 250, multi-lobe inflammation of the lung tissue, diastolic blood pressure less than 60 mm gt; st., confusion and urea of blood more than 1, mg / dl. Adequate treatment includes the fastest possible initiation of antibiotic therapy, preferably no later than 8 hours after the onset of the disease. Supportive treatment of pneumonia includes fluids, antipyretic and analgesic drugs and O2 for patients with hypoxemia.

Because microorganisms are difficult to identify, antibiotics are selected taking into account the likely pathogens and severity of the disease. Agreed recommendations have been developed by many professional organizations. Recommendations should be adapted to the local characteristics of the sensitivity of pathogens, the available drugs and the individual characteristics of the patient. It is important that none of the guidelines have recommendations for the treatment of viral pneumonia.

In bronchiolitis in children caused by RSV, ribavirin and specific immunoglobulin are used in monotherapy and in combination, but data on their effectiveness are inconsistent. Ribavirin is not used in adults with RSV infection. Amantadine or rimantadine orally at a dose of 200 mg once a day, taken within 48 hours of the onset of the disease, reduce the duration and severity symptoms in patients with suspected influenza during the epidemic, but effectiveness in terms of preventing unwanted outcomes of influenza pneumonia is unknown. Zanamivir (10 mg in the form of inhalation twice a day) and oseltamivir (orally 2 times a day for 75 mg, with an extremely severe flow of 2 times 150 mg) are equally effective in reducing duration of symptoms caused by influenza A or B if the reception is started within 48 hours of the onset of symptoms, although zanamivir may be contraindicated in patients with bronchial asthma. Acyclovir 5-10 mg / kg intravenously every 8 hours for adults or 250-500 mg / m2 body surface intravenously every 8 hours for children protects against infection of the lung caused by the varicella virus. If the patient does not begin treatment with antiviral drugs in the first 48 hours from the onset of the disease, then they should be used and to patients with the flu 48 hours after the onset of the disease. Some patients with viral inflammation of the lung tissue, especially those with influenza, develop additional bacterial infections and require antibiotics directed against S. pneumoniae, N. influenzae and Staphylococcus aureus. With empirical therapy, the condition of 90% of patients with bacterial pneumonia improves, which is manifested by a decrease coughing and shortness of breath, normalizing the temperature, reducing pain in the chest and reducing the number of white blood cells. The lack of improvement should cause suspicion of an atypical microorganism, resistance to an antibiotic with an inadequate spectrum action, co-infection or superinfection with a second pathogen, obstructive endobronchial lesion, immunosuppression, distant foci of infection with repeated infection (in the case of pneumococcal infection) or insufficient adherence to treatment (in the case of outpatients). If none of these causes is confirmed, failure of treatment is likely to result from inadequate immune protection.

Treatment for pneumonia of the viral origin is not carried out, since most viral pneumonia is resolved without it.

Patients older than 35 years after 6 weeks after treatment should undergo a second X-ray study; Preservation of an infiltrate causes suspicion of a possible malignant endobronchial formation or tuberculosis.

In addition to treatment

Physiotherapy for pneumonia What to do with pneumonia? Antibiotics for pneumonia Than to treat? Zaxter Paxeladine R-Cynex Saironem Tavanik Fagotsef Fazizhin Hailefloqs Cebopim Zedex Thyme Herb Galavit

Prevention

Some forms of community-acquired inflammation of the pulmonary tissue can be prevented by the use of pneumococcal conjugate vaccine (for patients <2 years), N. influenzae B (HIB) vaccine (for patients <2 years) and influenza vaccine (for patients> 65 years of age). Pneumococcal, HIB and influenza vaccine are also recommended for high-risk patients. High risk patients not vaccinated against influenza can be prescribed amantadine, rimantadine or oseltamivir during flu epidemics.

Forecast

The status of candidates for outpatient treatment usually improves within 24-72 hours. The state of hospitalized patients may improve or worsen, depending on the concomitant pathology. Aspiration is the main risk factor for death, as well as the elderly age, the amount and nature of concomitant pathology and certain pathogens. Death can be caused by pneumonia itself, by progression to a septic syndrome that damages other organs, or by aggravation of underlying co-morbidities.

