Pneumonia in a child - symptoms, treatment, causes
Inflammation of the lungs or pneumonia is one of the most common acute infectious and inflammatory diseases of a person. Moreover, the concept of pneumonia does not include various allergic and vascular lung diseases, bronchitis, and also pulmonary function disorders, caused by chemical or physical factors (injuries, chemical burns).
Especially often there are pneumonia in children, the symptoms and signs of which are reliably determined only on the basis of X-ray data and a general blood test. Pneumonia among all pulmonary pathologies in young children is almost 80%. Even with the introduction of progressive technologies in medicine - the discovery of antibiotics, improved methods of diagnosis and treatment - until now this disease is among the top ten most frequent causes of death. According to statistics in various regions of our country, the incidence of pneumonia in children is, %.
When and why can a child develop pneumonia?
Lungs in the human body perform several important functions. The main function of the lungs is the gas exchange between the alveoli and the capillaries, which envelop them. Simply put, oxygen from the air in the alveolus is transported to the blood, and from the blood carbon dioxide enters the alveolus. They also regulate body temperature, regulate blood coagulability, are one of the filters in the body, contribute to the purification, removal of toxins, disintegration products arising from various traumas, infectious inflammatory processes.
And when food poisoning, a burn, a fracture, surgical interventions occur, in case of any serious injury or disease, there is a general decrease in immunity, it is easy to cope with the filtration load toxins. That is why very often after a child has suffered or is suffering from injuries or poisonings, pneumonia occurs.
The most common pathogens are pathogens - pneumococci, streptococci and staphylococci, and recently cases of lung inflammation from such pathogens as pathogenic fungi, legionella (usually after staying at airports with artificial ventilation), mycoplasma, chlamydia, which are not often mixed, associated.
Pneumonia in a child, as an independent disease that occurs after a serious, strong, prolonged hypothermia, it is extremely rare, as parents try not to allow such situations. As a rule, in most children, pneumonia occurs not as a primary disease, but as a complication after an acute respiratory viral infection or influenza, less often other diseases. Why is this happening?
Many of us believe that acute viral respiratory diseases in the last decades have become more aggressive, dangerous their complications. Perhaps this is due to the fact that both viruses and infections have become more resistant to antibiotics and antiviral drugs, so they are so hard for children and cause complications.
One of the factors contributing to the increase in the incidence of pneumonia in children in recent years has been the overall poor health in the younger generation - how many children are born with congenital pathologies, malformations, lesions of the central nervous system. Especially severe pneumonia occurs in premature or newborn babies, when the disease develops against the background of intrauterine infection with insufficiently formed, not mature respiratory system.
In congenital pneumonia, the herpes simplex virus, cytomegalovirus, mycoplasmas are not infrequently causative agents, and with infection during labor, chlamydia, group B streptococci, opportunistic fungi, E. coli, Klebsiella, anaerobic flora, when infected with hospital infections, pneumonia begins on day 6 or 2 weeks after birth.
Naturally, pneumonia often happens in cold weather, when the organism is subjected to seasonal adjustment from heat to cold and vice versa, there are overloads for immunity, at this time there is a lack of natural vitamins in foods, temperature changes, damp, frosty, windy weather contribute to children's hypothermia and their infection.
In addition, if a child suffers from any chronic diseases - tonsillitis, adenoids in children, sinusitis, dystrophy, rickets (see. rickets in infants), cardiovascular disease, any severe chronic pathologies, such as congenital lesions central nervous system, malformations, immunodeficiency states - significantly increase the risk of developing pneumonia, weighed down its course.
The severity of the disease depends on:
- Extensibility of the process (focal, focal, draining, segmental, lobar, interstitial pneumonia).
- The child's age, the younger the baby, the narrower the airways, the less intense gas exchange in the child's body and the heavier the course of pneumonia.
- Places where and for what reason there was a pneumonia:
- community-acquired: most often have an easier flow
- hospital: more severe, because it is possible to infect bacteria resistant to antibiotics
- Aspiration: when inhaled foreign objects, mixture or milk. - The most important role in this is played by the general health of the child, that is, his immunity.
Improper treatment of influenza and ARVI can lead to pneumonia in the child
When a child falls ill with an ordinary cold, SARS, influenza - the inflammatory process is localized only in the nasopharynx, trachea and larynx. With a weak immune response, and also if the causative agent is very active and aggressive, and the treatment in the child is carried out incorrectly, the process of reproduction of bacteria descends from the upper respiratory tract to the bronchi, then bronchitis. Further, the inflammation can affect the lung tissue, causing pneumonia.
What happens in the body of a child in a viral disease? Most adults and children in the nasopharynx always have different opportunistic microorganisms - streptococci, staphylococci, without causing harm to health, because local immunity holds them back growth.
However, any acute respiratory disease leads to their active reproduction and with the correct action of the parents during the illness of the child, immunity does not allow their intensive growth.
What should not be done during ARVI in the child, so as not to cause complications:
- You can not use antitussives. Coughing is a natural reflex that helps the body to clear the trachea, bronchi and lungs from mucus, bacteria, toxins. If for the treatment of a child, in order to reduce the intensity of dry cough, use antitussives that affect the cough center in the brain, such as Stoptosin, Broncholitin, Libexin, Paxeladin, then sputum and bacteria may accumulate in the lower respiratory tract, which ultimately leads to inflammation lungs.
- It is not possible to conduct any preventive therapy with antibiotics for colds, with a viral infection (see. antibiotics for colds). Against the virus, antibiotics are powerless, and with opportunistic bacteria immunity should cope, and only when complications arise according to the doctor's appointment is shown their use.
- The same applies to the use of various nasal vasoconstrictors, their use contributes to a faster penetration of the virus into the lower respiratory tract; therefore, galazoline, naphthysine, sanorin should not be used in case of a viral infection safely.
- Abundant drink - one of the most effective methods of removing intoxication, dilution of sputum and rapid cleansing respiratory tract is an abundant drink, even if the child refuses to drink, parents should be very persistent. If you do not insist that the child drink enough fluids, in addition, the room will have dry air - this will help to dry the mucosa, which can lead to a longer course of the disease or complication - bronchitis or pneumonia.
- Permanent ventilation, lack of carpets and carpeting, daily wet cleaning of the room in which the child is, Humidification and air purification with the help of a humidifier and an air cleaner will help to cope faster with the virus and prevent development pneumonia. As clean, cool, moist air helps to dissolve sputum, quickly remove toxins with sweat, cough, wet breath, which allows the child to recover faster.
Acute bronchitis and bronchiolitis - differences from pneumonia
With SARS usually the following symptoms:
- High temperature in the first 2-3 days of the disease (see Fig. antipyretics for children)
- Headache, chills, intoxication, weakness
- Qatar upper respiratory tract, runny nose, cough, sneezing, sore throat (it does not always happen).
In acute bronchitis with Orvy, the following symptoms may occur:
- Minor increase in body temperature, usually up to 38C.
- First the cough is dry, then it becomes wet, there is no shortness of breath, unlike pneumonia.
- Breathing becomes hard, on different sides there are variously scattered rales that change or disappear after coughing.
