Can there be a good blood test for pneumonia or inflammation?
Pneumonia is an inflammation of one or more segments of the lung tissue, in severe cases, a whole lobe of the lung can become inflamed. The disease is severe, threatening with its complications, so it is very important to make a diagnosis on time.
The diagnosis of "pneumonia" consists of a whole set of indicators. If you suspect a pneumonia, the doctor will definitely conduct an objective examination:
- Will calculate the pulse, it can be increased;
- Measures the body temperature, it also rises with inflammation;
- listen to the heartbeat, depending on the severity of the condition, the sound of heart tones can change;
- Listen to breathing to assess wheezing, their location and size, often it explains the cough;
- will determine the boundaries of normal lung tissue by percussion (tapping).
For the completeness of the clinical diagnosis, in addition to the examination, the data of laboratory and instrumental studies are needed. Without them, the diagnosis will not be justified.
In addition to general objective examination, the diagnosis will require data from laboratory and non-invasive research methods.
Lung can only provide a radiographic examination, so a snapshot of the lungs will have to be done. He will clearly see what changes have occurred in the lung tissue, where exactly the affected area is located and what size it is. Often it is on the basis of the picture that the final diagnosis is made.
The very first type of mandatory laboratory testing is a general blood test.
In the general analysis of blood there are several reliable indicators of the inflammatory process in the body:
- the level of leukocytes in the blood rises, sometimes significantly;
- changes in the leukoformula (that is, in the ratio of different types of leukocytes), the number of stabilonuclear leukocytes becomes more than 6;
- increase in the rate of erythrocyte sedimentation;
- an increase in the level of eosinophils (also a type of leukocytes), is characteristic of eosinophilic pneumonia.
Despite the obvious inflammatory process, the blood reaction will not necessarily be obvious. In some cases, if the condition is poor, the blood test is good.
In fact, the stab shift to the left, an increase in the rate of erythrocyte sedimentation, and an increase in the overall level of leukocytes are characteristic changes for the inflammatory process in the body. But there are situations when, with a clear disease, the blood remains calm. Usually it happens with weak immunity. In these cases, not only the blood does not react, but even the temperature does not practically increase, it keeps within 37-3 °.
In addition, a lingering reaction of the blood can be observed when the inflammation occurs after a severe illness, and the body is already depleted, and can not respond adequately to the inflammation. And even with pneumonia, the analysis can be good.
Also, the picture of inflammation may not appear in elderly patients. The fact is that with age, the reactive capabilities of the body are reduced, and even severe diseases occur with a blurred clinical and laboratory picture.
That is why the diagnoses are not exhibited only by one symptom or clinical indicator.
Can there be a good blood test for pneumonia ???
An error may occur. Good analysis, with pneumonia, can not be!
Changes in the general blood test for pneumonia:
- with mild pneumonia in the blood test, moderate leukocytosis and shift of the leukocyte formula to the left, increased ESR;
- with moderate severity - pronounced leukocytosis with a shift to the left to young forms, increased ESR;
- with severe course in the analysis high leukocytosis, toxic granulocyte neutrophil, sharp shift leukocyte formula to the left right up to myelocytes, decrease in the number of eosinophils, lymphocytes, very high ESR. In the blood, anemia is also possible with prolonged intoxication; an increase in the number of eosinophils more than 5% is an early and characteristic sign of allergization and allergy.
- with a favorable course of pneumonia (pneumonia) in the analysis of blood before the crisis, the number of eosinophils and monocytes increases;
- the absence of leukocytosis in blood analysis is observed in weakened and elderly patients and is a prognostically unfavorable sign.
Pneumonia is a clear inflammatory process, blood is unlikely to show a good analysis
if you have a blood test that consists of a single ESR, then there may be a normal figure for pneumonia.
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, %|
|Legionellae - a rare pathogen, affects weakened people and is the leader after streptococcus by frequency of deaths (infection in rooms with artificial ventilation - shopping centers, airports)||, %|
|Hemophilus rod - causes pneumonia in patients with chronic bronchial and lung diseases, as well as in smokers.||, %|
|Enterobacteria are rare pathogens, affecting mainly patients with renal / hepatic, cardiac insufficiency, diabetes mellitus.||, %|
|Staphylococcus is a frequent pathogen of pneumonia in the elderly population, and complications in patients after the flu.||, %|
|Other pathogens||, %|
|The causative agent is not installed||3, %|
When the diagnosis is confirmed, depending on the type of pathogen, the patient's age, the presence of concomitant diseases, a corresponding therapy, in severe cases, treatment should be performed in a hospital setting, with mild forms of inflammation, hospitalization of the patient is not is required.