Pneumococcal infection still causes approximately 66% of all fatal cases of community-acquired pneumonia with a known pathogen. The total mortality in hospitalized patients is approximately 12%. Adverse prognostic factors include age less than 1 year or older than 60 years; involving more than one share; the content of leukocytes in peripheral blood is less than 5000 / μL; concomitant pathology (heart failure, chronic alcoholism, hepatic and renal insufficiency), immunosuppression (agammaglobulinemia, anatomical or functional asplenism), infection with serotypes 3 and 8, and hematogenous spread with positive blood cultures or with extrapulmonary complications (arthritis, meningitis or endocarditis). Infants and children are in a group of special risk for pneumococcal otitis media, bacteremia and meningitis.

Lethality in legionella infection is 10-20% among patients with community-acquired pneumonia and is higher among immunosuppressive or hospitalized patients. Patients who respond to treatment recover very slowly, radiologic changes usually persist for more than 1 month. Most patients require hospitalization, many require respiratory ventilation support and 10-20% die, despite adequate antibiotic therapy.

Mycoplasma pneumonia has a favorable prognosis; almost all patients recover. Chlamydia pneumoniae responds slower to treatment than mycoplasma, and tends to recur after premature discontinuation of treatment. People of young age usually recover, but mortality among the elderly reaches 5-10%.

ilive.com.ua

Symptoms of pneumonia in an adult. Treatment of pneumonia

The acute infectious pathology, which is characterized by the destruction of lung tissue, is called pneumonia. Such a disease is more commonly known as pneumonia. There are many varieties of disease. And all the symptoms of pneumonia in an adult depend on the form of pathology. Understanding such a subtle nuance is an effective key to its treatment.

Brief description of the disease

Pneumonia develops if the infectious and inflammatory process, localized in the respiratory system, extends to the connective tissues of the lungs and the alveoli. Of course, this greatly affects the functioning of the body. After all, the part of fibrin and blood sweat in the alveoli. The patient is hampered by normal breathing, a violation of gas exchange is developing.

The disease can manifest itself in different ways. From the area of the lesion and the localization of the focus depends on the symptoms of pneumonia in an adult. Sometimes intoxication develops. Coagulability of blood can be impaired, bronchial passability worsens.

Despite the rapid development of modern medicine, pathology is quite common. And even today it can lead to death. Therefore, one should know the symptoms of pneumonia in an adult. After all, it is very important to identify the disease in time and start an adequate treatment.

Causes of the development of ailment

In general, the inflammation of the lungs occurs due to the action of microorganisms:

bacteria (streptococci, pneumococci);
viruses (pathogens of influenza, parainfluenza, rhinoviruses);
fungi (aspergillus, histoplasm).

In addition to the above, in the development of pathology can take part special types: legionella, chlamydia, mycoplasma. It is the latter group that provokes the development of atypical pneumonia in adults.

But even if the pathogen has entered the body, a person does not necessarily develop pathology. Symptoms of pneumonia in an adult will only appear if there are factors that reduce immunity.

These include:

any chronic pathologies (diseases of the urinary system, blood circulation, oncology, liver diseases, HIV infection);
bad habits;
mechanical trauma to the lung area;
complete immobility, prolonged hypodynamia;
inefficient nutrition (lack of minerals, vitamins);
occupational hazards;
debilitating physical exertion;
fatigue, neurosis, chronic stress;
elderly age;
taking certain medications (immunosuppressants, chemotherapy, hormonal drugs);
penetration of chemical agents in the respiratory tract.

Common signs of illness

Symptoms of pneumonia in an adult are divided into:

typical (pulmonary);
atypical (extrapulmonary).

Of course, it is very problematic to diagnose ailment at home at home. However, if you know the common features with which a dangerous pathology manifests, it is quite possible to distinguish it from banal ARVI.

But it should be understood that the following are the general symptoms of pneumonia in an adult.

