Pneumonia in adults

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 of 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 the 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 explained highly virulent flora, causing the listed forms of the disease, as well as rapidly developing resistance to traditional antibacterial drugs.

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

Causes of pneumonia

In adults over 30 years, the most frequent pathogens of pneumonia are bacteria, and in all age groups, In all socio-economic conditions and in all geographic areas, Streptococcus pneumoniae dominates. 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 is especially colonized by the so-called normal flora, which is safe due to the immune defenses of the body. If pathogens overcome numerous protective barriers, an infection develops.

See also: Inflammation of the lungs

The protective factors of the upper respiratory tract include IgA saliva, proteolytic enzymes and lysozyme, as well as inhibitors growth, produced by normal flora and fibronectin, which covers the mucosa and inhibits adhesion. Nonspecific protection of the lower respiratory tract includes cough, clearance of the ciliated epithelium and angular structure of the respiratory tract, which prevents infection of air spaces. Specific protection of the lower respiratory tract is provided by pathogen-specific immune mechanisms, including opsonization IgA and IgG, anti-inflammatory effects of surfactant, phagocytosis by alveolar macrophages and T-cell immune responses. These mechanisms protect most people from infection. But in many conditions (for example, in systemic diseases, malnutrition, hospitalization or stay in a nursing home, antibiotic therapy), the normal flora changes, its virulence increases (for example, when exposed to antibiotics) or protective mechanisms are broken (for example, cigarette smoking, nasogastric or endotracheal intubation). Disease-causing organisms, which in these cases reach the alveolar spaces by inhalation, due to the contact or hematogenous spreading or aspiration, can multiply and cause inflammation of the lung tissue.

Specific pathogens that cause inflammation of the lung tissue are not excreted in more than half the patients, even with a comprehensive diagnostic study. But, since under similar conditions and risk factors there are certain trends in the nature of the pathogen and the outcome of the disease, pneumonia are classified into out-of-hospital (acquired outside the medical institution), hospital (including post-operative and associated with artificial ventilation of the lungs), acquired in nursing homes, and in persons with weakened immunity; this allows us to prescribe empirical treatment.

The term "interstitial pneumonia" refers to a variety of unrelated states with unknown etiology, characterized by inflammation and fibrosis of pulmonary interstitium.

Community-acquired pneumonia develops in people with limited contact or without contact at all with medical institutions. Streptococcus pneumoniae, Haemophilus influenzae and atypical microorganisms are commonly identified (i.e. e. Chlamydia pneumoniae, Mycoplasma pneumoniae Legionella sp). Symptoms - fever, cough, shortness of breath, tachypnea and tachycardia. The diagnosis is based on clinical manifestations and chest X-ray. Treatment is carried out empirically selected antibiotics. The prognosis is favorable for relatively young and / or healthy patients, but many pneumonia, especially those caused by S. pneumoniae and the influenza virus, are fatal in the elderly and weakened patients.

Many microorganisms cause out-of-hospital pneumonia, including bacteria, viruses and fungi. In the etiologic structure different pathogens prevail depending on the age of the patient and other factors, but the relative importance of each as a cause of community-acquired inflammation lungs is questionable, since most patients do not undergo a complete examination, but even with a survey, specific agents are detected in less than 50% of cases.

S. pneumoniae, H. influenzae, C. pneumoniae and M. pneumoniae - the most frequent bacterial pathogens. Chlamydia and mycoplasma are clinically indistinguishable from other causes. Frequent viral pathogens are the respiratory syncytial virus (RSV), adenovirus, influenza virus, metapneumovirus and parainfluenza virus in children and influenza in the elderly. Bacterial superinfection may make it difficult to differentiate the viral from bacterial infection.

FROM. pneumoniae causes 5-10% of community-acquired pneumonia and is the second most frequent cause of lung infections in healthy people aged 5-35 years. FROM. pneumoniae is usually responsible for outbreaks of respiratory tract infections in families, educational institutions and military training camps. It causes a relatively benign form, rarely requiring hospitalization. Pneumonia caused by Chlamydia psittaci (ornithosis) occurs in patients with birds.

Reproduction of other organisms causes lung infection in immunocompetent patients, although the term community-acquired pneumonia is commonly used for more frequent bacterial and viral etiologies.

Fever Ku, tularemia, anthrax and plague - rare bacterial infections, in which there can be a pronounced pneumonia; the last three infectious diseases should cause suspicion of bioterrorism.

Adenovirus, Epstein-Barr virus and Coxsackie virus are widespread viruses that rarely cause pneumonia. Chicken pox and gantavirus cause infection of the lung with chickenpox in adults and gantavirus pulmonary syndrome; A new coronavirus causes severe acute respiratory syndrome.

The most frequent fungal pathogens are Histoplasma (histoplasmosis) and Coccidioides immitis (coccidioidomycosis). Less common are Blastomyces dermatitidis (blastomycosis) and Paracoccidioides braziliensis (paracoccidioidomycosis).