Characteristic first signs of pneumonia, the vastness of the inflammatory process, acute development and danger of serious complications in untimely treatment - are the main reasons for the urgent circulation of the population for medical help. At present, a sufficiently high level of medical development, improved diagnostic methods, and a huge the list of antibacterials of a wide spectrum of action has considerably lowered a death rate from an inflammation of lungs (cm. antibiotics for bronchitis).
Typical first signs of pneumonia in adults
The main symptom of the development of pneumonia is a cough, usually it is first dry, obtrusive and persistent. protivokashlevye, expectorants with a dry cough), but in rare cases cough at the beginning of the disease can be rare and not strong. Then, as the inflammation develops, the cough becomes pneumatic with pneumonia, with a discharge of mucopurulent sputum (yellow-green color).
Any catarrhal virus disease should not last more than 7 days, and a sharp deterioration of the condition later 4-7 days after the onset of an acute respiratory viral infection or influenza indicates the onset of an inflammatory process in the lower respiratory ways.
Body temperature can be very high up to 39-40C, and can remain subfebrile 3, -3, C (with atypical pneumonia). Therefore, even with a low body temperature, coughing, weakness and other signs of malaise, you should definitely consult a doctor. Caution should be a repeated temperature jump after a light gap during the course of a viral infection.
If the patient has a very high temperature, one of the signs of inflammation in the lungs is the inefficiency of antipyretic drugs.
Pain with deep breath and cough. The lung itself does not hurt, as it is devoid of pain receptors, but involvement in the pleura process gives a pronounced pain syndrome.
In addition to cold symptoms, the patient has dyspnea and pale skin.
General weakness, increased sweating, chills, decreased appetite are also characteristic for intoxication and the onset of the inflammatory process in the lungs.
If such symptoms appear either in the midst of a cold, or a few days after the improvement, these may be the first signs of pneumonia. The patient should immediately consult a doctor to undergo a complete examination:
- To pass blood tests - general and biochemical
- To make a roentgenography of a thorax, if necessary and a computer tomography
- Sputum for culture and sensitivity of the pathogen to antibiotics
- Sputum for culture and microscopic determination of mycobacterium tuberculosis
The main first signs of pneumonia in children
Symptoms of pneumonia in children have several characteristics. Attentive parents may suspect the development of pneumonia with the following discomforts in the child:
Body temperature above 38C, lasting for more than three days, not knocked down by antipyretics, there may also be a high temperature of up to 3, especially in young children. At the same time, all signs of intoxication are manifested - weakness, increased sweating, lack of appetite. Small children (as well as elderly people), can not give high temperature fluctuations with pneumonia. This is due to imperfect thermoregulation and immaturity of the immune system.
There is frequent shortness of breath: in children up to 2 months of age, 60 breaths per minute, up to 1 year, 50 breaths, after a year, 40 breaths per minute. Often the child spontaneously tries to lie down on one side. Parents may notice another sign of pneumonia in the child, if you undress the baby, then when breathing from the patient lung can be noticed the retraction of the skin in between the ribs and the lag in the process of breathing one side of the chest. There may be irregular breathing rhythm, with periodic stops of breathing, changes in the depth and frequency of breathing. In infants, shortness of breath is characterized by the fact that the child begins to nod his head in time with the breath, the baby can stretch his lips and inflate his cheeks, foamy discharge from the nose and mouth can appear.
- Atypical pneumonia
Inflammation of the lungs caused by mycoplasma and chlamydia differ in that first the disease passes like a cold, there is a dry cough, runny nose, swelling in the throat, but the presence of dyspnea and a stably high temperature should alert parents to the development pneumonia.
- Character of cough
Because of the perspiration in the throat, only coughing can appear first, then the cough becomes dry and painful, which is amplified by crying, feeding the baby. Later, the cough becomes wet.
- Behavior of the child
Children with pneumonia become capricious, whiny, sluggish, they are disturbed by sleep, sometimes can completely refuse to eat, and also to appear diarrhea and vomiting, in babies - regurgitation and rejection of breasts.
- Blood test
In the general analysis of blood, changes are detected that indicate an acute inflammatory process - increased ESR, leukocytosis, neutrophilia. Shift of the leukoformula to the left with increasing stab and segmented leukocytes. In viral pneumonia, along with high ESR, there is an increase in leukocytes due to lymphocytes.