So, to pulmonary signs carry:

Cough. Often it is moist, with abundant sputum. However, the elderly can be observed dry.
Dyspnea. Its occurrence is associated with physical activity. As a rule, it is moderate.
Pain. Patients experience severe discomfort in the sternum, exactly in the place where the inflammation occurred. When the pneumonia is localized in the lower parts of the lungs, a person experiences symptoms of diaphragm irritation. Pain occurs in the abdomen.
Rattles are heard, rapid breathing.
In the case of effusion into the pleural cavity of the fluid, the patient develops acute pain, intensified after coughing, shortness of breath, severe discomfort during movement or deep inspiration. In some cases, a violation of hemodynamics may develop: the pressure will decrease, the pulse will become more frequent, hypoxia will develop.
The nasolabial triangle acquires a cyanotic shade.

Like many infectious diseases, pneumonia leads to intoxication. In this case, extrapulmonary symptoms are observed.

These include:

hyperthermia;
deterioration of the condition: a decline in strength, weakness, fatigue;
headache, discomfort in the joints and muscles.

However, it should be understood that the clinical picture will be quite diverse in such pathology as pneumonia. Symptoms in adults, treatment depends on many factors. Among which: the causative agent, the mechanism of the development of the disease, the conditions of the onset and course of the disease, the spread of the process, the presence of complications, the severity.

Types of pathology

There are several classifications. Let's consider some of them.

If you take into account the causative agent of the disease, then distinguish the following types of pneumonia:

bacterial;
viral;
mycoplasmic;
fungal;
mixed.

According to the mechanism of development, the disease is classified as follows:

primary (independent disease of the respiratory system);
secondary (complication of some pathologies);
posttraumatic;
postoperative;
infarct-pneumonia (triggered by pulmonary artery embolism or thrombosis).

In the prevalence of the inflammatory process, pneumonia can be:

one-sided;
two-sided.

Depending on the course of the disease, the following forms are distinguished:

sharp;
protracted;
chronic.

Classification by prevailing defeat:

parenchymal pneumonia (cereal, lobar);
focal (bronchopneumonia, lobular);
pathology with connective tissue damage.

Consider the most common species. We will analyze what causes pneumonia symptoms in adults, treatment of the disease and the main features of the pathology.

Viral disease

This pathology has its own peculiarities. However, in its pure form it is extremely rare. In adults, viral-bacterial pneumonia is most often diagnosed.

As a rule, pathology is a complication of acute respiratory viral infection, influenza. If viral pneumonia is diagnosed, the symptoms in adults are as follows:

muscle pain;
runny nose, nasal congestion;
fever;
general tiredness;
headache;
cough with whitish transparent phlegm;
chills;
pain in the sternum, worse with deep breaths, coughing.

Asymptomatic pneumonia

In some cases, there may be inflammation of the lungs, which is not manifested by virtually no signs. This pathology is characterized as a latent form of the disease.

Pneumonia without symptoms in an adult is a dangerous condition. As a result of the absence of characteristic signs, the necessary treatment is not carried out. And this, in turn, can lead to quite unpleasant consequences.

In addition, a person does not even suspect that he is contagious, and leads a normal life. The danger lies in the fact that he continues to infect other people.

A latent form of pneumonia can develop as a result of reduced immunity, the intake of certain medications (antitussives, antibiotics, glucocorticosteroids).

And still, one can suspect a pathology by the following symptoms:

pallor of the skin, mucous membranes;
shortness of breath;
a rapid pulse;
fatigue, weakness;
an unusual blush;
wheezing.

Croupous pneumonia

In pathology, a whole lobe of the lung is affected. Sometimes the inflammation spans several lobes. The development of croupous pneumonia is triggered by pneumococcus. The causative agent is highly pathogenic. Therefore, there are severe symptoms of pneumonia in adults: with temperature, intoxication of the body.

The following signs of ailment are characteristic:

chills;
hyperthermia (up to 39 degrees Celsius);
cough (first 2 days - dry);
pain in the sternum stitching;
"Rusty" sputum due to veins of blood (appears on day 3);
shortness of breath.

In case of complication of the pathology, skin hyperemia, cyanosis of the nasolabial triangle, herpetic rash on the chin, cheeks, nose, pressure decrease, wheezing in the chest are observed.

Focal pneumonia

Such a disease is characterized by a gradual, barely noticeable beginning. In this case, there are symptoms of pneumonia in adults with a temperature of 38-39 degrees.