- On the roentgenogram, the intensification of the pulmonary pattern is determined, the structure of the roots of the lungs decreases.
- There are no local changes in the lungs.
Bronchiolitis occurs most often in children up to a year:
- The difference between bronchiolitis and pneumonia can be determined only by X-ray examination, based on the absence of local changes in the lungs. According to the clinical picture, the acute symptoms of intoxication and the increase in respiratory insufficiency, the appearance of dyspnoea - very much resemble pneumonia.
- In bronchiolitis, the breathing in a child is weakened, shortness of breath with the help of an auxiliary musculature, nasolabial the triangle becomes a bluish hue, a common cyanosis is possible, a pronounced pulmonary-cardiac failure. When listening to a boxed sound is detected, the mass of scattered small bubbling rales.
Signs of pneumonia in the child
With a high activity of the causative agent of the infection, or with a weak immune response of the body to it, when even the most effective preventive medical measures do not stop inflammatory process and the child's condition worsens, parents can for some symptoms guess that the child needs more serious treatment and urgent examination doctor. In this case, in no case should not begin treatment by any popular method. If it really is pneumonia, it will not only not help, but the condition may worsen and time for adequate examination and treatment will be missed.
Symptoms of pneumonia in a child 2 - 3 years and older
How to identify attentive parents with a cold or viral illness that it is necessary to urgently call a doctor and suspect a pneumonia in the child? Symptoms that require an X-ray diagnosis:
- After Orvi, influenza within 3-5 days there is no improvement or after a slight improvement again there is a temperature jump and increased intoxication, coughing.
- Lack of appetite, sluggishness of the child, sleep disturbance, capriciousness persist within a week after the onset of the illness.
- The main symptom of the disease remains a strong cough.
- The body temperature is not high, but the baby has shortness of breath. In this case, the number of breaths per minute in a child increases, the rate of breaths per minute in children aged 1-3 years 25-30 breaths, children 4-6 years - a rate of 25 breaths per minute, if the child is in a relaxed calm condition. With pneumonia, the number of breaths becomes larger than these figures.
- With the other symptoms of a viral infection - cough, temperature, cold, severe pallor of the skin is observed.
- If the temperature is high for more than 4 days and antipyretic agents such as Paracetamol, Efferalgan, Panadol, Tylenol are not effective.
Symptoms of pneumonia in infants, children under one year of age
The onset of the disease can be noticed by the mom by changing the behavior of the baby. If the child constantly wants to sleep, become sluggish, apathetic or vice versa, a lot of naughty, crying, refuses to eat, while the temperature may slightly increase - mom should urgently turn to pediatrician.
Body temperature
In the first year of life, pneumonia in a child, a symptom which is considered to be high, not knocked down temperature, is different in that at this age it is not high, does not reach 3, or even 3, -3,. The temperature is not an indication of the severity of the state.
The first symptoms of pneumonia in an infant
This causeless anxiety, lethargy, decreased appetite, the baby refuses from the breast, the sleep becomes restless, short, there is a loose stool, there may be vomiting or regurgitation, a runny nose and a paroxysmal cough that worsens during crying or feeding child.
Child's breathing
Pain in the chest with breathing and coughing.
Sputum - with a damp cough, purulent or mucopurulent sputum (yellow or green) is secreted.
Shortness of breath or an increase in the number of respiratory movements in young children is a clear sign of pneumonia in a child. Dyspnoea in babies can be accompanied by nodding to the breath, as well as the baby blows his cheeks and extends his lips, sometimes there are foamy discharge from the mouth and nose. The symptom of pneumonia is considered to be the excess of the number of breaths per minute:
- In children up to 2 months - the norm is up to 50 breaths per minute, more than 60 is considered a high frequency.
- In children, after 2 months to a year, the norm is 25-40 breaths, if 50 or more, this is an excess of the norm.
- In children older than one year, the number of breaths more than 40 is considered a shortness of breath.
The skin relief during breathing changes. Attentive parents can also notice the retraction of the skin during breathing, more often on one side of the patient's lung. To notice this, it is necessary to undress the baby and observe the skin between the ribs, it retracts when breathing.
With extensive lesions, there may be a lag of one side of the lung with deep breathing. Sometimes you can notice periodic stopping of breathing, disturbance of rhythm, depth, breathing frequency and the child's desire to lie on one side.
Cyanosis of the nasolabial triangle
This is the most important symptom of pneumonia, when the blue skin appears between the lips and the spout of the baby. Especially this sign is pronounced when the child sucks the breast. With severe respiratory failure, a slight blueing can be not only on the face, but also on the body.
Chlamydia, mycoplasmal pneumonia in children
Among the pneumonias, the causative agents of which are not banal bacteria, but various atypical representatives secrete mycoplasmal and chlamydial pneumonia. In children, the symptoms of such pneumonia are slightly different from the course of the usual pneumonia. Sometimes they are characterized by a hidden sluggish current. Symptoms of SARS in a child can be as follows:
- The onset of the disease is characterized by a sharp rise in body temperature to 3, C, then a stable subfebrile temperature of -3, -3 is formed, or even a temperature normalization occurs.
- It is also possible the onset of the disease with the usual signs of ARVI - sneezing, choking in the throat, a bad cold.
- Persistent dry debilitating cough, shortness of breath may not be permanent. Such a cough usually occurs with acute bronchitis, and not pneumonia, which complicates the diagnosis.
- When listening to a doctor, scanty data are usually presented: rare variegated rattles, pulmonary percussion sound. Therefore, according to the nature of wheezing, it is difficult for a doctor to determine atypical pneumonia, since there are no traditional signs, which greatly complicates the diagnosis.
- In the analysis of blood in atypical pneumonia there may be no significant changes. But usually there is increased ESR, neutrophilic leukocytosis, a combination with anemia, leukopenia, eosinophilia.
- On the x-ray of the chest reveals a pronounced enhancement of the pulmonary pattern, non-uniform focal infiltration of the pulmonary fields.
- Both chlamydia and mycoplasma have a feature that exists for a long time in the epithelial cells of the bronchi and lungs, therefore, pneumonia usually has a prolonged recurrent character.
- Treatment of atypical pneumonia in the child is carried out by macrolides (azithromycin, josamycin, clarithromycin), because the pathogens to them are most sensitive (to tetracyclines and fluoroquinolones, too, but they are children contraindicated).
Indications for hospitalization
The decision on where to treat a child with pneumonia - in a hospital or at home, the doctor takes, while he takes into account several factors:
- The severity of the condition and the presence of complications - respiratory failure, pleurisy, acute disorders of consciousness, heart failure, falls AD, lung abscess, pleural empyema, infectious-toxic shock, sepsis.
- The defeat of several lobes of the lung. Treatment of focal pneumonia in the child at home is entirely possible, but with croupous pneumonia treatment is best done in a hospital.
- Social indications are poor living conditions, inability to perform care and doctor's prescriptions.
- Age of the child - if the infant is sick, this is the reason for hospitalization, because the pneumonia of the baby is a serious threat to life. If pneumonia develops in a child under 3 years of age, treatment depends on the severity of the condition and most often doctors insist on hospitalization. Older children can be treated at home provided that the pneumonia is not severe.
