Pneumonia symptoms in adults

Pneumonia in adults

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

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

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

Epidemiology

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

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

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

Causes of pneumonia

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

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

See also: Inflammation of the lungs

The protective factors of the upper respiratory tract include IgA saliva, proteolytic enzymes and lysozyme, and growth inhibitors produced by normal flora and fibronectin that 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 of IgA and IgG, anti-inflammatory effects of surfactant, phagocytosis by alveolar macrophages and T-cell immune reactions. 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), normal flora changes, its virulence increases (for example, when exposed to antibiotics), or protective mechanisms are broken (for example, when smoking cigarettes, nasogastric or endotracheal intubation). Disease-causing organisms, which in these cases reach the alveolar spaces inhalation, due to contact or hematogenous spreading or aspiration, can multiply and cause inflammation of the pulmonary 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 health facility), hospital (including postoperative and associated with artificial ventilation of the lungs), acquired in nursing homes, and in immunocompromised individuals; this allows you to assign 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 patient's age and other factors, but the relative importance of each as a cause of the out-of-hospital inflammation of the 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.

Ku fever, tularemia, anthrax and plague are rare bacterial infections in which there may be severe pneumonia; the last three infectious diseases should raise 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 pulmonary embolism, which is more is likely in patients with minimal sputum production, absence of concomitant ARVI or systemic symptoms and risk factors thromboembolism.

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

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

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

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

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

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

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

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

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

What it is necessary to survey?

Lungs

How to inspect?

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

What tests are needed?

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

Who to contact?

Pulmonologist

Treatment of pneumonia

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

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

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

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

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

In addition to treatment

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

Prevention

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

Forecast

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

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

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

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

ilive.com.ua

Symptoms and signs of pneumonia in adults

Is pneumonia dangerous for adults?

Pneumonia is an acute infectious disease that occurs with inflammation of the lung tissue. Inflammation of the lungs remains one of the leading causes of death from respiratory diseases, despite a giant leap in the development of medicine. Symptoms of pneumonia in adults, children and the elderly, as before, make doctors worry about the fate of patients.

In 2006, 591493 cases of pneumonia were detected in Russia, which amounted to 4 ‰ among adults & 8 years. But these figures from official reports do not fully reflect the true picture. The calculations of scientists show that the real incidence of pneumonia in Russia reaches 15 ‰. The absolute number of cases of pneumonia is 1500000 people every year. According to statistics in 2006, pneumonia and its complications claimed the lives of 3, 70 Russian adults.

If elderly patients & g; 0 years there is a chronic concomitant pathology (chronic obstructive pulmonary disease, cancer; alcoholism; diseases of the liver, kidneys, heart and blood vessels; diabetes), then with severe pneumonia, mortality increases to 30%. The highest mortality from pneumonia in Russia is registered in adult men of working age. Typical for Russians, the risk factor for the fatal outcome of pneumonia is later seeking medical help.

Signs that increase the risk of death from pneumonia in adults:

• Male.
• Severe hypothermia before the disease.
• Dyspnea with respiratory rate & g; 8 in 1 min.
• Violation of the mental state of the patient.
• Concomitant diseases - chronic heart failure, decreased immunity, diabetes, atherosclerosis of the heart vessels, oncological processes, chronic renal failure.
• Low blood pressure
• Low body temperature

If patients who died of pneumonia knew the first signs of a dangerous illness and turned to the doctor on time, their lives could be saved.

The first signs and symptoms, indicating an inflammation of the lungs:

• Suddenness of onset of the disease;
• fever (a sharp increase in body temperature & 8 ° C);
• chills (muscle trembling);
• chest pain when coughing and deep breathing;
• dry or unproductive cough with sputum rusty;
• shortness of breath - a feeling of lack of air;
• general weakness and fatigue;
• heavy sweats at night and at the slightest load.

These signs in a person who has fallen ill with a "cold" should alert his relatives, as he is quite likely to diagnose pneumonia. If you suspect an inflammation of the lungs, consult a doctor.

Objective signs of the disease

The doctor, examining the patient, reveals the objective symptoms of pneumonia:

• Dullness of sound when tapping over the affected places of the lungs;
• hard breathing over the inflamed part of the lung tissue;
• listening to wheezing over the site of inflammation.