The disease manifests itself by the following signs:

the temperature rises to febrile;
weakness;
cough with phlegm;
sweating;
dyspnea;
painful syndrome in the chest with inspiration, cough;
hard breathing;
acrocyanosis.

Atypical form of the disease

Sometimes symptoms of pneumonia in an adult without temperature are observed. This form is provoked by atypical microorganisms:

mycoplasma;
legionella;
chlamydia.

Atypical pneumonia can cause and viruses, fungi, protozoa. Symptoms of pneumonia in an adult without a temperature are very similar to a cold.

The main signs of the disease:

weakness, fatigue;
headache;
stuffy nose, runny nose;
dry cough, significantly worse at night;
a sore throat;
shortness of breath, wheezing;
nausea, vomiting.

However, if the pathology is provoked by the legionella microorganism, then the temperature may rise. For pathology, a strong cough is characteristic. A somewhat different clinic is observed if it is provoked by chlamydia, mycoplasma pneumonia. Symptoms in adults without temperature are a characteristic manifestation of such a pathology.

This form of illness is susceptible to:

smokers;
living in the general closed premises (barracks, hostels);
people with weakened immunity;
patients suffering from chronic lung diseases;
children;
young people.

Radical pneumonia

This is a very serious form of pathology. Symptoms of radical pneumonia in adults may not appear for a long time. But at the same time very often lead to dangerous consequences. The insidiousness of the pathology lies in the difficulty of diagnosis. After all, the focus of inflammation at the root of the lung is localized.

The disease proceeds much brighter than a simple pathology. It should not be forgotten that the radical pneumonia is very dangerous. Symptoms and treatment in adults should be observed by a doctor. After all, if the therapy is wrong, the risk of complications is high.

Symptoms are characterized by the following symptoms:

wheezing in the lungs;
severe cough (dry or with a lot of sputum);
elevated temperature, not confused by drugs;
discomfort in the throat, pershenie;
coryza;
weakness, chills.

The main method of combating pathology is antibiotic therapy. If the treatment is chosen correctly, then the patient becomes much easier already for 2-3 days. Often used and fizioprotsedury.

Treatment of ailment

The approach to combating the disease must be comprehensive. The basis of treatment is made up of antibiotics. Preference is given to the penicillin drug. However, in a number of cases, other medicines may be prescribed.

The most popular antibiotics used to treat pneumonia are:

"Augmentin".
"Amoxicillin."
"Cefazolin."
"Amoxiclav."
"Cefatoxime."
"Azithromycin".

In addition, symptomatic therapy is prescribed. The patient is recommended expectorant drugs, restorative drugs, antipyretic drugs. Depending on the form of pathology, mucolytic, antimicrobial medications are prescribed.

If there are symptoms characteristic of a form such as SARS, symptoms in adults without temperature, then antibiotics are selected depending on the bacterium that caused the ailment. As a rule, the following drugs are prescribed:

"Erythromycin".
"Azithromycin".
"Tetracycline."

Conclusion

Any form of pneumonia today is successfully cured. But the main thing is to consult a doctor in a timely manner and fully comply with the prescribed treatment. The implementation of such simple rules will give a quick recovery. Health to you!

syl.ru

Pneumonia in a child - symptoms, treatment, causes

Inflammation of the lungs or pneumonia is one of the most common acute infectious and inflammatory diseases of a person. Moreover, the concept of pneumonia does not include various allergic and vascular lung diseases, bronchitis, and also pulmonary function disorders, caused by chemical or physical factors (injuries, chemical burns).

Especially often there are pneumonia in children, the symptoms and signs of which are reliably determined only on the basis of X-ray data and a general blood test. Pneumonia among all pulmonary pathologies in young children is almost 80%. Even with the introduction of progressive technologies in medicine - the discovery of antibiotics, improved methods of diagnosis and treatment - until now this disease is among the top ten most frequent causes of death. According to statistics in various regions of our country, the incidence of pneumonia in children is, %.

When and why can a child develop pneumonia?

Lungs in the human body perform several important functions. The main function of the lungs is the gas exchange between the alveoli and the capillaries, which envelop them. Simply put, oxygen from the air in the alveolus is transported to the blood, and from the blood carbon dioxide enters the alveolus. They also regulate body temperature, regulate blood coagulability, are one of the filters in the body, contribute to the purification, removal of toxins, disintegration products arising from various traumas, infectious inflammatory processes.