- General health - in the presence of chronic diseases, weakened overall health of the child, regardless of age, the doctor may insist on hospitalization.
Treatment of pneumonia in children
How to treat pneumonia in children? The basis of therapy for pneumonia is antibiotics. At a time when there were no antibiotics in the arsenal of doctors with bronchitis and pneumonia, a very frequent cause of death of adults and children there was pneumonia, therefore, in no case should one refuse to use them, no folk remedies for pneumonia are effective. From the parents it is required to strictly follow all the doctor's recommendations, the proper care of the child, the observance of the drinking regime, nutrition:
- Reception of antibiotics must be carried out strictly in time, if the appointment of the drug 2 times per day, this means that there should be a break of 12 hours between meals, if 3 times a day, then a break of 8 hours (cm. 11 rules how to take antibiotics correctly). Antibiotics are prescribed - penicillins, cephalosporins for 7 days, macrolides (azithromycin, josamycin, clarithromycin) - 5 days. The effectiveness of the drug is estimated within 72 hours - an improvement in appetite, a decrease in temperature, dyspnea.
- Antipyretics are used if the temperature is above 39C, in infants above 38C. Initially, antibiotic treatment of antipyretics is not prescribed, as the evaluation of the effectiveness of therapy is difficult. It should be remembered that during a high temperature in the body, the maximum amount antibodies against the causative agent of the disease, so if the child can tolerate the temperature of 38C, it is better not to knock down. So the body quickly cope with the microbe that caused pneumonia in the baby. If the child had at least one episode of febrile seizures, the temperature should be knocked down already at 3, C.
- Nutrition of the child with pneumonia - lack of appetite in children during illness is considered natural and the child's refusal from food intake due to increased strain on the liver when fighting infection, so you can not force a child to feed. If possible, prepare light food for the patient, exclude any ready-made chemicals, fried and fatty, try to feed child simple, easily assimilated food - cereals, soups on a weak broth, steam cutlets from low-fat meat, boiled potatoes, various vegetables, fruit.
- Oral hydration - in water, natural freshly diluted juices - carrot, apple, weakly boiled tea with raspberries, rose hips infusion, water-electrolyte solutions (Regidron and etc).
- Airing, daily wet cleaning, use of air humidifiers - ease the condition of the baby, and the love and care of parents works wonders.
- No restorative (synthetic vitamins), antihistamines, immunomodulating agents are not used, as often lead to side effects and do not improve the course and outcome of pneumonia.
Reception of antibiotics for pneumonia in a child (uncomplicated) usually does not exceed 7 days (macrolides 5 days), and if bed rest is observed, perform all the doctor's recommendations, in the absence of complications, the child quickly recovers, but for a month there will still be residual effects in the form of a cough, slight weakness. With atypical pneumonia, treatment can be delayed.
In the treatment of antibiotics in the body, the intestinal microflora is broken, so the doctor prescribes probiotics - RioFlora Immuno, Acipol, Bifiform, Bifidumbacterin, Normobakt, Lactobacterin. Analogues of Linex - a list of all probiotics). To remove toxins after the end of therapy, the doctor can prescribe sorbents, such as Polysorb, Enterosgel, Filtrum.
With the effectiveness of treatment for general regimen and walks, it is possible to transfer the child from the 6th to the 10th day of the disease, the hardening to resume after 2-3 weeks. With a mild pneumonia, large physical exertion (sport) is allowed after 6 weeks, with complicated after 12 weeks.
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Pneumonia in children treatment and symptoms | How to treat pneumonia in a child
Synonym for the disease is pneumonia. Pneumonia is characterized by inflammation of the parenchymal, respiratory part of the lungs. How to cure a disease in a child, read further in the article.
Symptoms of pneumonia in children
At the kid with signs of an inflammation of lungs appear:
1. cough. Although in infants, coughing may not be;
2. decreased appetite;
3. increased body temperature;
4. general condition of the child - worsens;
5. dyspnea.
Symptoms of pneumonia depend on the etiology, nature and phase of the flow, the morphological substrate of the disease and its prevalence in the lungs, as well as complications (pulmonary suppuration, pleurisy, etc.). Acute pneumonia usually begins sharply, often after cooling: the patient experiences a tremendous chill; body temperature rises to febrile numbers 39 - 40 ° С, less often up to 38 or 41 ° С; the pain of breathing on the side of the affected lung is enhanced by coughing, at first dry, then moist, with purulent viscous phlegm. The patient's condition is difficult. Skin covers are hyperemic and cyanotic. Respiration is rapid, superficial, with swelling of the wings of the nose.
After applying antibacterial therapy, the high temperature gradually decreases. The thorax lags behind in the act of breathing on the side of the affected lung, the percussion of which, depending on the morphological stage of the disease, reveals blunted tympanitis (tidal stage), shortening (dullness) of pulmonary sound (stage of red and gray curing) and pulmonary sound (stage permission).
Cardiovascular insufficiency develops (especially in infancy), exchange-dystrophic pathology of the heart. The motility of housing and communal services and the enzymatic activity of gastric juice are disturbed. There are violations of kidney function (changes in filtration, reabsorption, secretion), liver, endocrine system (increased secretion corticosteroids, catecholamines), metabolism (acidosis, fluid retention, dysproteinemia, hypoglycemia, hypocholesterolemia and other). Many changes are adaptive, protective.
Signs of pneumonia in children of different phases and forms
Depending on the staged nature of the morphological changes in auscultation, respectively, increased vesicular breathing, bronchial respiration and vesicular or weakened vesicular breathing. In the phase of custody during pneumonia, enhanced vocal tremor and bronchophonia are determined. Due to the uneven development of morphological changes in the lungs, percussion and auscultatory patterns can be variegated.
Due to the defeat of the pleura (parapneumonic serous-fibrinous pleurisy), a pleural friction noise is heard. At the height of the disease, the pulse is rapid, mild, corresponds to a lowered blood pressure, from the side of the cardiovascular system, the mute tone and the accent of the 2nd tone on the pulmonary artery. In the analysis of blood - neutrophilic leukocytosis, increased ESR, anemia.
Radiographic examination determines the homogeneous shading of the entire affected part or part of it, especially on the side radiographs. X-rays can be inadequate in the first hours of the illness. Similarly, pneumococcal may occur staphylococcal pneumonia. More often it proceeds more severely, accompanied by destruction of the lungs with the formation of thin-walled air cavities, lung abscesses.
With the phenomena of severe intoxication, staphylococcal (usually multifocal) pneumonia occurs in children, complicating the viral infection of the bronchopulmonary system (viral-bacterial pneumonia). For this type of pneumonia is characterized by a pronounced intoxication syndrome, manifested by hyperthermia, chills, flushing of skin covers and mucous membranes, dizziness, headache, severe shortness of breath, hemoptysis, tachycardia, nausea, vomiting.