With timely access to a doctor, adequate therapy and proper care for a sick child or adult, pneumonia does not lead to serious complications. Therefore, at the slightest suspicion of pneumonia, the patient should be given medical care as soon as possible.
Symptoms of pneumonia in children
Pneumonia in a child is an acute infectious disease that occurs with inflammation of the respiratory parts of the lungs. The disease is accompanied by the accumulation of inflammatory fluid in the pulmonary vesicles-alveoli. Symptoms of pneumonia in children are similar to those in adults, but are supplemented by severe fever and intoxication.
The term "acute pneumonia in children" is out of use in medicine, because the very definition of the disease includes a characterization of an acute process. The International Council of Scientists-Experts decided to divide pneumonia into groups according to other signs that determine the outcome of the disease.
How dangerous is pneumonia?
Despite the progress in medicine, the incidence of lung inflammation in children remains high. Pneumonia is a life-threatening, life-threatening condition. Infant mortality from pneumonia remains high enough. In the Russian Federation, within a year, it dies from pneumonia & g; about 1000 children. Basically, this terrible number unites infants who died from pneumonia in the age of 1 year.
The main causes of the fatal outcome of pneumonia in children:
- Later, parents applied for medical help.
- Later, the diagnosis and delay of the correct treatment.
- Presence of concomitant chronic diseases that worsen the prognosis.
In order to timely establish an accurate diagnosis and take measures to treat a dangerous disease, you need to know its external signs - symptoms.
The main symptoms of pneumonia in children:
- Fever - increase in body temperature to high figures (8 8 ° C).
- Dyspnoea - increased frequency of respiration more than 40 per minute (in children 1-6 years).
- Cough dry or with phlegm.
- Appearance of cyanotic coloring of the skin of the lips, nasolabial area, fingertips.
- Changes in respiratory noise in the lungs during listening (wheezing, hard breathing).
- Intoxication, expressed general weakness, refusal to eat.
The increase in body temperature in a child is the first symptom of many diseases, for example, a common viral infection (ARI). In order to recognize pneumonia, we must remember: an important role is played not by the height of the fever, but by its duration. For microbial inflammation of the lungs it is characteristic continuation of fever for more than 3 days against the background of competent treatment of viral & g; infection.
If we evaluate the significance of the symptoms for the diagnosis of pneumonia in children, the most terrible sign will be the appearance of dyspnea. Shortness of breath and tension of additional muscles are more important signs than having wheezing when listening to the chest.
Cough is a symptom of pneumonia in children. In the early days of the disease, cough can be dry. With the resolution of acute inflammation of the lung tissue, the cough will become productive, moist.
If a child with a respiratory viral infection (ARI) has similar symptoms, an urgent call for a doctor is necessary. Underestimation of the severity of the baby's condition can lead to sad consequences - the development of acute respiratory failure and death from pneumonia.
The doctor will examine the small patient, prescribe an examination and an effective treatment. Listening to the lungs in the early days of the disease may not reveal characteristic signs of inflammation. The presence of disseminated wheezing when listening is often a symptom of bronchitis. To clarify the diagnosis for suspected pneumonia, an X-ray of the lungs is necessary. X-ray symptoms of pneumonia are darkening (infiltration) of pulmonary fields, which confirms the diagnosis.
Laboratory Symptoms of Pneumonia
Valuable information about the fact of inflammation in the body carries a general blood test. Signs that increase the presence of pneumonia: a high content of white blood cells in 1 cu. mm blood (more than 15 thousand) and an increase in ESR. ESR is the sedimentation rate of red blood cells. This analysis reflects the amount of inflammatory metabolic products in the liquid part of the blood. The magnitude of ESR shows the intensity of any inflammation processes, including inflammation of the lungs.
How to determine the risk of a child with pneumonia?
The following factors are identified that increase the risk of lung inflammation in children:
- Delayed physical and mental development of the child.
- Low weight of a newborn baby.
- Artificial feeding of a baby under the age of 1 year.
- Refusal of vaccination against measles.
- Pollution of air (passive smoking).
- Overcrowded dwelling, where the baby lives.
- Smoking of parents, including mother's smoking during pregnancy.
- Lack of microelement of zinc in the diet.
- Mother's inability to care for an infant.
- Presence of concomitant diseases (bronchial asthma, heart disease or digestive system).
