Bronchial pneumonia

What is bronchial pneumonia?

Bronchial pneumonia is a disease in which inflammatory processes in the lungs are observed. The trigger mechanism for such an ailment is bacteria and viruses that enter the respiratory system and affect the bronchial tubes. Bronchial pneumonia is often the result of bronchitis or ARVI, especially if these two diseases have not been treated properly or have not been completely eliminated.

Main risk groups

Such inflammation occurs not only because of streptococci or pneumococci. The reasons may be the following:

• If a piece of product has got into the respiratory tract;
• if there is a neoplasm that transmits the lungs;
• because of poisoning with poisonous gases;
• can be a complication after some types of operations.

Bronchopulmonary disease can be observed absolutely in any person, but physicians allocate a separate category of persons who are more predisposed to this:

• babies and children under the age of 3;
• if there are problems with the birth of the respiratory system;
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• in the presence of immunodeficiency;
• for people who are already 60 years old;
• if a history of a disease such as asthma or bronchitis;
• There is also a tendency for HIV-infected individuals;
• People with diabetes or having heart problems may suffer from inflammation.

And, of course, a separate category is smokers who self-poison themselves and provoke the development of many diseases, including pulmonary ailments.

Bronchial pneumonia and its symptoms

There are certain symptoms that can tell a person that they have inflammation. Such a disease manifests itself in the form of:

Fever, when the temperature can range from 3 to 39 degrees. This condition is observed for 1-3 days, while there is weakness, lack of appetite. A person can be tormented by chills or, conversely, constantly thrown into a fever. The dream is broken.The calf muscles feel pain.

Temperature has always been an indicator that the body is trying to fight the infection. It is for this reason, doctors recommend at this temperature not to take antipyretics.

Cough is a natural protective mechanism, through which the human body tries to eliminate all the irritating accumulation.

Pulmonary cough is dry in nature, while in most cases it is exacerbated. If pneumonia is not treated, expectoration will appear with sputum. Such secretions have a greenish-yellow hue, with a heavier form of pneumonia bloody inclusions will be observed.

A person with pneumonia begins to experience difficulty in breathing. In this case, dyspnea may accompany not only the state of active activity, but also be observed at rest.

Since bronchial pneumonia is a lung disease, then, accordingly, this organ will also be ill. At the beginning, discomfort can occur only when coughing or during a deep inspiration. The place of pain localization is the affected side of the lung. Its nature can be stabbing or pulling.

Separate attention deserves the symptoms and in children:

• not always a child may have a fever, it may even be below normal;
• it is important to pay attention to the breath that can be whistling and loud;
• there is also shortness of breath;
• in a pneumonia can pass such an apparently harmless disease, as ARVI or bronchitis, which for a long time do not pass;
• the child's activity is significantly reduced, he becomes apathetic;
• loss of appetite.

While the child is growing, his body also grows. The same goes for the respiratory tract. Therefore, it is so important to determine the timing of pneumonia in a child, since this disease can develop rapidly, especially in infants. The earlier the disease is diagnosed, the better the treatment will be.

Timely diagnostics

If there is any of the above symptoms, you should immediately go to the doctor. Especially it concerns children. The therapist will perform a number of procedures:

• temperature measurement;
• percussion and auscultation of the lungs.

But for the sake of justice it is worth noting that the tapping is not so often used today, because it does not always give a full result. It is believed that with pneumonia, the sound will be somewhat shortened in the place where there is inflammation, but this does not always work. Therefore, they rely more on listening. With the help of a phonendoscope, a doctor can hear characteristic wheezing, noise from friction of the pleura, etc. All these symptoms can indicate the stage of the disease.

In addition, the doctor may refer the patient to radiography and some laboratory tests. If the case raises doubts, they can prescribe a CT scan, take phlegm for analysis and conduct tests in order to determine the presence of the pathogen.

In fact, radiography today is particularly popular, as it gives the most detailed picture of the lungs. It is carried out twice: the first time, when it is necessary to specify the diagnosis, and the second - after the treatment is completed. This allows the specialist to assess the patient's condition and how effective the therapy has been, whether there are any complications.

Treatment of bronchial pneumonia

Like any other disease, pneumonia should be noted on time to take appropriate measures. All the doctor's instructions should be carried out unquestioningly, otherwise there is a threat of even a lethal outcome.

Basically for successful recovery, you need to remember the following points:

Bed rest. In this period, you can not load the body with active activity. The room in which the patient is located should be constantly ventilated, and ideally there should be a wet cleaning every morning. If the patient does not have a temperature, he should breathe fresh air. In winter it can be done on the balcony, but it is necessary to dress warmly beforehand.

As soon as the bronchial pneumonia is over, it is recommended after 15-20 days to begin the hardening procedures.

To avoid recurrence, any active physical activity is allowed no earlier than 6 weeks after recovery.

It is important to observe a certain diet in case of inflammation. It is desirable to take more of those foods that contain proteins and complexes of various vitamins. Also during this period it is necessary to use a lot of warm liquid: herbal infusions, weak tea, mineral water.

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If the general condition allows the initiation of physiotherapy methods, they should be used. But only on condition that there is no temperature. Usually, pneumonia is prescribed chest massage, inhalation, which facilitate breathing and help to remove phlegm.

Inflammation of the lungs is also treated with antibiotics. But here you should always seek advice from a doctor, as in each case the drug must be selected individually. This selection is influenced not only by the stage of the disease, but also by the reason for which it arose.

Usually antibiotics are taken orally in the form of tablets or intravenous / intramuscular injections. In parallel, the doctor can prescribe antipyretics, vitamin complexes, antiallergic and expectorant medications.

As for children, then treatment is carried out only in the hospital. If the state of health causes fear, the baby is placed in the intensive care unit.

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Any medicine for a child is prescribed only from the calculation of its weight. In the opposite case, if parents start self-medication, they can only do harm. Therefore, at the first alarming symptoms the child should immediately lead him to the doctor, in order to avoid complications and even death.

respiratoria.ru

Bronchial pneumonia: symptoms and diagnosis

Bronchopneumonia, focal pneumonia are other names of this disease. Bronchial pneumonia, the symptoms and diagnosis of which the topic of this article is - this kind of pneumonia, which affects small bronchi and surrounding lung tissue.

Bronchial pneumonia: a characteristic of the disease

In bronchial pneumonia, inflammation is focal. It can develop against the background of some infectious (influenza and other respiratory viral infections) and some non-infectious diseases (oncological pathology, myocardial infarction). It happens primary (in unchanged lung tissue) or secondary (on the background of bronchitis and other diseases).

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At risk for developing bronchopneumonia are children under 2 years old, elderly people, patients with chronic lung diseases.

Bronchial pneumonia: symptoms of disease

Symptoms of bronchial pneumonia are:

1. intoxication (weakness, fatigue, feeling of "brokenness headache);

2. febrile fever (above 38º);

3. cough (at first - dry, then - wet);

4. sputum discharge mucopurulent, sometimes with blood veins;

5. respiratory failure (dyspnea - rarely) is an important symptom of bronchial pneumonia;

6. sometimes - a pain in the chest.

Bronchial pneumonia: diagnosis of the disease

Upon examination, the doctor may or may not reveal (if the focus is small or in the central lobules) dullness of the percussion sound. When auscultation of pathological changes in the diagnosis of bronchial pneumonia may also not be, or in a limited area can be determined dry or wet raznochilernye rattles, crepitus. In the analysis of blood, an "inflammatory" shift is detected (an increase in the number of leukocytes with a shift of the formula to the left, acceleration of the ESR).

The main method of diagnosing bronchial pneumonia is radiography of the lungs, revealing foci of darkening, blurring of the pulmonary field.

Bronchial pneumonia: treatment of a disease

If you have any symptoms of pneumonia, you should immediately contact the hospital. The treatment shows the observance of bed rest, plentiful drink, rational nutrition.

Bronchial pneumonia is the basis for prescribing antibiotic therapy. The specific antibacterial preparation, as well as the dosage and course of treatment of bronchial pneumonia, are determined individually by the attending physician in each case, and depends on the clinical picture, the results of the examination, the presence of complications, individual contraindications.

Of other medications for bronchial pneumonia are mucolytics, drugs that increase immunity and others. Physiotherapy (ozocerite and paraffin applications, mustard plasters, therapeutic mud, electrophoresis of various preparations, shortwave inductothermy or diathermy) and physiotherapy exercises are also shown.