In severe infectious-toxic shock, vascular insufficiency develops (blood pressure 90 - 80/60 - 50 mm Hg. pale skin, cold extremities, the appearance of sticky sweat). With the progression of intoxication syndrome, cerebral disorders, cardiac insufficiency, heart rhythm disturbances, development of shock lung, hepatorenal syndrome, DIC syndrome, toxic enterocolitis. Such pneumonia can lead to a rapid fatal outcome.
Focal pneumonia, bronchopneumonia arise as a result of complications of acute or chronic inflammation of the upper respiratory tract and bronchi, in patients with stagnant lungs, heavy, exhausting diseases, in the postoperative period, as a result of fat emboli in trauma, with thromboembolism. The disease can begin with chills, but not as pronounced as with lobar pneumonia. Body temperature rises to 38-3, ° C, rarely higher. Appears and intensifies cough, dry, then with mucopurulent phlegm. Possible pain in the chest when coughing and inhaling.
When the focal focal (usually staphylococcal) pneumonia in children, the condition worsens: pronounced dyspnea, cyanosis, shortening pulmonary sound, breathing can be strengthened vesicular with foci of bronchial, the focus of small- and medium-vesicular wheezing.
On the roentgenogram (sometimes only on the tomogram), lobular, subsegmental and segmental shadows are revealed, the pulmonary pattern is strengthened, and bullae and foci of abscess formation can be detected radiographically.
Segmental pneumonia affects children of different ages and is characterized by the defeat of one or more segments of the lung. The disease is not much different from focal pneumonia and depends on the location of the vastness of the lungs. This disease is prone to a prolonged course of the disease.
Interstitial pneumonia is caused by viruses, mycoplasmas, pneumocystitis and fungi. The disease occurs in premature infants, and at an older age - against the background of dystrophy, anemia.
Intrauterine pneumonia occurs when the fetus is infected in the womb or when aspirating amniotic fluid during labor. Diseases in newborns are interstitial and focal.
Destructive pneumonia is a purulent lesion of the lungs, the epidemiological situation contributes to the origin. The disease is characterized by the flow of abscesses, the formation of cavities, the rapid penetration of inflammation into the pleura and the formation of pneumothorax.
Symptoms of focal pneumonia
Focal bronchopneumonia occurs in children most often. The disease of this form is characterized by an increase in intoxication and is manifested by a rise in temperature to 39 degrees, a violation of sleep, anxiety, apathy to the environment. When the child's appetite decreases, he refuses the breast, becomes inattentive, often groans. There is a loose stool, vomiting, constant regurgitation, braking gain in weight. A beginning cough is observed, characteristic signs of cyanosis are visible, the skin acquires a gray-earthy color, the rhythm of breathing is disturbed, there is shortness of breath with a change in the frequency of breathing and there are seizures apnea. Foamy discharge from the nose and mouth is also intensified.
The main symptoms of the disease:
1. toxicosis;
2. a fever and a fever of 40 degrees;
3. significant changes in the lungs;
4. changes in peripheral blood (leukocytosis, elevated ESR);
5. segmental, focal, lobar infiltrative foci were detected during X-ray diffraction;
6. signs of respiratory failure (dyspnea, cyanosis of the skin).
Signs of pneumonia in newborns
When intrauterine infection of the fetus, the disease is determined almost immediately after birth, especially when the baby is premature or with asphyxiation. Skin covers acquire a grayish-yellow hue and the child's crying is almost not audible. Arrhythmia is accompanied by wet and scattered wheezing, the temperature almost immediately rises to 40 degrees and the condition of the newborn baby is very difficult. The baby often belches, and sometimes there is vomiting, the legs swell, the child loses significantly in weight, and the umbilical cord falls off more slowly than in a healthy baby.
Signs of the disease in a newborn baby can be detected after two days and are much different from intrauterine infection. The breathing of the full-term baby is rapid and becomes noisy, and in preterm infants - rare and weak. The immune system of the baby is very weak and often pimples appear on the skin. If the infection is found in the body of the child after childbirth, then there are severe symptoms of respiratory disease - a runny nose, nasal congestion. The newborn child becomes capricious, does not sleep well and eats, the skin begins to darken, the temperature rises and the face becomes bluish. A newborn baby breathes with difficulty, the pulse rate is rapid. In preterm infants, the disease is not detected immediately, but gradually, and those born at the time of the inflammation of the lungs are in acute form.
Diagnosis of pediatric pneumonia
Based on clinical and laboratory data, shortening of percussion sound is taken into account, vesicular breathing intensification is noted, sometimes with foci of bronchial, crepitus, small and medium bubbling rales, on radiographs (sometimes on tomograms) - focal shading. Explore sputum or swabs from the pharynx to bacteria, including mycobacterium tuberculosis, viruses, mycoplasma pneumonia.
Differential diagnosis is carried out with acute bronchitis and exacerbation of chronic bronchitis (unlike pneumonia less pronounced intoxication, radiographically do not reveal foci of shading).
Diagnosis of chronic pneumonia
The chronic form of the disease is a chronic inflammatory nonspecific process, which is based on irreversible morphological changes in the form of deformation of the bronchi and pneumatic sclerosis in one or some segments, accompanied by relapses of inflammation in the bronchi, as well as pulmonary tissue.
Criteria for diagnosis:
1. the presence of characteristic clinical symptoms of varying severity,
2. cough with phlegm,
3. stable localized wheezing in the lungs, recurrent exacerbations.
X-ray reveals signs of limited pneumosclerosis, bronchographically - deformation and expansion of the bronchi in the lesion.
Diagnosis of acute pneumonia
Acute pneumonia is an acute inflammatory disease of the lungs, caused by bacterial, viral pathogens, certain chemical agents, and allergic factors.
The clinical picture of focal pneumonia in children of preschool and school age is composed of respiratory complaints, signs of intoxication, ND syndrome and local physical changes. At children of early age first of all there are signs of DV, intoxications, and local symptomatology is revealed later. Quickly there is emphysema due to violation of bronchial patency, an increase in the tone of the vagus nerve and high extensibility of the lung tissue due to the small number of elastic fibers.
Croupous acute inflammation of the lungs is characterized by a loss of the lobe, although in children, the inflammatory focus often does not occupy the entire share, but several segments. In the first year of life, croupous pneumonia is rare. Depending on the localization of the focus in the clinical picture may appear uncharacteristic symptoms: pain in the right iliac areas, vomiting, diarrhea (with lower right-side pneumonia), meningeal form (with upper right aft pneumonia). Complications of croupous pneumonia (massive pleurisy, abscess of the lung) in children are rare.
Diagnosis is carried out on the basis of clinical data (intoxication, fever against the antipyretics, dyspnea in the absence of obstructive syndrome, local symptomatology over the lungs) and laboratory-instrumental studies, the most important of which are radiography and clinical analysis blood. X-ray examination is especially important in young children, as often the changes on the roentgenogram develop before the local symptomatology over the lungs.
Criteria for diagnosis of the disease:
1. violation of the general condition,
2. increased body temperature,
3. cough,
4. Dyspnea of varying severity and characteristic physical changes.
X-ray confirmation is based on the detection of focal infiltrative changes in the lungs.