And when food poisoning, a burn, a fracture, surgical interventions occur, in case of any serious injury or disease, there is a general decrease in immunity, it is easy to cope with the filtration load toxins. That is why very often after a child has suffered or is suffering from injuries or poisonings, pneumonia occurs.

The most common pathogens are pathogens - pneumococci, streptococci and staphylococci, and recently cases of lung inflammation from such pathogens as pathogenic fungi, legionella (usually after staying at airports with artificial ventilation), mycoplasma, chlamydia, which are not often mixed, associated.

Pneumonia in a child, as an independent disease that occurs after a serious, strong, prolonged hypothermia, it is extremely rare, as parents try not to allow such situations. As a rule, in most children, pneumonia occurs not as a primary disease, but as a complication after an acute respiratory viral infection or influenza, less often other diseases. Why is this happening?

Many of us believe that acute viral respiratory diseases in the last decades have become more aggressive, dangerous their complications. Perhaps this is due to the fact that both viruses and infections have become more resistant to antibiotics and antiviral drugs, so they are so hard for children and cause complications.

One of the factors contributing to the increase in the incidence of pneumonia in children in recent years has been the overall poor health in the younger generation - how many children are born with congenital pathologies, malformations, lesions of the central nervous system. Especially severe pneumonia occurs in premature or newborn babies, when the disease develops against the background of intrauterine infection with insufficiently formed, not mature respiratory system.

In congenital pneumonia, the herpes simplex virus, cytomegalovirus, mycoplasmas are not infrequently causative agents, and with infection during labor, chlamydia, group B streptococci, opportunistic fungi, E. coli, Klebsiella, anaerobic flora, when infected with hospital infections, pneumonia begins on day 6 or 2 weeks after birth.

Naturally, pneumonia often happens in cold weather, when the organism is subjected to seasonal adjustment from heat to cold and vice versa, there are overloads for immunity, at this time there is a lack of natural vitamins in foods, temperature changes, damp, frosty, windy weather contribute to children's hypothermia and their infection.

In addition, if a child suffers from any chronic diseases - tonsillitis, adenoids in children, sinusitis, dystrophy, rickets (see. rickets in infants), cardiovascular disease, any severe chronic pathologies, such as congenital lesions central nervous system, malformations, immunodeficiency states - significantly increase the risk of developing pneumonia, weighed down its course.

The severity of the disease depends on:

Extensibility of the process (focal, focal, draining, segmental, lobar, interstitial pneumonia).
The child's age, the younger the baby, the narrower the airways, the less intense gas exchange in the child's body and the heavier the course of pneumonia.
Places where and for what reason there was a pneumonia:
- community-acquired: most often have an easier flow
- hospital: more severe, because it is possible to infect bacteria resistant to antibiotics
- Aspiration: when inhaled foreign objects, mixture or milk.
The most important role in this is played by the general health of the child, that is, his immunity.

Improper treatment of influenza and ARVI can lead to pneumonia in the child

When a child falls ill with an ordinary cold, SARS, influenza - the inflammatory process is localized only in the nasopharynx, trachea and larynx. With a weak immune response, and also if the causative agent is very active and aggressive, and the treatment in the child is carried out incorrectly, the process of reproduction of bacteria descends from the upper respiratory tract to the bronchi, then bronchitis. Further, the inflammation can affect the lung tissue, causing pneumonia.

What happens in the body of a child in a viral disease? Most adults and children in the nasopharynx always have different opportunistic microorganisms - streptococci, staphylococci, without causing harm to health, because local immunity holds them back growth.

However, any acute respiratory disease leads to their active reproduction and with the correct action of the parents during the illness of the child, immunity does not allow their intensive growth.