AstroMeridian.ru

Bronchopneumonia

Bronchopneumonia is an inflammatory disease that affects small areas of the lung. Consider the main symptoms, types, methods of diagnosis, treatment and measures to prevent the disease.

The disease is called focal pneumonia, as it differs from the classic clinical symptomatology of inflammation. There are several types and forms that differ in the nature of the course and complexity of therapy. The peculiarity of the disease is that the patient is waiting for a long treatment, which does not exclude relapses.

Most often, the disease occurs in elderly patients and in children in the first years of life. This is explained by the specific regulation of breathing, the structure of the respiratory system and the metabolic processes.

ICD-10 code

According to the international classification of diseases of the 10th revision, bronchopneumonia refers to:

Class X

Diseases of the respiratory system (J00-J99):

J00-J06 Acute respiratory infections of the upper respiratory tract

J10-J18 Influenza and pneumonia:

• J10 Influenza caused by an identified influenza virus
• J11 Influenza, virus not identified
• J12 Viral pneumonia, not elsewhere classified
• J13 Pneumonia caused by Streptococcus pneumoniae
• J14 Pneumonia caused by Haemophilus influenzae (Afanasyev-Pfeffer's stick)
• J15 Bacterial pneumonia, not elsewhere classified
• J16 Pneumonia caused by other infectious agents not elsewhere classified
• J17 Pneumonia in diseases classified elsewhere
• J18 Pneumonia without specification of agent:
  • J18.0 Bronchopneumonia, unspecified
  • J18.1 Shared pneumonia, unspecified
  • J18.2 Hypostatic pneumonia, unspecified
  • J18.8 Other pneumonia, causative agent not specified
  • J18.9 Pneumonia, unspecified

J20-J22 Other acute respiratory infections of the lower respiratory tract

J30-J39 Other diseases of the upper respiratory tract

J40-J47 Chronic diseases of the lower respiratory tract

J60-J70 Lung diseases caused by external agents

J80-J84 Other respiratory diseases affecting mainly the interstitial tissue

J85-J86 Purulent and necrotic conditions of the lower respiratory tract

J90-J94 Other diseases of the pleura

J95-J99 Other respiratory diseases

To identify the root cause of the disease and its pathogen, it can use an additional encoding in μb 10.

ICD-10 code J18.0 Bronchopneumonia, unspecified

Causes of bronchopneumonia

The defeat of the inflammatory inflammatory system has several causes, as a rule, they are associated with infectious agents.

Consider the main factors:

• Infection, originating in the bronchi and extending to the lungs. Inflammation can be triggered by such pathogens as: Staphylococcus aureus, pneumococci, Escherichia coli, Klebsiella.
• Long-term exposure to the respiratory system of aggressive chemical or physical stimuli.
• In most cases, this is a separate disease, but may act as a complication or symptom of others neglected and chronic diseases, causing severe disruption in the immune system (bronchitis, bronchiolitis).
• External infections that develop against a weakened immune system and other diseases. So, with the flu, the bronchial mucosa changes, because of this, bacteria and viruses provoking focal inflammation begin to multiply.

If the disease has a bacterial form, then this is due to the invasion of bacteria into the parenchyma of the lung tissue. The immune system responds to infection and inflammation occurs. This reaction provokes the filling of exsudate alveolar sacs. The focal form has several isolated foci, so replacing air with a fluid affects one or more of the pulmonary lobes.

Causative agent bronchopneumonia

In most cases, the causative agent of the inflammatory process are low-microbial microorganisms. It can be: streptococci, Escherichia coli, Staphylococcus, fungi, Haemophilus influenzae. The spectrum of pathogens is quite wide, and varies depending on the age category of the patients.

• In young children - a virus, in older children and young patients - mycoplasma (microorganisms are similar to viruses and bacteria, provoke atypical inflammation). In any case, the symptoms of the disorder develop slowly.
• In adults, these are bacteria: streptococci, hemophils, staphylococci.
• In elderly patients, with oncology, weakened immune system, after transplantation and those who take immunosuppressors are viral, bacterial and fungal infections. In this case, even fungi of the genus Candida, Pneumocystis carinii and tuberculosis, can be provoked by the disease.

Pathogenesis

The mechanism of development of the defeat of the respiratory system is closely related to bronchiolitis and acute bronchitis. Pathogenesis has a hematogenous character, so it can occur when generalizing the infection (septic pneumonia). Most often the inflammation spreads to the pulmonary tissue downward (bronchiolitis, catarrhal bronchitis), that is itrabronchial, less often peribronhial (destructive bronchitis and bronchiolitis).

Great importance in the development of the disorder have:

• aspiration pneumonia - autoinfection with aspiration;
• hypostatic pneumonia - congestion in the lungs;
• postoperative pneumonia - neuroreflex disorders;
• immunodeficiency pneumonia - immunodeficiency states.

Basal lungs on each side usually fall under the defeat. Despite the differences in the cause and causative agents of the disease, morphological changes have a number of common features.

1. With any etiology of the disease, bronchiolitis or acute bronchitis is the basis, which can be represented by various forms: serous, mixed, mucous or purulent.
2. The mucous membrane swells, becomes full-blooded, which provokes an abundant secretion of mucus with goblet cells and glands. Damage to the bronchial tree is due to sloughing of the prismatic epithelium of the mucous membrane. Because of the edema of the wall, bronchioles and bronchi thicken.
3. The drainage function of the bronchi is disturbed, which causes the aspiration of infected mucus along the distal parts of the bronchial tree. Pathology usually occurs in the posterior and posterior segments of the lungs.
4. Depending on the size of the lesion, there is a lobular, azyznaya, draining lobular, segmental and polisegmentent forms of the disease. In the alveoli accumulate exudate with mucus, erythrocytes, neutrophils and macrophages. The fluid is distributed unevenly, while the interalveolar septa are also impregnated with a cellular infiltrate.

Particular attention should be paid to the fact that the disorder has some peculiarities in patients of different ages. Thus, newborns on the surface of the alveoli form hyaline membranes from condensed fibrin. In children from 1 to 2 years old, pathology affects the posterior ones adjacent to the spine and incompletely spread out after the birth of the lungs. In patients older than 50 years, the process proceeds slowly, which is associated with the age-related reduction of the lymphatic system.

Symptoms of bronchopneumonia

All inflammatory diseases that affect the respiratory system have similar signs. Symptoms of bronchopneumonia develop slowly, especially if it appears against the background of another disease

Patients complain about:

• Strong fever
• Chills
• Dry cough or cough with sputum
• Painful sensations in the chest
• Tachycardia
• Rapid breathing
• Chroches in the lungs
• Leukopenia
• Leukocytosis
• Increase of ROE

If the disease has a secondary form, that is, develops, for example, against the background of bronchitis, then the symptomatology manifests itself as a sharp deterioration in the state of health. There is increased weakness, fatigue, headaches. The temperature rises to 38-39 degrees, there is a cough and shortness of breath.

During percussion, the sound does not always change (the focus is small or localized in the central lobes), but may shorten or acquire a tympanic character (with a close location of the foci of inflammation or their merger). Appear small bubble or dry rales of a non-permanent nature, breathing remains vesicular. In blood tests, leukocytosis is often detected, but in rare cases, there may be a decreased number of leukocytes.

First signs

Inflammatory lesions of the respiratory system, like any other disease, is not immediately apparent. The first signs can be seen when the disease begins to progress, spreading through the body. The process of determining the disease is complicated by the fact that it can develop against the background of other infections and damage to the body.

Regardless of its shape, it has such characteristics:

• Sharp deterioration of state of health
• Severe headaches, migraines
• Increased weakness
• Fatigue
• Increased body temperature
• Dry or wet cough

If it develops against the background of acute bronchitis, then in addition to high fever, feverish condition, loss of appetite, muscle weakness, chills, intoxication of the body. The patient complains of painful sensations behind the sternum, which are manifested when coughing and deep inspiration.

Temperature

Regardless of the form of the disease, there is a definite clinical picture that allows you to diagnose it. Temperature is one of the symptoms that indicate pathological processes in the body. If the ailment develops on the background of bronchitis or catarrh of the upper respiratory tract, then it is difficult to suspect bronchopneumonia, because apart from a slight increase in temperature, there are no other symptoms. But in some cases, the secondary form of the disorder manifests itself acutely, as a rule, in young patients. The temperature rises to 38-39 ° C, accompanied by chills, increased weakness, headaches, cough and pain in the chest.