Complications of pneumonia in a child
If the child is prescribed the right treatment, then the disease proceeds without complications, otherwise the following complications occur:
1. Pleurisy is an inflammatory process of the pleura that causes severe pain and compression of the lungs;
2. Pulmonary destruction - one of the signs of a lethal outcome in the disease. With pulmonary destruction, lung tissue is destroyed;
3. cardiopulmonary insufficiency is one more sign of a lethal outcome in children. With cardiopulmonary insufficiency, the work of the heart is disrupted on the basis of the inflammatory process and intoxication of the body.
How to treat traditional methods of pneumonia in a child?
Therapy for mild and comfortable living conditions can be performed at home, but most patients need inpatient treatment. For emergency indications, patients with shared and other pneumonias and expressed infectious-toxic syndrome are hospitalized. At the height of the disease, bed rest is shown, a mechanically and chemically sparing diet with restriction of table salt and a sufficient number of vitamins, especially A and C. With the disappearance or a significant decrease in the effects of intoxication, the regime is extended, physical culture, in the absence of contraindications (heart diseases, digestive organs), the patient is transferred to diet number 15.
Immediately after taking sputum, smears or rinses for bacteriological examination, etiotropic antibacterial therapy is initiated, which is carried out under the control of clinical efficacy, in the subsequent - taking into account the sown microflora and its sensitivity to antibiotics.
1. In case of community-acquired pneumonia, semisynthetic penicillins, penicillas, macrolides of a new generation are prescribed;
2. for nosocomial pneumonia, "protected" penicillins, aminoglycosides, second-third generation cephalosporins, fluoroquinolones and other antibiotics of the reserve group are prescribed;
3. with pneumonia with intrauterine infection - macrolides of a new generation (spiromycin, Roxithromycin, Azithromycin);
4. with pneumonia in patients with immunodeficiency appoint cephalosporins of the third and fourth generation, fluoroquinolones.
5. In severe viral-bacterial pneumonia, often due to the interaction of the influenza virus and staphylococcus, along with intravenously administered broad-spectrum antibiotics, the introduction of a specific donor influenzaγglobulin for 3 - 6 ml.
6. Combinations of antibiotics for the treatment of complicated pneumonia: cephalosporins + semisynthetic penicillins; semisynthetic penicillins + aminoglycosides; cephalosporins + aminoglycosides. They also use detoxifying agents (haemodesis, etc.). Mucolytic therapy, bronchodilator therapy, physiotherapy, immunocorrective therapy, exercise therapy are prescribed.
With severe tachycardia, a decrease in systolic pressure to 100 mm Hg. Art. and below patients prescribed strophanthin, sulfocamphocaine. Outpatients discharged from the hospital during the period of clinical recovery or remission should be taken under medical observation. To conduct rehabilitation, they are sent to local sanatoriums. The prognosis has significantly improved since the beginning of the use of antibacterial agents. But it remains serious with staphylococcal and "freelander" pneumonias, with frequently recurring chronic forms of the disease complicated by obstructive process, respiratory and pulmonary heart failure, as well as when pneumonia occurs in people with severe cardiovascular and other diseases systems. The mortality in these cases remains high.
Features of therapy of pneumonia in children
First of all, you must provide your child with the appropriate conditions that will favorably affect the course of the disease. This is primarily a moist and fresh air in the room where the child is, constant airing, copious drinks (compotes, teas, fruit drinks, juices), the food should be vitamin and caloric. As adults and children need to take antibiotics under the supervision of a doctor (Azithromycin, Erythromycin, Zinnat, Augmentin). Contraindicated give the child aminoglycosides, tetracyclines, since they can cause side effects.
With the correct course of antibiotics, the child's health improves rapidly. If you can not sell heat, then you need to change antibiotics or it can cause lung abscess. Along with the reception of antibiotics will also help the methods of traditional medicine (infusions and herbal teas, herbal teas, saline and alkaline inhalations) and dietary supplements. During the recovery period, physiotherapy, exercise therapy (gymnastics and massage), breathing exercises, laser therapy, phytopreparation, homeopathy, and vitamin therapy are recommended. It is necessary to avoid hypothermia and drafts. Take care of the health of your children with extreme care and care.
Stages of treatment of chronic pneumonia in children
Early rehabilitation - with exacerbation, antibacterial drugs, secretolitic and expectorants, bronchodilators, postural drainage, exercise therapy, respiratory gymnastics, vitamin therapy, reparants, general and chest massage, physical activity. Physiotherapy includes high-frequency electrotherapy, inhalation of mucolytic agents.
Late rehabilitation is carried out at a sanatorium stage. All the factors of sanatorium rehabilitation, microelement therapy, phytotherapy, general massage, high-frequency methods not used in the first stage of rehabilitation, galvanization of the lungs and medicinal electrophoresis.
Restorative treatment - immunocorrective therapy is used; biopreparations for elimination of intestinal dysbiosis, drugs that restore trophism of tissues, immunomodulation with physical factors of influence, spa rehabilitation.
Dynamic observation of children with chronic bronchopulmonary diseases is carried out constantly by the local doctor and pulmonologist, examination - once a quarter. Complete clinical and laboratory-instrumental examination is shown 2 times a year for the hospitalization of children. The child needs constant exercises of exercise therapy, hardening procedures.
Therapy of acute pediatric pneumonia
Treatment includes adherence to bed rest during the entire febrile period (the position of the child in the bed with an elevated head end), adequate and adequate nutrition with abundant drink.
In the treatment it is necessary to create a favorable microclimate and maintain the patency of the airways: with DN I, the room is ventilated systematically, where is sick, moisten the air with aerators; with DN II-III, various types of oxygen therapy are used: breathing of moistened, oxygen-enriched mixture; with toxic pneumonia, severe dehydration (especially in infants), detoxification activities are carried out in combination with oxygen therapy.
The main importance in the treatment of acute forms of the disease is rational antibiotic therapy, taking into account the sensitivity of the pathogen, vitamins C, B1, B2 and eubiotics (Lactobacterin, Bifidumbacterin). Symptomatic therapy includes antipyretics (paracetamol, analgin, acetylsalicylic acid), expectorants (Bromhexin, Mukaltin, Phytosbores), distracting therapy (mustard, medical cans, honey applications) and desensitizing agents (Tavegil, Suprastin, Pipolphen). At the end of the acute period, immunostimulants (metacil, pentoxil, eleutherococcus, etc.) are prescribed.
Physical methods of treatment are used from the first days of the disease to combat NAM. These are methods of general effect, segmental-reflex and local, which contribute to the resolution of inflammation at the level of the pneumonic focus. The choice of the method of physiotherapy depends on the stage of the disease, the condition of the patient, the presence of concomitant pathology.
Early rehabilitation - against the background of etiological treatment, secretion drugs, substitutive immunotherapy, exercise therapy, breathing exercises, immunomodulatory treatment with adaptogens are used.
With late rehabilitation, sanatorium factors are used, vitamin therapy, if possible, eliminate infectious allergies.
At the stage of restorative treatment, elimination of dysbacteriosis, sanation of foci of chronic infection, resort factors of rehabilitation, hardening are used. The duration of observation is one year.