Parasites that cause lung damage in patients in developed countries include Plasmodium sp. (malaria) Toxocara canis or catis (migration of larvae to internal organs), Dirofilaria immitis (dirofipyariosis) and Paragonimus westermani (paragonimiasis).

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 a pulmonary embolism, which is more likely in patients with minimal sputum production, absence of concomitant ARVI or systemic symptoms and risk factors for 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 who suspected drug-resistant or unusual microorganism (eg, tuberculosis), and patients whose condition worsens or who do not respond to treatment within 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 coughing or after inhalation of hypertonic saline, or the patient can undergo bronchoscopy or endotracheal suction, which can easily be performed through the endotracheal tube in patients with mechanical ventilation. 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 at risk of legionellosis inflammation of the lung tissue (for example, patients who smoke have chronic lung diseases, age over 40 years, receive chemotherapy or take immunosuppressants for organ transplant) should carry out a urine test for legionella antigens, which remains positive for a long time after the start of treatment, but allows to identify only L pneumophila serogroup 1 (70% of cases).

A fourfold increase in antibody titers up to> 1: 128 (or in a single serum upon recovery> 1: 256) 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 test Antibodies to pneumococcus in blood 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 Mycoplasma pneumoniae antigen by direct immunofluorescence method Mycoplasma infection: detection of mycoplasmas Chlamydia: detection of Chlamydia trachomatis Influenza A: antibodies to the influenza virus A and B in the blood Antibodies to the cytomegalovirus class IgM and IgG in blood Cytomegalovirus infection: detection of cytomegalovirus HIV / AIDS test HIV infection: detection of human immunodeficiency virus (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. Prognosis should reinforce, rather than replace, clinical data, as the choice of location of treatment is affected by the set 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, RaO2 / on the inhaled O2 (PO2) less than 250, multi-lobe inflammation of the lung tissue, diastolic blood pressure less than 60 mm Hg. st, confusion and urea blood more than 19.6 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 of the symptoms in patients with suspected influenza during the epidemic, but the 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 the duration Symptoms caused by influenza A or B if the intake 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 in cough 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 of 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 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 adults

Pneumonia or pneumonia is a fairly common disease that can result in a fatal outcome. Therefore, it is very important to know the symptoms of pneumonia in adults, in order to respond immediately and start treatment.

Symptoms of different types of pneumonia in adults

The disease is dangerous because it is difficult to determine and the time taken to establish the diagnosis and causes of the disease can be irretrievably lost.

Depending on the nature of the course and appearance, the following types of pneumonia are distinguished:

• virus;
• croupous;
• radical;
• fungal;
• hidden.

Symptoms of croupous pneumonia

These include:

• chills;
• a sharp rise in temperature to 40 degrees;
• sweating;
• weakness and lethargy;
• vomiting;
• dyspnea;
• swelling;
• chest pain;
• confusion of consciousness;
• headache.

Croup pneumonia is one of the forms of pneumococcal pneumonia and can affect the lobe of the lung.

Symptoms of viral pneumonia

Signs of a viral lung injury are:

• fever;
• weakness and malaise;
• nausea and vomiting;
• aches and pains in the joints and muscles;
• coryza;
• dry cough turning into wet;
• pus in sputum.

Symptoms of radical pneumonia

This inflammation is manifested by the following symptoms:

• elevated temperature;
• cough;
• an increase in leukocytes in the blood.

Determine this type of disease is quite difficult. This is due to the location of the focus of the disease on the root of the lung. Most often do an X-ray, but sometimes doctors can confuse it with tuberculosis or bronchial cancer.

Symptoms of fungal pneumonia

Symptoms may differ slightly from one another, depending on which kind of disease is provoked. Although in general they are similar:

• there is a cough;
• the temperature rises;
• muscle pains are felt.

Most often, the disease can be triggered by candidiasis, streptotrichosis, blastomycosis. Infection occurs by inhalation of spores of a fungal bacterium, which can be found on rotting boards, molds, in damp areas.

Symptoms of Chlamydia pneumonia

There is a separate type of SARS, which is provoked by chlamydia. Symptoms of pneumonia caused by chlamydia are as follows:

• signs of colds;
• overgrowth in bronchitis;
• weakness;
• elevated temperature;
• intoxication of the body;
• a hoarse voice;
• increased coughing attacks;
• rattling in the lungs.

Signs of latent and chronic form of the disease

The most dangerous of the diseases is a latent form of pneumonia, which is difficult to determine due to the lack of temperature in the patient, coughing and pain in the chest. However, experienced doctors still know certain symptoms of latent pneumonia:

• abrupt wheezing;
• droplets of sweat on the forehead after a slight load;
• dyspnea;
• the appearance of a painful, spotted blush on the cheeks;
• difficulties with deep inspiration;
• rapid pulse;
• general weakness;
• constant thirst;
• lack of movement of one half of the chest during breathing;
• pain in lateral bends of the body.