Elevated temperature indicates that the immune system struggles with all its strength against bacteria and viruses that damage the respiratory system. Against the background of the above symptoms there is a tachycardia, breathing becomes vesicular. When analyzing blood, neutrophilic leukocytosis can be detected. Especially acute temperature is maintained in the first days, after it acquires a subfebrile form.

Cough

Against the background of various pathological symptoms accompanying the defeat of the bronchi, a number of signs that appear independently of the form of inflammation. Cough refers to such symptoms. It can be wet with phlegm-purulent phlegm with blood veins or dry. On its background there is shortness of breath and rapid breathing, tachycardia develops and pains in the chest area.

Cough reflex is a protective function of the body from various infectious agents that enter the respiratory tract. If this reflex is suppressed, it will lead to a disruption of the drainage function of the bronchial tree. This will exacerbate the course of the disease, since the body will not be able to get rid of the accumulated inflammatory exudate.

As a rule, at first, the cough is dry and nasal. Sputum greenish, begins to stand out gradually, later it appears veins of blood. Against the backdrop of coughing and rapid breathing, serous-mucous discharge comes from the nose. When rattling the lungs, weak wheezing and vesicular breathing are determined. If the cough passes without temperature, radiographic and fluorographic studies are used to identify the disorder. With the help of these methods it is possible to determine the foci of shading and their magnitude in the pulmonary lobes.

Bronchopneumonia without temperature

Diseases of the respiratory organs have a certain set of symptoms, through which the ailment can be quickly and diagnosed. But in some cases, resort to differential diagnosis. One such example is bronchopneumonia without temperature. This phenomenon is very rare and most often in children. As a rule, the absence of temperature is accompanied by the following symptoms:

• Tachycardia
• General intoxication of the body
• Anxiety
• Weakness and lethargy
• Convulsions
• Pale skin
• Chest pain during movement
• Unhealthy blush
• Drowsiness
• Reduced appetite

Atypical form of inflammation is associated with individual reactions of the body to infectious stimuli. The causes that cause the latent course of the disease can be such factors as: violation of the immune status, improper intake of antibiotics. It is almost impossible to detect pathology without medical examination and special diagnostic methods.

Effects

Inflammatory diseases of the respiratory system adversely affect the entire body, causing disruptions in the work of all organs and systems. The consequences of ailment directly depend on its form, complexity, correctness of diagnosis, selected therapy and individual characteristics of the patient's body. Most often, the disease leads to the development of chronic bronchitis with inflammation of the bronchial mucosa, bronchial asthma.

More negative consequences are considered - fibrosis and abscess of the lung:

• Abscess is the decomposition of the organ tissues due to the pus formed in the inflammation focus. It can be formed either singly or in groups, hitting several sections of the lung at the same time.
• Fibrosis - develops due to severe damage to the tissues of the organ during inflammation. In places of damage, connective tissue is formed. The disease causes severe pain in the chest due to insufficient intake of oxygen to the affected areas. In this case, bronchopneumonia takes on a chronic form.

Another negative consequence of the pathology is infectious-allergic myocardium, acute cardiovascular insufficiency, dysbacteriosis, infectious-toxic shock. In elderly patients, most often there is respiratory failure due to disruption of gas exchange in the lungs and problems with the cardiovascular system.

The consequences of bronchopneumonia in children differ somewhat from similar processes in adults. The difference is that the total intoxication of the body is more pronounced than pulmonary pathological symptoms. Because of this, there are problems in diagnosis, which means that the wrong treatment is prescribed, which leads to serious complications.

Incomplete or incorrect treatment in children leads to such pathological results:

• Delayed diuresis - in many children who have had respiratory system diseases, urination disorders occur. To eliminate them, use various medications.
• Syndrome of intoxication - the child's body gradually accumulates the products of vital activity of viruses and bacteria, which aggravates inflammation. For a long time, high temperature, lethargy, lack of appetite. In addition, there may be a gastrointestinal disorder, exhaustion, headaches.
• Neurotoxicosis - the disorder has several stages. The first is characterized by a sharp increase in the activity of the child, hysterics. After this, there comes a period of inhibition, the baby becomes sluggish, loses appetite. At the last terminal stage, the temperature rises sharply, clonic convulsions appear and breathing stops.
• Chronic pneumonia - negatively affects the development of the baby's body, causes frequent relapses of the disease, reduced immunity. In addition, deformation of the chest is possible.
• Exudative pleurisy - an exudate of an inflammatory nature accumulates between the pleura sheets. Without proper treatment, leads to lung hydrothorax, which is treated with pleural puncture.
• Adhesive pleurisy - in the pleural cavity appears fibrin, causing severe pain in the chest. To eliminate the pathology requires a cicatricial operation.
• Sepsis is the most serious consequence of the disease. Pathology arises from the infection of the lungs in the blood, which carries it throughout the body. Characterized by a sharp increase in temperature, the appearance of abscesses in different parts of the body. To cure this complication is almost impossible, therefore the lethal outcome is 100%.
• Asthenia - after the course of therapy the child complains of increased weakness, there is a decrease in activity and performance, poor appetite and low body temperature. As a rule, the syndrome passes quickly and does not require medical care.

Complications

The aggressive course of respiratory diseases or their incorrect treatment leads to negative results. Complications cause violations by all organs and systems. Most often, the disease provokes the development of pleurisy, empyema, that is, the suppuration of the pleura and abscesses. Very rarely, one of the life-threatening complications arises - pneumothorax, that is, a rupture of the lung tissue. In this case, if the patient is not provided with timely medical assistance, then there is a risk of a lethal outcome.

There are two types of complications, consider them:

• Pulmonary
  • Pulmonary edema
  • Reactive pleurisy
  • Lung destruction
  • Abscess
  • Gangrene
  • Empyema of the pleura
  • Acute or chronic respiratory failure
• Extrapulmonary
  • Chronic and acute pulmonary heart
  • Intoxication psychosis
  • Impaired renal function
  • Meningitis
  • Hemolytic anemia
  • Meningoencephalitis
  • Sepsis

A severe course of inflammation leads to the development of multiple foci of infection and acute respiratory failure. If harmful microorganisms enter the blood, then this leads to sepsis, which leads to death. The presence of complications directly affects the course of the disease and the functioning of the body as a whole. The task of the doctor in time to identify complications and prescribe stronger therapy.

Diagnosis of bronchopneumonia

The effectiveness of the treatment of any disease directly depends on the methods used to detect it. Diagnosis of bronchopneumonia is a complex of studies that can determine the presence of the disease in the early stages. After examining the patient and collecting an anamnesis, the doctor sends it to the radiography. On the X-ray, the focus of inflammation is clearly visible. After that, a microbiological examination of sputum, mucus or a smear from the throat is carried out. This will determine the causative agent of the disease and select effective drugs to which the harmful microorganism is sensitive.

Particular attention is paid to differential diagnostic methods. This is necessary for separating the inflammatory process of other pathological processes in the lungs, determining the severity and complications. The development of pneumonia is indicated by characteristic symptomatic signs: intoxication of the body, cough with separation of sputum, rapid development of fever and elevated body temperature.

With the help of physical research, it is possible to determine the densification of the tissue and the characteristic disorders of the auscultative picture - sonorous, small-bubble, focal, lethargic crepitations or wheezing. Ultrasound examination of the pleural cavity and echocardiography can reveal pleural effusion. The patient is taken an overall blood test, in which the inflammatory process is reflected in the form of leukocytosis, increased ESR and stab-shift. In the urinalysis can be detected proteinuria or microhematuria.

Auscultation

When diagnosing diseases of the respiratory system, special attention is paid to the study of sound phenomena that arise in the body. Auscultation is carried out by applying to the chest a tool for listening. Distinguish direct, mediocre and mediated listening. The procedure is performed with a stethoscope and a phonendoscope. The patient should be in a standing or sitting position, breathing should be calm, even.

For the detection of pathological rales, comparative auscultation is used. This is due to the fact that more accurate data can be obtained by comparative listening to symmetrical areas of lung tissue. First, the front surface of the lungs is heard, beginning with the area of ​​the apices, and then the back surface and checking the symmetrical points. As a rule, 2-3 full respiratory cycles are studied at each point, that is, inhaling and exhaling.