How to treat pneumonia in a child by physical methods?
We will discuss how the physiotherapy of pneumonia in children is carried out.
1. Antihypoxic methods: oxygen therapy, aerotherapy, carbon dioxide and oxygen baths.
2. Anti-inflammatory methods: UHF microwave therapy, high-frequency magnetotherapy, X-ray irradiation in erythematous doses, heat therapy.
3. Bronchodrenating methods of treatment of pneumonia in children: inhalation of mucolytics and enzymes, therapeutic massage.
4. Desensitizing methods: electrophoresis of calcium, magnesium, copper.
5. Immunostimulating methods: heliotherapy, zinc electrophoresis.
Antihypoxic methods of therapy of pneumonia in children
Applied mainly with bronchiolitis. Depending on the severity of the condition, aerotherapy is used, with DN II-III, oxygen therapy (humidified oxygen, oxygen tent) is prescribed. In pneumonia, the optimal method of oxygen therapy is ventilation with positive end-expiratory pressure. Positive end-expiratory pressure reduces the water content in the pulmonary interstitium, resulting in increased mass transfer of gases in the alveoli. Age restrictions - children are appointed from 5 years. Positive pressure at the end of expiration is 4-8 mm of water, the duration of exposure is 15-20 minutes, daily; To treat pneumonia in a child, a course of 8 to 10 procedures is needed.
Aerotherapy. Cool air activates the upper airway thermoreceptors, which leads to an increase in the respiratory volume and alveolar ventilation, followed by an increase in PO2 in the alveoli. Carry out a regular airing of the room in which the child is located, humidifying the air or walking (at an air temperature of at least 10-15 ° C) for 1-2 2 1/2 hours, daily.
Carbonic baths. Under the influence of carbon dioxide on the respiratory center, the breathing deepens and shrinks, the diffusion of oxygen in the lungs is compensated, which leads to a decrease in hypoxemia. Baths are carried out with a concentration of carbon dioxide, g / l, at a temperature of 37-36 ° C, from 5 - 6 to 10-12 min, every other day; course 8- 12 procedures.
Oxygen baths. Penetrating through the skin and respiratory tract oxygen increases the oxygenation of the blood, helps reduce tissue hypoxia. Baths are appointed at a water temperature of 36-37 ° C, for 5 - 1 0 minutes, every other day; to treat pneumonia in a child, you need a course of 8-10 procedures.
Anti-inflammatory methods of treating pneumonia
Heat therapy is applied topically to the interlateral area and the lateral surface of the chest (temperature of ozocerite 37-42 ° С, paraffin - 40-45 ° С, the duration of the procedures is 20-30 minutes, daily or every other day; course 8 - 1 0 procedures). In children of early age and newborns with expressed catarrhal phenomena apply paraffin wax applications in the form of "boots" on the feet and the lower third of the shin (paraffin temperature 37-40 ° C).
Electrophoresis of iodine (2-5% solution of potassium iodide) is carried out with moderate catarrhal phenomena, the presence of fibrotic changes in the lungs in order to eliminate residual signs of inflammation. Current density, 3, 5 mA / cm2, duration of exposure 7-15 minutes, daily; course of 7-15 procedures.
Electrophoresis Donina (,% solution) is used to eliminate peribronchial and perivascular infiltration, with a strong cough. Current density, 3, 5 mA / cm2, duration of exposure 7-15 minutes, daily; course of 7-15 procedures.
Electrophoresis of mud preparations (Gumisol, Peloidin) is carried out at the stage of convalescence in the absence of bronchospasm, along the back axillary lines. Current density, 5, 7 mA / cm2, mud temperature 38-40 ° C, the duration of the procedure is 15-20 minutes, every other day; to treat pneumonia in a child, you need a course of 8-12 procedures.
Desensitizing therapies in pediatric pneumonia
Electrophoresis of calcium, magnesium and copper is carried out in the subacute phase of inflammation, segmentally or locally. Electrophoresis of a calcium solution is indicated for children with concomitant rickets, increased nervous excitability; electrophoresis of copper solution - with concomitant anemia; electrophoresis of magnesium solution - with pneumonia with obstructive syndrome. Current density, 2, 5 mA / cm2, duration of exposure 7-12 minutes, daily; course 8 - 1 0 procedures.
Zinc electrophoresis is used according to the method of Vermel or to the zone of the pneumonic focus, current density, 2 5 mA / cm2, for 7-12 minutes, every other day; to treat pneumonia in a child, you need a course of 8 - 1 0 procedures.
Sanatorium-and-spa therapy of pneumonia in children
Sanatorium treatment for acute forms of pneumonia is not performed. Children with repeated inflammatory diseases (bronchitis, pneumonia) are sent to local sanatoria (outside phase of exacerbation), where immunostimulating methods are prescribed (aerotherapy, heliotherapy, inhalation immunomodulators).
Physioprophylaxis is aimed at preventing respiratory diseases by increasing immunity (immunostimulating methods), reducing intoxication and inflammation (antiviral and anti-inflammatory methods).
Causes of pneumonia in children
As the etiological factor are different bacteria:
1. pneumococci,
2. staphylococci, streptococci,
3. Klebsiella pneumonia,
4. Gram-negative flora and mycoplasma (community-acquired form);
5. Staphylococcus, Pseudomonas aeruginosa (nosocomial form);
6. chlamydia, cytomegalovirus (with perinatal infection);
7. various bacteria in patients with immunodeficiency.
Viral-bacterial associations can play an important role in the onset of the disease, chemical and physical agents-effects on the lungs chemical substances (gasoline, etc.), thermal factors (cooling or burn), radioactive radiation (the etiological factors are usually combined with infectious). Pneumonia can be the result of allergic reactions in the lungs or the manifestation of a systemic disease (interstitial pneumonia in connective tissue diseases).
The causative agent penetrates into the lung tissue by bronchogenic, haematogenic and lymphogenous pathways from the upper respiratory tract, usually at presence in them of acute or chronic foci of infection or from infectious foci in the bronchi (with chronic bronchitis, bronchiectasis). A special role in pathogenesis is played by violations of the protective mechanisms of the bronchopulmonary system, as well as the state of humoral and tissue immunity. Survival of bacteria in the lungs, their reproduction and distribution along the alveoli, depend on their aspiration with mucus from the upper respiratory tract and bronchi is favored by cooling), from excessive formation of edematous fluid, embracing in croupous (pneumococcal) pneumonia, a whole or a few parts lungs. At the same time, possible immunological damage and inflammation of the lung tissue due to the reaction to the antigenic material of microorganisms and other allergens.
Pediatric pneumonia is different in children of different ages. Children from six months to five years of age fall ill with pneumonia caused by hemophilic and pneumococcal rods. In adolescents pneumonia is caused by chlamydia pneumonia. Weakened children (especially the first year of life) cause disease, E. coli (Staphylococcus aureus).
Causes of Infectious Pneumonia in Children
Pneumonia in childhood is most often infectious. Bacterial acute pneumonia in children caused by pneumococcus, staphylococcus, hemophilic rod, often develops against the background of ARVI, i.e. with a decrease in immunity and protective properties of the mucous membrane of the upper respiratory ways.