What should not be done during ARVI in the child, so as not to cause complications:

You can not use antitussives. Coughing is a natural reflex that helps the body to clear the trachea, bronchi and lungs from mucus, bacteria, toxins. If for the treatment of a child, in order to reduce the intensity of dry cough, use antitussives that affect the cough center in the brain, such as Stoptosin, Broncholitin, Libexin, Paxeladin, then sputum and bacteria may accumulate in the lower respiratory tract, which ultimately leads to inflammation lungs.
It is not possible to conduct any preventive therapy with antibiotics for colds, with a viral infection (see. antibiotics for colds). Against the virus, antibiotics are powerless, and with opportunistic bacteria immunity should cope, and only when complications arise according to the doctor's appointment is shown their use.
The same applies to the use of various nasal vasoconstrictors, their use contributes to a faster penetration of the virus into the lower respiratory tract; therefore, galazoline, naphthysine, sanorin should not be used in case of a viral infection safely.
Abundant drink - one of the most effective methods of removing intoxication, dilution of sputum and rapid cleansing respiratory tract is an abundant drink, even if the child refuses to drink, parents should be very persistent. If you do not insist that the child drink enough fluids, in addition, the room will have dry air - this will help to dry the mucosa, which can lead to a longer course of the disease or complication - bronchitis or pneumonia.
Permanent ventilation, lack of carpets and carpeting, daily wet cleaning of the room in which the child is, Humidification and air purification with the help of a humidifier and an air cleaner will help to cope faster with the virus and prevent development pneumonia. As clean, cool, moist air helps to dissolve sputum, quickly remove toxins with sweat, cough, wet breath, which allows the child to recover faster.

Acute bronchitis and bronchiolitis - differences from pneumonia

With SARS usually the following symptoms:

High temperature in the first 2-3 days of the disease (see Fig. antipyretics for children)
Headache, chills, intoxication, weakness
Qatar upper respiratory tract, runny nose, cough, sneezing, sore throat (it does not always happen).

In acute bronchitis with Orvy, the following symptoms may occur:

Minor increase in body temperature, usually up to 38C.
First the cough is dry, then it becomes wet, there is no shortness of breath, unlike pneumonia.
Breathing becomes hard, on different sides there are variously scattered rales that change or disappear after coughing.
On the roentgenogram, the intensification of the pulmonary pattern is determined, the structure of the roots of the lungs decreases.
There are no local changes in the lungs.

Bronchiolitis occurs most often in children up to a year:

The difference between bronchiolitis and pneumonia can be determined only by X-ray examination, based on the absence of local changes in the lungs. According to the clinical picture, the acute symptoms of intoxication and the increase in respiratory insufficiency, the appearance of dyspnoea - very much resemble pneumonia.
In bronchiolitis, the breathing in a child is weakened, shortness of breath with the help of an auxiliary musculature, nasolabial the triangle becomes a bluish hue, a common cyanosis is possible, a pronounced pulmonary-cardiac failure. When listening to a boxed sound is detected, the mass of scattered small bubbling rales.

Signs of pneumonia in the child

With a high activity of the causative agent of the infection, or with a weak immune response of the body to it, when even the most effective preventive medical measures do not stop inflammatory process and the child's condition worsens, parents can for some symptoms guess that the child needs more serious treatment and urgent examination doctor. In this case, in no case should not begin treatment by any popular method. If it really is pneumonia, it will not only not help, but the condition may worsen and time for adequate examination and treatment will be missed.

Symptoms of pneumonia in a child 2 - 3 years and older

How to identify attentive parents with a cold or viral illness that it is necessary to urgently call a doctor and suspect a pneumonia in the child? Symptoms that require an X-ray diagnosis:

After Orvi, influenza within 3-5 days there is no improvement or after a slight improvement again there is a temperature jump and increased intoxication, coughing.
Lack of appetite, sluggishness of the child, sleep disturbance, capriciousness persist within a week after the onset of the illness.
The main symptom of the disease remains a strong cough.
The body temperature is not high, but the baby has shortness of breath. In this case, the number of breaths per minute in a child increases, the rate of breaths per minute in children aged 1-3 years 25-30 breaths, children 4-6 years - a rate of 25 breaths per minute, if the child is in a relaxed calm condition. With pneumonia, the number of breaths becomes larger than these figures.
With the other symptoms of a viral infection - cough, temperature, cold, severe pallor of the skin is observed.
If the temperature is high for more than 4 days and antipyretic agents such as Paracetamol, Efferalgan, Panadol, Tylenol are not effective.