Sounds heard over the lungs are divided into groups such as:

• The basic respiratory noises are various kinds of breath which are listened to above normal lungs.
• Adverse respiratory noises are sounds that form above the breath, normal and pathological. They are listened to simultaneously with the main respiratory noises, these can be wheezing, pleural friction noise, pericardial noises.

Every healthy person over the lungs hears such kinds of breathing:

1. Vesicular - occurs over a large surface of the lung tissue. Formed by the expansion of the alveoli due to the intake of air in them and the tension of their elastic elements.

• Enhanced vesicular breathing is possible with both inspiration and exhalation. As a rule, it arises from the difficulty of passage of air through the small bronchi, with their puffiness or spasms.
• Weakened - occurs with emphysema due to a decrease in the number of alveoli. This occurs as a result of destruction of the interalveolar septa and a decrease in the elasticity of their walls. It occurs with inflammation of the respiratory muscles and intercostal nerves, bruises and fractures of the ribs.

When filling the alveoli with inflammatory exudates, this type of breathing may not be heard. To its disappearance leads to a complete blockage of the large bronchus and the development of atelectasis.

1. Bronchial respiration occurs over certain parts of the airways and lungs. Formed by the passage of air through the vocal chord, along the bronchial tree, extending to the surface of the chest.

• Stenotic breathing - arises from the narrowing of the trachea or the main bronchus. It is characterized by increased laryngotracheal breathing.
• Mixed breathing - occurs over the foci of compacted pulmonary tissue, which are located in the depth of a healthy tissue. The inspiratory phase is similar to vesicular breathing, and exhalation with bronchial.
• Rigid - is listened to when narrowing the lumen of the bronchi due to the inflammatory process or swelling. It is characterized by a loud and long breath, but a normal exhalation.

In addition to the above-described types of breathing, there are also secondary respiratory sounds:

Chryps - may be dry and wet. Formed by the passage of air through the bronchial tree. Dry appear when there is a viscous, thick secret in the bronchi, and wet - when filling the bronchi with a moist secret.

• Crepitation - occurs as a result of the spreading of the asleep alveoli, which contain a small amount of exudate.
• Noise of friction of the pleura - indicates the development of dry pleurisy. From other noises differs in that it is heard both during inspiration and exhalation, but does not change after a cough.

With auscultation, there is an increase in signs of bronchophonia. Breath bronchial or vesiculobronchial with dry and wet wheezing. Creption is heard in the initial phase of the disease. If the inflammation spreads to the pleura, then there is a noise of friction of the pleura. In severe course, tachycardia and arterial hypotension, collapse, are possible.

Analyzes

In the process of diagnosing the defeat of the respiratory tract, the patient is prescribed a number of procedures to determine the causative agent of the disease, severity and other characteristics. Analyzes with bronchopneumonia are necessary for its confirmation and establishment of its variety. Blood and urine are used for this purpose. If the disease has a mild course, then in the blood there is a moderate leukocytosis and an increase in ESR. At moderate severity - pronounced leukocytosis and elevated ESR. Heavy form occurs with a large increase in leukocytes, high ESR, a decrease in lymphocytes and toxic granularity of neutrophils.

To obtain reliable results, blood is given on an empty stomach, the last meal should be at least eight hours before the test. The study is conducted before antibiotics are taken or 2-3 weeks after they are withdrawn. When passing urine tests, any deviations from the norm and changes indicate complications.

There is a specific research program used for inflammation of the respiratory system, which includes such analyzes as:

• General analysis of blood and urine
• Bacterioscopy of sputum
• Sputum culture (quantification of flora and determination of sensitivity to antibiotics)

Radiography of the lungs in two projections

If necessary, the above list is supplemented by a study of the function of external respiration and the study of blood gases, pleural punctures. With appropriate indications, a tomography of the lungs and serological tests, a biochemical blood test are performed. To determine bronchopneumonia of a chronic form, lung radiography is performed in three projections, lungs tomography, sputum examination, spirography, biochemical blood analysis, bronchography and fibrobronchoscopy.

Sputum during bronchopneumonia

One of the most important studies in the defeat of the respiratory system is the study of the coughing material. Sputum during bronchopneumonia contains conditionally pathogenic bacteria, the analysis of which makes it possible to draw up a treatment plan. To confirm the inflammatory process, a culture test for anaerobic microflora is carried out.

The material is obtained from the lower respiratory tract by aspiration through the trachea, protected by a brush biopsy or by a transcutaneous puncture. All procedures are invasive, so they are not used without appropriate indications. If the patient has a severe cough, then the collection of sputum is not difficult. If the patient does not have a cough with sputum, then inhalation with a 3% raster of sodium chloride is required.

Particular attention is paid to the study of the gas composition of the arterial blood. The analysis is performed in case of severe illness and complications. With its help, it is possible to identify various degrees of hypercapnia, decreased oxygen saturation, hypoxemia. All described signs are an indication for oxygen therapy.

Instrumental diagnostics

Various methods of studying the symptoms of pneumonia provide an opportunity to recognize the signs of pathology in a timely manner and make a treatment plan. Instrumental diagnosis of bronchopneumonia is represented by many methods, but the most valuable and informative is bronchoscopy and radiography. Most often, the second method is used, because with its help it is possible to visually see the localization of inflammatory foci on the roentgenogram.

Bronchoscopy is used for differential diagnosis. To do this, it is necessary to take bronchoalveolar flushing and to study the harmful microorganisms that caused the disorder. Instrumental methods help to identify the causative agent of the disease and the localization of inflammation. Due to this, the doctor can make an effective therapy plan that prevents complications of the disease and its relapse.

X-ray

X-ray examination of the organs of the respiratory system is one of the main diagnostic methods. X-ray is necessary for the recognition of atypical forms of inflammation, the symptoms of which are not sufficiently pronounced. Different types of bronchopneumonia differ both in etiology and in pathogenesis, but they can produce similar radiographic semiotics.

Expressed bronchopneumonia - the radiographic picture is clear, the focal nature of inflammation is seen. Foci of infiltration can capture groups of pulmonary lobules or be limited to the defeat of several acini. On the roentgenogram they have sizes from 1-15 mm in diameter, can merge into large spotted shadows, which causes a continuous shading.

• Focal inflammation - foci have an irregular shape, which is due to the projection fusion of individual elements. Through the shadow of a large hearth, it is possible to trace the pulmonary pattern, which, due to vascular hyperemia and puffiness, is strengthened.
• The aziotic form - individual focal shadows do not differ from the foci that arise with hematogenous tuberculosis dissemination. On the roentgenogram, there is an increase in the bronchoconstrictive pulmonary pattern and the widening of the root shadows.
• Viral form - X-ray indicates the segmental nature of inflammation. From the pulmonary roots, moderate darkening. Sometimes a specific path appears that connects the enlarged root with pneumonic dimming.

Differential diagnostics

Since diseases of the respiratory system have many symptoms, the process of identifying the primary ailment is significantly complicated. Differential diagnosis is necessary to distinguish the inflammatory process from other lung lesions. For this, anamnesis, clinical, virological, parasitological, bacteriological and other methods of investigation are used.

• Most often bronchopneumonia has to differentiate from bronchitis, pleurisy. This is due to the fact that all the mentioned ailments are accompanied by similar symptoms. Since, pneumonic foci cause shortness of breath, cough, and sometimes cyanosis.
• Differentiation with tuberculosis is more complicated. This is because the infiltrate has the same localization and gives the same data for auscultation and percussion. In this case, X-ray and bronchoscopy are used.

Who to contact?

Pulmonologist

Treatment of bronchopneumonia

Any inflammatory disease requires immediate treatment, especially if it concerns the respiratory system. Treatment of bronchopneumonia involves taking effective measures to prevent the spread of infection through the body, the development of various complications and exacerbation of chronic infections.

To eliminate the inflammatory process, the following methods are used:

1. The patient is provided with bed rest, to minimize the load on the cardiovascular system and the body as a whole. Particular attention is paid to nutrition, which should consist of easily digestible foods.
2. Antibiotics are used only after determining the sensitivity of the pathogen to them. Most often, they are prescribed a wide spectrum of action, as well as drugs from different clinical groups. The duration of the course of therapy is determined by the attending physician, who monitors the changes in the patient's analyzes and status.
3. Medicines that dilute and excrete phlegm are used without fail. Advantage is better to give to means on a vegetative basis as they do not cause accustoming, have a minimum of contra-indications and side effects.
4. It is necessary to use desensitizing drugs to reduce local inflammation and remove toxins from the body.
5. Vitaminotherapy is needed to restore the protective properties of the immune system. As a rule, complex multivitamin preparations are used, which contain all the necessary vitamins, minerals and macro elements.