If during the manifestation of acute pneumonia is not treated, the disease can go into a chronic form. Sometimes this can be triggered by complications for the destruction of the lungs after its acute form. Symptoms of chronic pneumonia are:

• hard breathing;
• cardiopalmus;
• signs of intoxication;
• change in blood composition;
• dyspnea;
• deformation of the chest;
• moist cough with purulent secretions without a smell;
• inflammation of the nasopharynx and mouth;
• difficult breathing during complications;
• polyhypovitaminosis;
• hypoproteinemia.

Exacerbations of the disease can occur within one or several weeks, and then a period of remission occurs. It is very important to properly treat and preventive measures, which are aimed at improving immunity and increasing the body's resistance.

WomanAdvice.ru

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.

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, %
Legionella - a rare pathogen, affects weakened people and is the leader after streptococcus in frequency deaths (contamination 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 confirming the diagnosis, depending on the type of pathogen, the age of the patient, the presence of concomitant diseases, appropriate therapy is conducted, in severe cases, treatment should be performed in a hospital setting, with mild forms of inflammation, hospitalization of the patient is not necessary.

Characteristic first signs of pneumonia, the vastness of the inflammatory process, acute development and the risk of serious complications when untimely treatment - are the main reasons for the urgent circulation of the population for medical care. Currently, a fairly high level of development of medicine, improved diagnostic methods, as well as a huge list antibacterial drugs of a wide spectrum of action have considerably lowered a death rate from an inflammation of lungs (see. 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 after 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 tract.

Body temperature can be very high up to 39-40C, and may remain low-grade 37.1-37.5C ​​(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 antipyretic agents, may also not be a high temperature up to 37.5, 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 can notice another sign of pneumonia in a child, if you undress a baby, then when you breathe from a sick lung you can notice 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, a dry cough appears, a runny nose, a sore throat, but the presence of dyspnea and a stably high temperature should alert parents to the development of 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 whimsical, whiny, sluggish, they are disturbed by sleep, sometimes they can completely refuse to eat, and also appear diarrhea and vomiting, in infants - regurgitation and rejection of the breast.

• 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 an adult

Pneumonia (pneumonia) is a very serious disease, ignoring its signs in any case impossible, because the consequences can be unpredictable. Doctors still can not accurately answer the question of why infection in some people stops in the upper respiratory tract, while in others it moves deeper and attacks the lungs. But one expert can state with full confidence - pneumonia develops only when the immunity is already weakened by some other disease.

Symptoms of pneumonia in an adult appear somewhat differently than in a child. In general, they depend on the severity of the disease and on the type of infectious agent that caused them.

Causes and Symptoms of Pneumonia

In an adult, pneumococcus is the most common disease. Having penetrated into the bronchi and the alveoli, they generate an inflammatory process there. When the fluid component enters the alveoli from the walls of the vessels, the respiratory difficulty appears in the diseased person. Against this background, the body develops oxygen starvation, because the affected part of the lung becomes dysfunctional. To strengthen the influx to the tissues of the blood, the heart begins to actively contract. All these processes lead to the appearance of the first symptoms of pneumonia in an adult: a sharp rise in temperature, chest pain, a cough with a separation of reddish sputum.

In the case when the inflammatory process is caused by other infectious agents: mycoplasma, legionella, chlamydia - the symptomatology will be similar, but this inflammation proceeds somewhat easier. So, the symptoms of pneumonia in an adult person in the case when it is stimulated by mycoplasmas will show up in a chill, sore throat, runny nose (optional), fever, shortness of breath, leading to chest pain. If the development of the disease occurred as a result of the effects of chlamydia, the first signs of a disease will be similar to those that occur with colds: dry cough, sore throat, runny nose, temperature increase. If the pathogen is Legionella, the symptoms, other than those listed above, will be supplemented by loss of appetite, diarrhea.

Common Symptoms of Pneumonia

Regardless of the type of pathogen, the first signs of the disease are most often the same. This is an obsessive dry cough, over time moisturizing, an increase in temperature (it can vary between 37-40 degrees). In severe pneumonia, the skin becomes a pronounced bluish tinge, breathing becomes quicker.

Such symptoms are completely nonspecific, so even doctors sometimes confuse the disease with ARVI. And only when the temperature reaches high values, dyspnea appears, leukocytosis is noted, pneumonia is diagnosed. To confirm suspicions, carry out radiography.

How to treat pneumonia in adults

Ill be hospitalized. He is assigned bed rest, frequent intake of warm liquids, high-calorie meals. The main method of treatment - antibacterial therapy (the drug is selected for each patient individually, depending on many features). If necessary, it can be supplemented by the use of immunostimulants, expectorants, antihistamines, etc. In the case of delayed treatment, complications of pneumonia in adults can lead to death.

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