Symptoms of pneumonia in infants, children under one year of age

The onset of the disease can be noticed by the mom by changing the behavior of the baby. If the child constantly wants to sleep, become sluggish, apathetic or vice versa, a lot of naughty, crying, refuses to eat, while the temperature may slightly increase - mom should urgently turn to pediatrician.

Body temperature

In the first year of life, pneumonia in a child, a symptom which is considered to be high, not knocked down temperature, is different in that at this age it is not high, does not reach 3, or even 3, -3,. The temperature is not an indication of the severity of the state.

The first symptoms of pneumonia in an infant

This causeless anxiety, lethargy, decreased appetite, the baby refuses from the breast, the sleep becomes restless, short, there is a loose stool, there may be vomiting or regurgitation, a runny nose and a paroxysmal cough that worsens during crying or feeding child.

Child's breathing

Pain in the chest with breathing and coughing.
Sputum - with a damp cough, purulent or mucopurulent sputum (yellow or green) is secreted.
Shortness of breath or an increase in the number of respiratory movements in young children is a clear sign of pneumonia in a child. Dyspnoea in babies can be accompanied by nodding to the breath, as well as the baby blows his cheeks and extends his lips, sometimes there are foamy discharge from the mouth and nose. The symptom of pneumonia is considered to be the excess of the number of breaths per minute:

In children up to 2 months - the norm is up to 50 breaths per minute, more than 60 is considered a high frequency.
In children, after 2 months to a year, the norm is 25-40 breaths, if 50 or more, this is an excess of the norm.
In children older than one year, the number of breaths more than 40 is considered a shortness of breath.

The skin relief during breathing changes. Attentive parents can also notice the retraction of the skin during breathing, more often on one side of the patient's lung. To notice this, it is necessary to undress the baby and observe the skin between the ribs, it retracts when breathing.

With extensive lesions, there may be a lag of one side of the lung with deep breathing. Sometimes you can notice periodic stopping of breathing, disturbance of rhythm, depth, breathing frequency and the child's desire to lie on one side.

Cyanosis of the nasolabial triangle

This is the most important symptom of pneumonia, when the blue skin appears between the lips and the spout of the baby. Especially this sign is pronounced when the child sucks the breast. With severe respiratory failure, a slight blueing can be not only on the face, but also on the body.

Chlamydia, mycoplasmal pneumonia in children

Among the pneumonias, the causative agents of which are not banal bacteria, but various atypical representatives secrete mycoplasmal and chlamydial pneumonia. In children, the symptoms of such pneumonia are slightly different from the course of the usual pneumonia. Sometimes they are characterized by a hidden sluggish current. Symptoms of SARS in a child can be as follows:

The onset of the disease is characterized by a sharp rise in body temperature to 3, C, then a stable subfebrile temperature of -3, -3 is formed, or even a temperature normalization occurs.
It is also possible the onset of the disease with the usual signs of ARVI - sneezing, choking in the throat, a bad cold.
Persistent dry debilitating cough, shortness of breath may not be permanent. Such a cough usually occurs with acute bronchitis, and not pneumonia, which complicates the diagnosis.
When listening to a doctor, scanty data are usually presented: rare variegated rattles, pulmonary percussion sound. Therefore, according to the nature of wheezing, it is difficult for a doctor to determine atypical pneumonia, since there are no traditional signs, which greatly complicates the diagnosis.
In the analysis of blood in atypical pneumonia there may be no significant changes. But usually there is increased ESR, neutrophilic leukocytosis, a combination with anemia, leukopenia, eosinophilia.
On the x-ray of the chest reveals a pronounced enhancement of the pulmonary pattern, non-uniform focal infiltration of the pulmonary fields.
Both chlamydia and mycoplasma have a feature that exists for a long time in the epithelial cells of the bronchi and lungs, therefore, pneumonia usually has a prolonged recurrent character.
Treatment of atypical pneumonia in the child is carried out by macrolides (azithromycin, josamycin, clarithromycin), because the pathogens to them are most sensitive (to tetracyclines and fluoroquinolones, too, but they are children contraindicated).