Proceeding from this, it can be concluded that treatment is a rather lengthy and complex process that should only be occupied by a doctor.

Care for bronchopneumonia

The process of recovery in any disease largely depends not only on the drugs used, but also on care. In bronchopneumonia, bed rest and a number of other procedures are indicated, the observance of which is necessary to prevent complications.

Consider the main nuances of care for patients:

• Providing bed rest before overall well-being.
• Compliance of milk and vegetable diet.
• Abundant use of liquid.
• Receiving diluting and expectorant drugs.
• Compliance with symptomatic therapy prescribed by a doctor.

If treatment takes place in a hospital, then intervention of medical personnel is required to conduct a dynamic assessment of the patient's condition. The nurse must monitor the patient's position in bed, taking medication and the procedures prescribed by the doctor.

If the treatment is assigned to a child, then in addition to the above procedures, the following are added:

• Teaching your child the right breathing.
• Carrying out a vibrating massage.
• Provide drainage position (with head down).
• Prevention to prevent complications.

Treatment of bronchopneumonia in the home

Simple forms of inflammatory lung diseases, as a rule, do not heal in a hospital environment, since therapy is not complicated. Treatment of bronchopneumonia at home is most often done with sulfonamides. But do not forget that even mild forms of inflammation have, although not pronounced, but pathological processes - respiratory failure, hypoxemia, anemia. Therefore, special attention should be given to the organization of the patient's regime, if the home conditions do not allow this, then hospitalization is better.

Therapy should be differentiated depending on the severity of the ailment and the characteristics of the patient's body. The use of sulfonamides quickly eliminates malaise, reduces fever and reduces toxic effects. In intoxication combined treatment with antibiotics with a wide spectrum of action is used.

It is extremely important to organize a dietary diet with a high content of B and C vitamins, since in the pathogenesis of respiratory failure they have a leading role. Since the disease causes an increased permeability of the vessels, calcium chloride is used to eliminate this defect. The medicine causes irritation of the cells of connective tissue by increasing the tone of the vagus nerve. For these purposes, you can use ascorbic acid. The task of home treatment is not only to eliminate structural changes in the lungs, but also to restore their normal functioning.

Medications for bronchopneumonia

Treatment of inflammatory lesions of the respiratory system should begin with the first painful symptomatology. Medication is prescribed after the determination of the causative agent, therefore at the beginning of the therapy, antibiotics of a wide spectrum of action are used. Since many harmful micro-organisms quickly develop resistance to such drugs, their constant improvement is required.

For treatment use such antibiotics as:

• Semisynthetic penicillins
• Carbapenems
• Fluoroquinolones
• Cephalosporins
• Tetracyclines
• Macrolides
• Aminoglycosides
• Monobactams

Modern antibacterial agents have high bioavailability and an extended spectrum of action. They have minimal toxic effect on the kidneys, central nervous system, liver.

Antiviral therapy is carried out with such medicines:

• Saquinavir
• Arbidol
• Acyclovir
• Foscarnet
• Ganciclovir
• Valaciclovir
• Zidovudine
• Zalcitabine
• Didanosine

Bronchodilators in inhalation form:

• Anticholinergics
• β-2-agonists
• Methylxanthines
• Expectorants and mucolytic drugs:
• Acetylcysteine
• Amroxol
• Lazolvan
• Ambroben
• Bromhexine
• Bronhosan
• Sinupret
• Gedelix.

Calcium chloride

Calcium is very important for the normal functioning of the body. The thing is that the ions of this substance contribute to the transmission of nerve impulses, the reduction of smooth and skeletal muscles, blood clotting, the functioning of the heart muscles and other organs. With a decrease in the calcium content in the blood plasma, a number of pathological reactions are observed, primarily expressed by hypocalcemia and tetany.

Indications for use of calcium chloride:

• Insufficiency of parathyroid gland function
• Tetany
• Spasmophilia
• Dehydration
• Allergic complications associated with taking medications
• Pulmonary, nasal, gastrointestinal bleeding
• Before surgery to increase blood clotting

The drug is administered intravenously drip / spray and inside. When using the medication, side effects may occur: heartburn, bradycardia, pain in the epigastric region, a feeling of heat. The drug is not used intramuscularly with necrosis or severe tissue irritation. Calcium chloride is contraindicated in atherosclerosis, a tendency to thrombosis and a high level of calcium in the blood.

Antibiotics for bronchopneumonia

Therapy of pneumonia is a long process, which involves the use of different medications. Antibiotics for bronchopneumonia fight with harmful microorganisms that cause disease. To select an effective drug, a number of tests are performed, one of which is sputum analysis. This study allows you to adjust the therapy scheme for a speedy recovery.

When choosing medicines, it is necessary to take into account such factors as: type of bronchopneumonia, contraindications, toxicity of medicines, the spectrum of action of the drug, the speed of penetration into body fluids, and the rate at which the therapeutic dose is reached in the outbreaks inflammation. In some cases, antibiotic drugs do not give the proper result. This is due to improper selection of the drug, its dosage and duration of administration, development of resistance of pathogens and frequent changes of drugs.

To eliminate the sickness form of the disease, such means are used:

• The first line is Amoxicillin, Ceftazidime, Penicillin, Cefepime. With intolerance of these drugs, alternative drugs can be used: Ticarcillin, Cefotaxime, Ciprofloxacin. In some cases, a combination of medications is used to quickly improve the patient's condition.
• The second line - is used in the case when the drugs of the first line were ineffective. For therapy apply - Cefipim, Fluoroquinolone, Meropenem, Ticarcillin.
• The grounds for using the above mentioned means are a severe course of the disease, a mixed type of infection, combinations of harmful microorganisms that are resistant to many drugs.
• For the treatment of the out-of-hospital type of inflammation, use such medications:
• Medium and easy stage - Fluoroquinolone, Aminopenicillin, Clartromycin, Doxycycline.

• Severe stage - Azithromycin, Ceftriaxone, Cefotaxime.

If the patient has a long-term use of antibiotics, then mandatory appoint probiotics and eubiotics - Lineks, Lactobacterin, Bifiform, Bifikol. They prevent the intestinal dysbacteriosis, that is, maintain the normal composition of the microflora. Antibiotics are taken only for medical reasons. If the first 2-3 days after the start of treatment, the positive effect of therapy does not occur, that is, the risk of intoxication of the body and increased inflammation.

Folk treatment

In the therapy of bronchopneumonia, a lot of methods are used, which together give a positive result, speeding up the recovery process. Folk treatment is effective in that plant natural ingredients are used to eliminate inflammation. Such drugs have anti-inflammatory, vasodilating, analgesic and other actions, but they have a minimum of adverse reactions and contraindications. If such a combination is combined with classical treatment, the pathological process will be quickly eliminated.

Consider the most popular folk recipes:

• Anti-inflammatory properties have a balm, for the preparation of which you will need: 250 g of aloe, 500 ml of cahors and 350 g of liquid honey. Before cutting aloe leaves, the plant is recommended not to water for 14 days. After cutting, carefully wipe off dust, grind and place in a glass jar. The plant is flooded with honey and Cahors, mixed well and infused for 14 days in a dark, cool place. After the balsam has been brewed, it must be filtered and wrung out. The medicine is taken for 1 spoon 2-3 times a day.
• Good inhalation effects on the respiratory system. To do this, take a piece of bandage 10-15 cm, carefully rub onion and put in a mug for inhalation. To achieve a therapeutic effect, over a mug you need to breathe 10-15 minutes 5-6 times a day.
• Particularly effective are such tools as: lime honey, onion and garlic juice, dried berries cranberries and raspberries, aloe juice, rose hips, oregano, lime blossom. Of these ingredients, you can prepare decoctions and infusions to eliminate inflammation and strengthen the immune system.
• From the decoction of mother-and-stepmother and violet or honey with althea, you can prepare an excellent expectorant. All ingredients are taken in equal proportions. The medicine is taken 3-4 times a day 2-3 times a day.

Herbal Treatment

Methods of folk treatment - is the use of only natural plant components, which favorably affect the body. Treatment with herbs is very popular, because such products are safe to use, have a minimum of side effects and contraindications.