The lesion of the bronchopulmonary lymph nodes is typical - in the form of an expansion of the shadow of the lung root on the roentgenogram.
The pathological process, especially in young children, is, as a rule, segmental (inflammatory process in the whole segment or several segments). Pathogenesis is led by intoxication and respiratory insufficiency (ND), causing changes in all organs and systems.
Viral infection, causing inflammation of the upper respiratory tract and bronchial tubes, and in some cases pneumonia, still often favors the activation of bacterial infection and the emergence of bacterial focal or lobar pneumonia. The appearance of bacterial pneumonia usually at the end of the first or at the beginning of the second week after the respiratory viral a significant reduction in the bactericidal activity of the alveolar-macrophagal system lungs. Chronic pneumonia may occur as a result of unresolved acute pneumonia with the slowing and stopping of resorption of exudate in the alveoli and the formation of pneumosclerosis, inflammatory-cell changes in the interstitial tissue is often of an immunological nature (lymphocyte and plasma cell infiltration).
The prolonged course of acute pneumonia, their transition to a chronic form is promoted by immunological disorders, which are caused by repeated respiratory viral infection, chronic infection of the upper respiratory tract (chronic tonsillitis, sinusitis, etc.) and bronchi.
Ways of infection of pneumonia in children
Most often, harmful bacteria enter the lungs by airborne droplets. This happens according to the following plan:
1. Microbes settle on the mucous membrane of the bronchi (after viral infections).
2. Viral infection disrupts the working capacity of the mucociliary apparatus.
3. Epithelial cells are destroyed.
4. The immune system gives "failure which contributes to the penetration of viruses into the respiratory system, in particular, into the lungs.
5. The inflammatory process begins.
Groups of risk of pneumonia in children. The smaller the child's age, the more he is sick and harder. This is due to the fact that the baby's body, like all its organs, is just being formed. Therefore, they can not adequately withstand viruses. The result is - pediatric pneumonia.
More common than usual pneumonia occurs:
1. in infants, who are on mixed or artificial feeding;
2. in children who suffer rickets;
3. in infants who suffer from diathesis (exudative);
4. in children who suffer from hypotrophy.
Prevention of pneumonia in children
Adult same, it is strongly recommended:
1. quit smoking. Passive smoking reduces the flow of air (oxygen) into the body of the child. Causes toxic poisoning of the respiratory system, which can lead to pneumonia;
2. to increase their education in order to know more about the child's body. Be able to properly care for him and create wonderful living conditions for the child.
AstroMeridian.ru
Pneumonia in children - symptoms
Pneumonia in children, especially the first years of life, is a common disease that affects the lungs. Duration of treatment, the likelihood of relapse and the transition of pneumonia to the chronic stage are good reasons to understand the need for early diagnosis of the disease. About the existing forms of the disease and how to recognize the child pneumonia, we will explain in this article.
How to determine pneumonia in a child?
Determine the symptoms of pneumonia possible, but not always it is possible in the early stages, especially in infants. The thing is that in the first days of the disease the symptoms are very similar to acute bronchitis.
- For bronchitis and pneumonia in children, the secondary type of development of the disease is more typical (on days 5-7 after the ORVI, ORZ in children).
- Severe dry cough, shortness of breath and chest pain.
- High body temperature.
Only a specialist can make a final diagnosis.
How does pneumonia manifest in children?
Manifestations of pneumonia in children can vary significantly. It depends on the type of pathogen. The severity of the disease and the brightness of the manifestation of symptoms are due to the extent of lung damage.
Calling pneumonia can:
- viruses;
- bacteria;
- worms;
- allergies;
- fungi, etc.
For viral pneumonia in children, the symptoms in the form of cough, high fever, poorly amenable to medication, characteristic wheezing and other things persist. But atypical pneumonia, which is caused by chlamydia and mycoplasmas, you can and completely confuse with the usual ARI.
The first signs of atypical pneumonia in children:
- prolonged dry cough;
- sneezing, a bad cold;
- a feeling of perspiration in the throat;
- high body temperature, but in some cases the temperature may remain within normal limits;
- loss of appetite;
- wheezing, not typical for normal pneumonia.
Symptoms of radical pneumonia in children also have their own characteristics. If other areas of the lung are affected, the disease is diagnosed more easily. Determine the localization of wheezing in this disease is extremely difficult. If the inflammation started in the basal part of the lung, additional tests should be performed, since in the pictures the basal pneumonia is similar to tuberculosis and bronchial cancer. Temperature, cough, loss of appetite and other symptoms are inherent in radical pneumonia, but the disease itself is protracted.
Symptoms of pneumonia in infants
In infants, it is especially difficult to diagnose pneumonia in the early stages, even for specialists. In the first two days of the disease, a cough or breathing with a characteristic noise is not observed in the child and there are no wheezing when listening to the lungs. Pneumonia in infants can also occur without fever. Given that the baby's respiratory system is just beginning to improve, the picture of the disease can develop into a serious and the treatment then has a very long time. But nevertheless signs of a pneumonia at thoracal children, let and not so strongly pronounced, are available.
- The child loses his appetite. A kid can often ask for a breast, but at the same time he practically does not suck.
- The nasolabial triangle of the baby acquires a bluish tinge. This is especially noticeable during sucking.
- The skin between the ribs of the baby begins to retract. To determine this, it is necessary to put the child to undress it and see if the given symptom is present.
- Rapid breathing. Babies who get pneumonia start breathing more often. So, in children up to 2 months there are more than 60 breaths per minute, for children up to a year there are more than 50 breaths, and in children after a year - more than 40 breaths per minute.
- Behavioral changes. The child can become sluggish and apathetic, the periods of sleep at the same time increase noticeably in time. There may be another option, when the child, by contrast, is a lot of naughty, crying and screaming.
WomanAdvice.ru
Pneumonia in children, its causes, symptoms and treatment principles
Pneumonia is an acute inflammatory infectious disease that affects the lower parts of the respiratory tract - the lungs themselves. Pneumonia in children under 6 years of age often develops as a result of a viral infection, complicated by the attachment of bacterial flora, after angina, bronchitis and other colds.
In childhood, especially in children younger than 1 year old, this disease can be severe enough and even cause respiratory failure or severe intoxication of the body, so even a suspicion of this disease should be the reason for seeking medical help and for diagnostics.
Etiology and pathogenesis
Inflammation of the lungs or pneumonia in children usually develops as a result of the entry of pathogenic microorganisms into the lower respiratory tract from the upper ones. Weakened by the illness of the child's body can not cope with the causative agent of the disease and then the inflammatory process begins in the alveoli and small bronchioles. Bacteria that enter the lungs actively multiply and release toxins that cause intoxication body - increased body temperature, headache, general deterioration and other similar symptoms.
Then the alveoli gradually fill with mucus, pus and other inflammatory fluids that appear as a result of vital activity microorganisms, because of this, normal gas exchange in the lungs is disrupted, respiratory failure develops, and the following appear symptoms of the disease - a strong cough, shortness of breath, blunting percussion sound, wheezing in the lungs and the emergence of foci of inflammation in chest radiograph.