Indications for hospitalization

The decision on where to treat a child with pneumonia - in a hospital or at home, the doctor takes, while he takes into account several factors:

The severity of the condition and the presence of complications - respiratory failure, pleurisy, acute disorders of consciousness, heart failure, falls AD, lung abscess, pleural empyema, infectious-toxic shock, sepsis.
The defeat of several lobes of the lung. Treatment of focal pneumonia in the child at home is entirely possible, but with croupous pneumonia treatment is best done in a hospital.
Social indications are poor living conditions, inability to perform care and doctor's prescriptions.
Age of the child - if the infant is sick, this is the reason for hospitalization, because the pneumonia of the baby is a serious threat to life. If pneumonia develops in a child under 3 years of age, treatment depends on the severity of the condition and most often doctors insist on hospitalization. Older children can be treated at home provided that the pneumonia is not severe.
General health - in the presence of chronic diseases, weakened overall health of the child, regardless of age, the doctor may insist on hospitalization.

Treatment of pneumonia in children

How to treat pneumonia in children? The basis of therapy for pneumonia is antibiotics. At a time when there were no antibiotics in the arsenal of doctors with bronchitis and pneumonia, a very frequent cause of death of adults and children there was pneumonia, therefore, in no case should one refuse to use them, no folk remedies for pneumonia are effective. From the parents it is required to strictly follow all the doctor's recommendations, the proper care of the child, the observance of the drinking regime, nutrition:

Reception of antibiotics must be carried out strictly in time, if the appointment of the drug 2 times per day, this means that there should be a break of 12 hours between meals, if 3 times a day, then a break of 8 hours (cm. 11 rules how to take antibiotics correctly). Antibiotics are prescribed - penicillins, cephalosporins for 7 days, macrolides (azithromycin, josamycin, clarithromycin) - 5 days. The effectiveness of the drug is estimated within 72 hours - an improvement in appetite, a decrease in temperature, dyspnea.
Antipyretics are used if the temperature is above 39C, in infants above 38C. Initially, antibiotic treatment of antipyretics is not prescribed, as the evaluation of the effectiveness of therapy is difficult. It should be remembered that during a high temperature in the body, the maximum amount antibodies against the causative agent of the disease, so if the child can tolerate the temperature of 38C, it is better not to knock down. So the body quickly cope with the microbe that caused pneumonia in the baby. If the child had at least one episode of febrile seizures, the temperature should be knocked down already at 3, C.
Nutrition of the child with pneumonia - lack of appetite in children during illness is considered natural and the child's refusal from food intake due to increased strain on the liver when fighting infection, so you can not force a child to feed. If possible, prepare light food for the patient, exclude any ready-made chemicals, fried and fatty, try to feed child simple, easily assimilated food - cereals, soups on a weak broth, steam cutlets from low-fat meat, boiled potatoes, various vegetables, fruit.
Oral hydration - in water, natural freshly diluted juices - carrot, apple, weakly boiled tea with raspberries, rose hips infusion, water-electrolyte solutions (Regidron and etc).
Airing, daily wet cleaning, use of air humidifiers - ease the condition of the baby, and the love and care of parents works wonders.
No restorative (synthetic vitamins), antihistamines, immunomodulating agents are not used, as often lead to side effects and do not improve the course and outcome of pneumonia.

Reception of antibiotics for pneumonia in a child (uncomplicated) usually does not exceed 7 days (macrolides 5 days), and if bed rest is observed, perform all the doctor's recommendations, in the absence of complications, the child quickly recovers, but for a month there will still be residual effects in the form of a cough, slight weakness. With atypical pneumonia, treatment can be delayed.

In the treatment of antibiotics in the body, the intestinal microflora is broken, so the doctor prescribes probiotics - RioFlora Immuno, Acipol, Bifiform, Bifidumbacterin, Normobakt, Lactobacterin. Analogues of Linex - a list of all probiotics). To remove toxins after the end of therapy, the doctor can prescribe sorbents, such as Polysorb, Enterosgel, Filtrum.

With the effectiveness of treatment for general regimen and walks, it is possible to transfer the child from the 6th to the 10th day of the disease, the hardening to resume after 2-3 weeks. With a mild pneumonia, large physical exertion (sport) is allowed after 6 weeks, with complicated after 12 weeks.

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