Consider effective recipes on herbs from bronchopneumonia:

• 1 spoonful of buds, ivy, pour 750 ml of steep boiling water and insist for 60 minutes. Infusion should be taken on 2 tablespoons 3-4 times a day before meals. Exceed this dosage is not recommended to avoid toxic effects of the plant.
• A handful of berries of viburnum fill with melted linden honey and let it brew for 6-8 hours. Spoon the medicine pour 250 ml of boiling water, and insist for 2 hours. The drug should be well filtered and taken warm 150 ml 1-3 times a day. Effectively eliminates a strong cough and sputum.
• Take the flowers of linden, mullein and raspberry flowers in the proportion 3. Pour the herbs 1 liter of boiling water and leave for 6-8 hours. Cooled infusion should be filtered and take 100 ml 3-4 times a day. Helps with a dry, debilitating cough.
• For the preparation of alcoholic infusion with pneumonia, the following ingredients are required: aloe leaves, leaves of blueberries, cowberries, beet juice, rutabaga and rosemary roots (all components are taken in equal proportions). Herbal collection pour 1 liter of vodka and insist in a dark cool place for 10-15 days. Before use, honey and butter should be added to the medicine. Take 1-2 spoons 2-3 times a day.
• Pour boiling water 2 parts of leaves of mother-and-stepmother and raspberry fruits, 1 part of oregano. The agent should be infused for 2-4 hours, take 1 spoon, diluted in a glass of water.

Homeopathy

For the treatment of bronchopneumonia and the restoration of normal functioning of the respiratory system, many methods are used to stop the inflammatory process. Homeopathy is one of the most popular means, as it is suitable for patients with intolerance to potent chemicals. Homeopathic remedies can effectively cure an ailment of any kind and prevent the development of relapses.

• At the initial stage of the disease, when there is a fever, chills and other symptoms of fever, take Aconite in 3 and 3 dilutions. In a couple of days, this remedy is replaced by Brion or Belladonna in the same proportions.
• The further use of medicines depends on the overall symptomatic pattern. So, if there is a dry cough with sputum discharge rusty shade, then take Sanguine in 3 dilutions.
• To eliminate dry and wet wheezing, wheezing and separation of phlegm, Antimonium Tartaricum is used in 3 and 6 dilutions. If the cough is accompanied by pain in the chest, then use Iodum or Kalium Yodatum in 3 and 6 dilutions.
• If the disease has a prolonged course, and antibiotic drugs do not help, then such homeopathic medicines: Sulfur, Arsenicum Album, Gepar Sulfur and Arsenicum Iodatum in 3 and 6 breeding.

All homeopathic preparations should be prescribed by a homeopath physician, after a thorough examination. It is contraindicated to take such medicines independently.

Operative treatment

Prolonged and chronic forms of bronchopneumonia entail many serious complications. Surgical treatment is indicated for pathological lesions of the respiratory system, when a prolonged inflammatory process led to irreversible changes in the lung tissue. Most often, the operation is necessary for chronic abscesses, the formation of primary lung cancer or bronchogenic cancer.

Patients may be scheduled for lung resection to improve general condition and save life. Most often, segmental resection, pneumectomy and lobectomy are used. All procedures are performed by the method of separate ligation of the lobe, segment or elements of the lung root.

If the pathology is bilateral, capturing individual segments of several lobes, then in this case case segmental resection is shown, which allows to radically cure a patient who was previously considered hopeless. If the inflammation is the cause of purulent intoxication, then in addition to general restorative therapy, postural drainage is carried out to facilitate the withdrawal of sputum and exudate.

Prevention

In addition to the main treatment used to eliminate bronchopneumonia, methods of preventing the disease are important. Prevention is indicated to patients of all ages, regardless of the form of the disease.

Let's consider the basic preventive recommendations:

• Elderly patients are recommended to vaccinate against streptococcal infection, which is the most common causative agent of the disease. For children at risk, vaccination against pneumonia is carried out.
• To prevent pathology, it is necessary to undergo an annual vaccination against influenza. Since very often this disease causes complications in the form of bronchopneumonia.
• Observance of elementary rules of hygiene, that is, washing hands with soap, the use of individual towels and dishes, also prevent infection by pathogens.
• Particular attention should be paid to strengthening the immune system. For these purposes, they use vitamin therapy, various complexes of microelements and minerals. A healthy full-fledged diet also refers to prevention methods, as it enhances the immune status.
• Abandonment of such harmful habits as smoking and alcoholism, in which the resistance of the bronchi and lungs decreases infection, is an important method of preventing not only diseases of the respiratory system, but also the body as a whole.

Singular for the prevention of bronchopneumonia

Singular is a medicine for the treatment of bronchi and lungs, from the pharmacological group of leukotriene receptor antagonists and antiasthmatics. It is prescribed, as a rule, to children of child age. The active component of the drug is Montelukast. It inhibits leukotriene receptors of the epithelium of the bronchi and lung tissue, making them resistant to the effects of cysteinyl leukotrienes. Tablets prevent bronchial spasms, increased eosinophils and sputum production. The agent causes bronchial relaxation within 2 hours from the time of administration and reduces the content of intracellular and inflammatory factors of the respiratory system.

• For patients older than 15 years, appoint 10 mg once a day before bedtime. Children from 2-5 years, 4 mg once a day, and for patients 6-14 years, 5 mg per day. The tablet should be thoroughly chewed and washed down with plenty of liquid.
• Side effects occur when the rules for the use of medicines are not observed. As a rule, the patient complains of thirst, increased anxiety, headaches, allergic reactions to the skin. In especially severe cases, anaphylaxis, increased bleeding, paresthesia, tachycardia and swelling are possible.
• In case of an overdose epigastric pain, drowsiness, severe thirst, vomiting appear. Treatment is symptomatic, hemodialysis is not carried out.
• Tablets are contraindicated for patients younger than 2 years. Prohibition of use is hypersensitivity to the active ingredient and other components of the drug.

Forecast

The course and effectiveness of treatment of inflammatory lesions of the bronchi and lungs largely depends on the type of disease, severity and individual characteristics of the patient's body. The prognosis is based on the state of the cardiovascular system, as it is closely related to bronchopneumonia. In addition, there is a dependence of the outcome of the disease on the age of the patient. That is, the older the patient, the more difficult the malaise and the worse the prognosis may be, because the disease often recurs.

Bronchopneumonia has a serious prognosis (up to a lethal outcome) in patients with circulatory failure, various diseases of the cardiovascular system, with dystrophy, beriberi and diseases accompanied by cachexia. With timely diagnosis and treatment, the prognosis is positive.

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Symptoms of bronchopneumonia

Symptoms and outcomes of focal pneumonia differ from the described bitterness of clinical manifestations of lobar inflammation lung, which is largely due to the features of pathogenesis and morphological changes in both clinical and morphological variants pneumonia.

First, with focal pneumonia, the inflammatory process is usually limited to the lobe or segment of the lung. Often, pneumonic foci can merge, capturing a larger proportion of the lobe of the lung or even the entire lobe. In these cases, they speak of discharge focal pneumonia. It is characteristic that, unlike the lobular inflammation of the lungs, the pleura is involved in the inflammatory process only with superficial localization or focal pustular pneumonia.

Secondly, in contrast to the lobar (croupous) inflammation of the lungs, focal pneumonia, as a rule, is not accompanied by hypersensitivity immediate type; more characteristic are normal and hyperergic reactions organism. This feature probably determines not so rapid, gradual formation of an inflammatory focus and significantly less vascular permeability than with croupous inflammation.

Thirdly, in connection with the less pronounced violations of vascular permeability in the focus of inflammation, exudate during focal pneumonia contains only a small amount of fibrin and in most cases has the character of serous or mucopurulent exudate. For the same reason, there are no conditions for a massive yield of red blood cells in the lumen of the alveoli.

Fourth, focal pneumonia almost always has the character of bronchopneumonia, in which the inflammatory process first the bronchial mucosa (bronchitis) is involved, only after that the inflammation as it passes to the parenchyma of the lung and forms pneumonia. Hence another important feature: in focal pneumonia, a significant amount of serous or mucopurulent exudate is contained directly in the lumen airways, which contributes to more or less pronounced violations of bronchial patency both at the level of respiratory bronchioles and at the level of larger bronchi.