The patient's condition is in direct proportion to the size of the affected area - with focal lesions of severe respiratory failure not there is a cough and a slight shortness of breath and the patient's condition is satisfactory and the disease is easily cured by admission antibiotics. If the whole or whole of the lung is affected by inflammation, the clinical picture of the disease completely changes, the condition of the sick child can be very difficult, up to a menacing life.
In most cases, pneumonia develops as a complication after the flu, bronchitis, sore throat or cold. The causative agents of the disease in children are often bacteria, less often viruses or other microorganisms - fungi or protozoa. Since it is necessary to start treatment, as soon as a suspicion of a disease appears, it is very important to at least approximately determine the pathogen - this determines the success of the therapy in the treatment of the child.
The causes of the development of the disease in children can be different - from massive infectious infection to hypothermia, which caused a drop in immunity. Diagnosis of the disease should include the determination of the type of pathogen, but since this takes a long time, the treatment starts with the empirical application of broad-spectrum antibiotics.
1. Most often pneumonia in children develop at the age of 6 months to 6 years - the causative agents of the disease in this case in children in 50% of cases is pneumococcus, about 10% - a hemophilic rod, less often - other pathogens - staphylococcus, mycoplasma, chlamydia or mushrooms.
2. In 7-15 years, children from pneumonia suffer much less often, pneumococcal causes about 30% of infections, less often - the causative agent is streptococcus, and more than 50% of all diseases cause atypical pathogens - mycoplasma, chlamydia.
3. Pneumonia in newborn infants and children up to 6 months of age - at this age from pneumonia preterm infants, children with developmental defects of the respiratory system, or those born with immunodeficiency. The causes of the development of the disease at this age are insufficiently formed respiratory organs, weakened organism and problems in the work of the immune system.
Signs of pneumonia
The first signs of the disease appear usually a few days after the onset of a viral infection or a cold. Acute pneumonia in children is broken fast enough, the deterioration of the condition can develop within a few hours and therefore even a suspicion of pneumonia should be the reason for contacting a doctor.Acute pneumonia is manifested by the following symptoms:
- A rise in body temperature is a symptom of pneumonia with a sharp increase in body temperature to 39-41 degrees and this temperature does not fall for several days, unlike acute respiratory disease and colds.
- Deterioration of the general condition of the patient is a symptom of the disease pneumonia is characterized by a sharp weakness, fatigue, refusal to eat, there is increased sweating, pallor of the skin or cyanosis nasolabial triangle.
- Cough - one of the most characteristic signs of the disease - cough can be dry or wet, with the separation of purulent sputum. Coughing attacks greatly deplete the patient, especially at night. Cough with pneumonia is permanent, painful, less often the cough can be paroxysmal or even with blood streaks in the sputum.
- Shortness of breath and respiratory failure - increased respiration, lack of air, pale skin - all these are characteristic symptoms of pneumonia.
- When breathing in the child, one can notice the retraction of the intercostal spaces or the lag of one half of the thorax from the other.
Clinical picture of the disease in children under 1 year old
In newborns and children under 1 year old, the symptoms of pneumonia may be very different from the usual ones and it is not so easy to recognize the disease. In young children, the characteristic signs of pneumonia are cough, an increase in body temperature may be absent or mild.
At this age, the changes in the state of the nervous system and the general deterioration of the child's condition come to the fore - it becomes sluggish, capricious, refuses food and constantly cries. Gradually, signs of respiratory insufficiency are getting worse - shortness of breath, cyanotic nasolabial triangle, quickening of breathing, coughing and entraining of intercostal spaces.
Diagnosis of the disease
Diagnosis of the disease includes examining the sick child, collecting anamnesis, percussion and auscultation of the chest, and for confirmation of the diagnosis is X-ray examination of the lungs, sputum and mucus analysis and examination of respiratory function in child. Diagnosis of pneumonia is not particularly difficult - the characteristic clinical symptoms and X-ray examination allows you to quickly diagnose. If the diagnosis is impossible - the diagnosis is made based on the clinical picture, percussion and auscultation.
Treatment of pneumonia
To start to treat a pneumonia it is necessary at the first signs of disease. Where the treatment will be performed - in a hospital or at home, is determined by the doctor and depends on the following conditions:- age of the child - all children of the first year of life with pneumonia are subject to compulsory admission;
- severity of the child's condition;
- presence or absence of concomitant diseases.
Treatment of pneumonia in children includes: proper child care, proper nutrition and drinking regimen, taking antibiotics and inhalation with medications to cough.
Care for a sick child
After the diagnosis of the disease was carried out, the child should be assigned bed rest and organize proper nutrition. The diet for pneumonia should include a sufficient amount of fresh vegetables and fruits, lean meat, cereals and dairy products. Nutrition during illness should be easy and, at the same time, rich and rich in vitamins and nutrients.
In addition, it is very important to adhere to the drinking regime - this will avoid dehydration and improve the condition of the sick child. For children over 2 years old - the norm of the drunk liquid is 2, -25 liters per day, it is best to give the sick child the juices, fruit drinks, compotes, warm milk or still mineral water. Warm alkaline drink is a good way to soften and relieve cough and reduce body temperature.
Drug therapy
- Antibiotics - the appointment of a course of antibiotics - the gold standard for the treatment of pneumonia. For mild and moderate forms of the disease, antibiotics are given orally, in more severe forms, as injections. Most commonly used are the following antibiotics: penicillins (ampicillin, ammox, amoxiclav), cephalosporins (ceftriaxone, cefuroxine, cephalexin), macrolides (aziromycin, erythromycin). When carrying out antibiotic therapy, it is necessary to prescribe pro and prebiotics for the prevention of dysbacteriosis (linex, hilakforte, bifidum bacterin, lactobacterin). If after the start of antibiotics, within 24-48 hours there was no improvement, it is required to change the way of administration of drugs or to change the group of antibiotic. Depending on the severity of the disease, the course of treatment is from 5-7 to 10-14 days.
- To get rid of cough and restore normal airway patency appoint inhalation and taking mucolytics and expectorants. Inhalations with antiseptic solutions or bronchodilators are prescribed in the early days of the illness, such inhalations facilitate breathing, help liquefy and facilitate the excretion of phlegm. In addition, inhalations are prescribed during the recovery period - to completely free the respiratory tract from microorganisms and faster regeneration of the mucous membrane. Cough with pneumonia can still a few weeks after recovery to torment the patient and then inhalations with medications will be the best way to get rid of it.
- After the state of the sick child improves, he is given a general restorative treatment - appoint vitamins, immunostimulants, physiotherapy, therapeutic massage and respiratory gymnastics. This helps to get rid of cough and stagnant phenomena in the lungs.
Prevention of pneumonia in young children includes timely treatment of all colds and foci of infection, increasing the overall immunity of the child - intake of vitamins, nutrition with sufficient vitamins and nutrients, hardening, physiotherapy, outdoor exercise and sufficient physical activity.
ingalin.ru