What forms can the disease have?Pneumonia in children is different for reasons and mechanism of occurrence. The disease can affect the entire lobe of the lung - this is a shared pneumonia. If the inflammation occupies a part of the lobe (segment) or several segments, it is called segmental (polysegmental) pneumonia. If the inflammation is covered by a small group of pulmonary vesicles, this variant of the disease will be called "focal pneumonia".
In inflammation, passed to the respiratory tissue of the bronchi, the disease is sometimes called bronchopneumonia. The process, caused by viruses or intracellular parasites such as chlamydia, is manifested by swelling (infiltration) of the perivascular tissue of the lungs from both sides. This type of disease was called "bilateral interstitial pneumonia." These symptoms of difference can be determined by medical examination and X-ray examination of sick children.
Inflammation of the lungs in children doctors are divided according to the conditions of origin for domestic (out-of-hospital) and hospital (hospital). Separate forms are intrauterine pneumonia in newborns and pneumonia with a pronounced lack of immunity. Community-acquired (home) pneumonia is called inflammation of the lungs, which has arisen in ordinary home conditions. Hospital (nosocomial) pneumonia is a case of illness that occurs after 2 or more days of the child's stay in the hospital for another reason (or within 2 days after discharge from there).
Mechanism of the development of pneumonia
The entry of a microbial pathogens into the respiratory tract can occur in several ways: inhalation, swallowing of nasopharyngeal mucus, dissemination through the blood. This way of introducing a pathogenic microbe depends on its kind.
The most frequent causative agent of the disease is pneumococcus. The microbe enters the lower parts of the lungs by inhaling or swelling of mucus from the nasopharynx. Intracellular parasites, such as mycoplasma, chlamydia and legionella, enter the lungs by inhalation. The spread of infection through the blood is most typical for infection with Staphylococcus aureus.
The type of causative agent that causes pneumonia in children depends on several factors: the age of the child, the place of origin of the disease, and also from the previous treatment with antibiotics. If within 2 months before the present episode the baby has already taken antibiotics, then the causative agent of the current inflammation of the respiratory tract can be atypical. In 30-50% of cases, community-acquired pneumonia in children can be caused by several types of microbes at the same time.
General rules for the treatment of pneumonia in childrenTreatment of the disease the doctor begins with the immediate appointment of antimicrobials to any patient with suspected inflammation of the lungs. The place of treatment is determined by the severity of the manifestation of symptoms.
Sometimes with a mild course of the disease in children of older age groups, treatment at home is possible. The decision on the place of treatment is made by the doctor, according to the patient's condition.
Indications for treatment in a hospital of children with pneumonia are: severity of symptoms and a high risk of an unfavorable outcome of the disease:
- The age of the child is less than 2 months, regardless of the severity of the symptoms.
- The age of the baby is younger than 3 years with lobar pneumonia.
- Inflammation of several lobes in a child of any age.
- Severe concomitant diseases of the nervous system.
- Pneumonia of newborns (intrauterine infection).
- The small weight of the baby, the delay of its development in comparison with peers.
- Congenital malformations of organs.
- Chronic concomitant diseases (bronchial asthma, heart disease, lung, kidney, cancer).
- Patients with decreased immunity from various causes.
- Impossibility of careful care and accurate performance of all medical appointments at home.
Indications for the urgent placement of a child with pneumonia, in the department of children's intensive care:
- Increasing the number of breaths & g; 0 in 1 min for infants under the age of one year, and for children older than the year, shortness of breath & g; 0 in 1 min.
- The retraction of the intercostal spaces and the jugular fossa (fossa at the beginning of the sternum) with respiratory movements.
- Moaning breathing and violation of the right rhythm of breathing.
- Fever that does not respond to treatment.
- Violation of the child's consciousness, the appearance of convulsions or hallucinations.
In uncomplicated course of the disease, body temperature decreases within the first 3 days after initiation of treatment with antibiotics. External symptoms of the disease gradually decrease in intensity. X-ray signs of recovery can be seen in the pictures of the lungs no earlier than 21 days after the start of antibiotic treatment.
In addition to antimicrobial treatment, the patient must comply with bed rest, plenty of drinking. Expectorants are prescribed if necessary.
Prevention of pneumonia
Protection from respiratory viral infection plays an important role in preventing the incidence of pneumonia.
It is possible to carry out vaccination against the main pathogens of pneumonia in children: a hemophilic rod and pneumococcus. At present, safe and effective vaccine-tablets are developed against microbes that cause pneumonia and bronchitis. Preparations from this class "Bronchovax" and "Ribomunil" have a children's dosage. They are appointed by the doctor to prevent such a dangerous disease as pneumonia.