Finally, fifthly, the relatively slow spread of inflammation within the affected segment leads to the fact that some of its areas are at different stages of the inflammatory process. While in one group of alveoli only hyperemia and edema of the interalveolar walls (stage of hyperemia) are revealed, the other groups of the alveoli are already completely filled with exudate (the stage of curation). Such a variegated morphological picture of the focus of inflammation with uneven compaction of the lung tissue, very characteristic for bronchopneumonia, is supplemented by the presence of sites of micro-teleclases, caused by a violation of the patency of predominantly small bronchi. Thus, for focal pneumonia as a whole, the staging of inflammation, which is detected in some patients with lobar (croupous) pneumonia, is not typical.

The clinical-morphological variant of focal pneumonia is characterized by the following pathogenetic and morphological features:

1. Relatively small length of the inflammatory focus, which captures 1 or more lobules or segment of the lung. An exception is the discharge pneumonia, which seizes significant parts of the lobe of the lung or even the entire lobe.
2. Focal pneumonia is accompanied by a normal or hyperergic reaction of the body, which determines a slower formation of the inflammatory focus and a moderate disruption of the vascular permeability.
3. Serous or muco-purulent exudate.
4. Involvement in the inflammatory process of bronchial tubes (bronchitis), which is accompanied by violations of patency of both small and (rarely) larger bronchi.
5. Absence of a clear staging of the inflammatory process, characteristic of croupous pneumonia.

These features of pathogenesis largely determine the clinical manifestations of focal pneumonia (bronchopneumonia). Nevertheless, it should be remembered that the biological properties of the causative agents of pneumonia and some other factors also have a significant effect on the clinical picture of this disease.

Resolve

In contrast to lobar (croupous) pneumonia, the onset of bronchopneumonia is more gradual and prolonged in time. Often focal pneumonia occurs as a complication of acute respiratory viral infection, acute or exacerbation of chronic bronchitis. Within a few days the patient notes an increase in body temperature to 3, -3, ° C, runny nose, lacrimation, coughing with a branch mucous or mucopurulent sputum, malaise and general weakness, which is regarded as a manifestation of acute tracheobronchitis or ARVI.

Against this background, it is very difficult to establish the onset of bronchopneumonia. Nevertheless, the ineffectiveness of the therapy administered for several days, the increase in intoxication, the appearance Dyspnea and tachycardia, or a new "wave" of fever increases suggest that focal pneumonia.

The patient is coughing up and separating the mucopurulent or purulent sputum, the body temperature rises to 3, -3, ° C (rarely higher), weakness increases, the headache worsens appetite.

Pain in the chest associated with involvement in the inflammatory process of the pleura (dry pleurisy), appear only in a part of patients with a superficial location of the focus or the presence of a focal focal pneumonia. However, even in these cases, pleural pain usually does not reach the same intensity as observed with lobar pneumonia. Pain increases or appears with deep breathing; its localization corresponds to the defeat of various parietal pleura sites. In some cases (with lesions of the diaphragmatic pleura), there may be abdominal pain associated with breathing.

Physical examination

When examined, the hyperemia of the cheeks is determined, perhaps a small cyanosis of the lips, an increased moisture of the skin. Sometimes there is a significant pallor of the skin, which is explained by pronounced intoxication and reflex increase in the tone of peripheral vessels.

When examining the chest, the lag in the act of breathing on the side of the lesion is revealed only in a part of the patients, mainly in individuals with discharge focal pneumonia.

When percussion over the lesion, a blunt percussion sound is detected, although at a small the extent of the inflammatory focus or its deep location, percussion of the lungs is not informative.

The greatest diagnostic value is the auscultation of the lungs. Most often, over the area of ​​the lesion, a pronounced weakening of the respiration is determined due to impaired bronchial patency and the presence of a multitude of micro-teleclases in the inflammatory focus. As a result, the sound oscillations formed when air passes through the vocal chink, along the trachea and (partially) the main bronchi, do not reach the surface of the chest, creating the effect of weakening the breath. The presence of violations of bronchial patency explains the fact that even with draining focal bronchopneumonia pathological bronchial breathing is not listened to as often as with lobar inflammation of the lungs.

In rare cases, when bronchopneumonia developed against a background of chronic obstructive bronchitis, and the focus of inflammation is located deep, with auscultation you can listen to hard breathing due to the narrowing of the bronchi located outside the pneumonic hearth.

The most vivid and reliable auscultative sign of focal bronchopneumonia is the definition of small bubble moist sonorous (consonant) wheezing. They are heard locally on the area of ​​inflammation and are caused by the presence of inflammatory exudate in the airways. Small-bubbly moist sonorous rales are heard most of the time throughout the inhalation.

Finally, in some cases with the involvement of the pleural pleura in the inflammatory process, you can listen to the noise of friction of the pleura.

The most significant differences between the two clinical and morphological variants of pneumonia are: lobar (croupous) and focal inflammation of the lungs (bronchopneumonia).

Comparative characteristics of lobar (croupous) and focal pneumonia

Symptoms	Fractional pneumonia	Focal bronchopneumonia
Features of pathogenesis
The amount of damage	Share, segment	One or more lobules, segment; multiple foci of inflammation possible
Spread of inflammation	Immediately along the alveolar tissue (Kohn's pores)	Inflammation of the bronchi "passes" to the parenchyma of the lung
The immediate-type hypersensitivity reaction in the respiratory zone of the lungs	Typical	Not typical
Involvement of bronchial inflammation	Not typical	Characteristically
Airway transmission	Not violated	Disrupted, possibly the occurrence of micro-teleclactases
Involvement in the inflammatory process of the pleura	Always	Only with superficial localization of the focus of inflammation or with a drain pneumonia
Stages of development of morphological changes	Typical	Not typical
The nature of the exudate	Fibrinous	Muco-purulent, serous
Clinical Features
Onset of disease	Acute, sudden with chills, fever and chest pain	Gradual, after the period of acute respiratory infections, acute tracheobronchitis or exacerbation of chronic bronchitis
Chest pain ("pleural")	Typical	Rarely, only with superficial localization of the focus of inflammation or with drainage pneumonia
Cough	At first dry, then with the separation of "rusty" sputum	From the very beginning productive, with the separation of muco-purulent sputum
Symptoms of intoxication	Expressed	Less common and less pronounced
Dyspnea	Typical	Possible, but less often
Dullness of percussion sound	In the stage of curing, pronounced blunting of sound	Less pronounced, sometimes absent
Type of breathing during auscultation	In the stage of the tide and the stage of resolution - a weakened vesicular, in the stage of curation - bronchial	Mostly weakened breathing throughout the disease
Adverse respiratory noises	In the stage of the tide and the stage of resolution - crepitation, in the stage of curing - the noise of friction of the pleura	Wet, finely bubbly sonorous rales
The appearance of bronhofonii	Characteristically	Not typical

The most significant clinical signs that allow differences, focal bronchopneumonia from lobar pneumonia, are:

• gradual onset of the disease, which develops, as a rule, against the background of acute respiratory viral infection, acute tracheobronchitis, or exacerbation of chronic bronchitis;
• the absence in most cases of acute "pleural" pain in the chest;
• cough with separation of mucopurulent sputum;
• absence in most cases of bronchial respiration;
• presence of moist small-bubbly sonorous rales.

It should be added that the signs listed in the table, which make it possible to distinguish two clinico-morphological variants pneumonia, relate to the typical classical course of these diseases, which is currently always. This is particularly true for cases of severe hospital pneumonia or pneumonia that have developed in weakened patients and elderly and senile patients

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Bronchopneumonia in children: symptoms, treatment. How to treat bronchopneumonia in children?

Focal pneumonia, or bronchopneumonia, is an inflammatory disease that affects small areas of the lung. Most often, bronchopneumonia develops in young children (up to 2-3 years). In today's article, let's talk more about this disease, consider the symptoms, causes and methods of therapy of pathology. Also recommendations on the treatment of bronchopneumonia of such a famous children's doctor and TV presenter as Evgeny Olegovich Komarovsky will be given.

Bronchopneumonia in children requires adequate and timely treatment, otherwise the outcome of the disease can be sad. Therefore, parents should take this disease seriously and take action at the first symptoms of the disease.

Causes of pathology

Bronchopneumonia, or focal pneumonia, in children develops under the influence of various bacteria and viruses. Most often precede such a disease is the infection of the upper respiratory tract. For example, it can cause bronchitis or ARVI. The most common pathogens are streptococci, pneumococci and many viruses.

Also, pneumonia can develop when food gets into the airways, squeezing the lungs with a tumor, inhaling poisonous gases, and also as a result of surgical intervention.

Bronchopneumonia: symptoms

In children, this pathology is manifested by the following symptoms:

• pallor of the skin;
• weakness;
• increased fatigue;
• headache;
• cough (both wet and dry) with discharge sputum;
• shortness of breath;
• heart palpitations to 110 beats per minute;
• wheezing when listening with a stethoscope;
• leukocytosis (increase of leukocytes in the blood);
• increased ESR (sedimentation rate of erythrocytes);
• increase in body temperature up to 39 ºС.

The centers of inflammation, as a rule, are concentrated on bronchioles and are present either in both lungs (most often) or in one of them. Proceeding from this, a right-sided bronchopneumonia, left-sided or bilateral, is diagnosed in the child. It is possible to detect foci of inflammation exclusively by radiography. Most often in pediatrics, there is bilateral bilateral bronchopneumonia in a child. With timely treatment, such a pathology is successfully treated.

The most dangerous bronchopneumonia in children without temperature, although this state is rare. The fact is that this particular form of the disease is most often left without parents' attention. Due to the lack of adequate treatment, the process is prolonged and aggravated. Parents should be alerted to any deviations in the behavior and well-being of the child. Only in this way it is possible to detect the disease and start treatment on time, thus protecting the baby from serious consequences.

Possible complications

Provided timely and quality therapy, the child will recover after 2-3 weeks. If treatment is delayed or carried out incorrectly, bronchopneumonia can provoke serious complications, namely:

• purulent otitis media;
• serous, or purulent, pleurisy;
• pericarditis;
• myocardial dystrophy;
• nephritis.

Bronchopneumonia in children: treatment

In such a difficult period, the kid needs special attention and proper care. This disease is very serious, therefore parents should necessarily know how to treat bronchopneumonia in children.

Based on the results of blood tests and X-rays, the doctor will be able to make an accurate diagnosis and prescribe the appropriate treatment. Therapy is aimed primarily at resorption of inflammatory foci. Antibiotics should be prescribed only in severe cases - this is what the well-known pediatric physician E. ABOUT. Komarovsky. Bronchopneumonia in children, if it is provoked by viral diseases, should be treated with antiviral drugs. Antibiotics in this case will not only be ineffective, but also can provoke serious complications. But in some situations without such strong medicines still can not do. In the event that the temperature of the child is greatly increased, there are signs of intoxication of the body, the child is weakened, the use of antibiotics is justified. However, only a specialist should prescribe the necessary dose of medicine. Self-medication can threaten not only health, but also the life of the child. Also, Dr. Komarovsky points out the advisability of carrying out physiotherapy procedures and adherence to the diet. Regardless of what the child has: right-sided bronchopneumonia, left-sided or bilateral-treatment should be comprehensive and symptomatic, depending on the cause of the disease.

Home therapy

Therapy of a typical form of bronchopneumonia can be performed at home, treatment of more complex cases should be performed in a hospital. This is due to the fact that the outcome of some forms of the disease can be lethal, so the constant supervision of a specialist is very important. If bronchopneumonia is diagnosed in children, treatment should be started by contacting a pulmonologist (specialist in lung diseases). After consultation with a doctor, people's remedies can be used to treat the disease.

Alternative medicine

Recipes of traditional medicine will help to improve the child's well-being and speed up the recovery process.

Honey and birch buds

750 g buckwheat honey (if this is not - you can use the usual) heat it over low heat, bring it to a boil. Add to honey 100 g of birch buds. Stir the mixture thoroughly and hold it for 7-8 minutes on low heat. After a lot of drain and cool. In a glass of boiled water, dilute a teaspoon of the obtained formula and give the child 30 minutes before bedtime.

Plantain

Collect the leaves of plantain, carefully wash, squeeze and dry for some time. Then spread a large towel or sheet on the bed and spread out the leaves of the plantain in an even layer. Top on them with a backrest put the baby, the remaining leaves to attach to his chest. Then the child is well wrapped in a wool blanket and left so all night. To conduct this procedure should be as many times as necessary.

Tar water

In a sterile 3-liter jar, pour 500 ml of medical tar, top up with boiling water, close tightly and leave for 9 days in a warm place. A teaspoon of the obtained composition should be given to the child before going to bed. The taste of the remedy is not very pleasant, so the baby can eat something sweet after it, most importantly, do not drink the medicine with water.

Garlic

In a clean plastic cup, you should make a few holes. Clean the garlic head and finely chop it. Put the mass in a glass and let the baby breathe over it for 15 minutes. It is recommended to conduct such a procedure as often as possible.

Honey pack

The skin of the child in the lungs should be well spread with honey. In a solution of water and vodka (in the ratio:) soak a clean cloth and apply from above. Then wrap the treated area with food film and wrap it with a woolen cloth. Twice a day, the compress should be changed to a new one.

Diet and diet

At the initial stage of the disease, bed rest is recommended. Be sure to daily ventilate and do a wet cleaning in the room where the child is. After the temperature of the body is normalized, it is allowed to walk outdoors. However, it is important to be careful and not to let the baby become hypothermic. After 2-3 weeks after recovery, the hardening procedures can be resumed, physical activity - not earlier than in 5-6 weeks.

There are no restrictions on food. It is important that the diet is balanced, with a high content of vitamins and proteins. It is necessary to ensure that food is frequent and fractional. You should know that kids are more prone to dehydration than adults. Such a threat is especially high against the background of increased body temperature. Therefore, it is necessary to provide the child with enough vitaminized liquid, it can be warm drinks, compotes, herbal teas, cold mineral water.

It is recommended to begin physiotherapeutic treatment after the body temperature is normalized. Useful are inhalations with medications that facilitate breathing and help to sputum, as well as chest massages.

Preventive measures

To prevent such a disease as bronchopneumonia in children, it is important to observe the rules of personal hygiene and maintain a healthy lifestyle from early childhood:

• wash hands regularly with soap and water;
• adhere to a balanced diet;
• give enough time for physical activity;
• to observe a mode of a dream and rest.

Conclusion

Bronchopneumonia in children is certainly a serious disease, but it is successfully treated provided all the recommendations of a specialist are observed. Parents always need to be alert and pay attention to the slightest changes in the child's condition. Take care of your children and be healthy!

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What is the difference between bronchial asthma and pneumonia?

Answers:

Irina Filippova

Pneumonia or pneumonia, when the alveoli are affected.
In bronchial asthma, bronchi are affected, here the leading symptom is obstruction, i.e., narrowing of the lumen of the bronchi.

Larissa Mikhailova

bronchial asthma is not cured

Katyusha-Katyusha

pneumonia passes into asthma (advanced stage of pneumonia)

Diam

Asthma is a chronic disease, and pneumonia is an acute inflammation of the lungs.

Sergey Korobov

The causes of... These are different diseases, but one organ - the lungs... One other can be concomitant ...

Vik Vikov

BRONCHIAL ASTHMA. The main symptoms of the disease and folk.. .
Bronchial asthma is a chronic disease of the respiratory system, which causes attacks of suffocation caused by impaired bronchial patency. When a bronchial asthma disease respiratory.. .

Also in the search you can see PNEUMONIA

♍Galina Zhigunova♍

This is absolutely two different diseases. Pneumonia: severe cough, pain in the chest, weakness, purulent sputum, temperature. Bronchial asthma: usually accompanied by attacks of suffocation, attacks it causes some allergen, there is no temperature, sputum is separated from labor, viscous, complicated EXIST, the patient takes a compulsory position, sits on the bed, leaning on his hands, hears wheezing on distance.

To the child 6 months.. Have put a bronchial pneumonia ...

Answers:

Yulia Yegorovskaya

Bronchial asthma? Or pneumonia? These are different things.
Bronchial asthma is difficult to treat, you need to go to an allergist and perform all of its appointments.
A pneumonia is an inflammation of the lungs, treated with antibiotics.

Alimzhan Kasimdzhanov

I know I'm sick! It is necessary to buy a nebulizer and my mouth rinse every day helps me!

Lori

I understand what you mean.. will need injections.. ceftriaxone. 5-7.. pricks.. + antihistamine and eofilin.. you need a doctor to prescribe the treatment.. nebulizer is also very good.

Irina Kobzar

your child was most likely diagnosed with bronchopneumonia. child in hospital and receives treatment. therefore as they say - there is nothing to do with its charter in a strange monastery ...

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