The main rule that confirms pneumonia is the asymmetry of objective findings, that is, the presence of pneumonia symptoms in only one lung. After the examination, the doctor will prescribe an X-ray of the chest.

X-ray symptoms of pneumonia

The main radiographic evidence of pneumonia is local dimming of the lung in a patient who has symptoms of inflammation of the lower respiratory tract.

X-rays for suspected pneumonia are performed by all patients: children and adults. This mandatory rule is associated with the risk of complications of pneumonia with a delay in the appointment of antibiotics. The consequences of procrastination can be fatal.

Treatment of inflammation of the lungs

The main component of treatment, determining the prognosis, is the correct choice of antimicrobial agent - antibiotic. Treatment of mild cases of inflammation of the lungs in adults can be carried out at home. In addition to antimicrobial drugs, the patient needs a bed rest for the time of fever, abundant warm drink and adequate nutrition. If the patient coughs up phlegm, then cough can be alleviated with the help of expectorants and compresses on the chest.

Diet for a patient with pneumonia is in frequent fractional nutrition, the food should be easily assimilated and fully-fledged in composition.

In case of a serious condition, the patient is treated in a hospital (hospital).

After recovering from pneumonia, the patient is observed at the clinic therapist for 1 year.

Prevention of disease

To prevent the disease will help vaccinate against pneumococcus - the main culprit of the disease. If the vaccine is contraindicated to a patient at risk, you can use drugs such as "vaccine-tablets." Such drugs contain surface proteins of microbial pathogens that enhance immunity. The action of such immunomodulators is regarded as "grafting only without injection. For a competent choice of treatment and prevention of pneumonia, a doctor's consultation is necessary.

ingalin.ru

Causes and symptoms of SARS in adults

What is atypical pneumonia, the symptoms in adults that manifest themselves during the illness - all this is necessary to know in order to begin treatment of the disease.Atypical pneumonia is a very complex disease, which is often confused with the common form of pneumonia.Correctly diagnose this ailment is possible only for the first reasons and certain symptoms.

With the help of immunological, microbiological and X-ray studies, this disease can be clearly and correctly diagnosed.

Antiviral and antimicrobial agents are prescribed only after a complete examination and depending on the severity of the disease.

The main problem with which specialists are facing these days is the lack of medicines against several pathogens of atypical pneumonia.

There are a number of quite dangerous microorganisms, which are the main cause of the development of this disease. They are able to multiply and conduct life activity within human cells.

The main difference between such microorganisms and other bacteria is that they do not accept other habitats. In people at risk of getting sick with this disease are people up to the age of forty, most often such a disease occurs in children.

Atypical pneumonia can be conditionally divided into two stages. The first resembles an ordinary cold, and the second is manifested in the same way as pneumonia, so it is very simple to confuse.

The main causes of the disease

As already mentioned above, there are quite a few pathogens of SARS. The main among them are:

1. Mycoplasma. This virus is most common. In 10-20% of cases, it manifests itself as simple inflammation of the lungs. Where there is usually a large population of people, this parasite can infect up to 50% of those present.
2. Chlamydia. This parasite contributes to the development of SARS. Among them, quite often there is pneumonia and bronchitis. This virus can stay in the human body for a long time without any symptoms appearing.
3. Salmonella.
4. The Legionnaires. This pathogen is very difficult to diagnose and can infect 10% of the population. The habitat of this parasitic organism is natural and artificial reservoirs. Moreover, they can live in air conditioners and other household devices.
5. Koksiella. This parasite can cause a fever, accompanied by atypical pneumonia and other fairly serious illnesses.
6. A variety of viruses.

This disease is transient, it can be infected by communicating with a person who is already a carrier of this disease. In other words, atypical pneumonia is transmitted by airborne droplets. In addition, you can get infected by using the objects of a sick person.

Atypical pneumonia is of two types: mycoplasmal and chlamydial. The first one infects 2-3% of adults. A greater risk of disease in children and adolescents, it ranges from 10 to 20%.

How is SARS going in adults?

This disease adults are much heavier than children. The main difficulties arise during the diagnosis of the disease, due to the fact that the symptoms of this disease often resemble signs of inflammatory processes of the respiratory organs. As a result, adults begin to engage in self-treatment, and the specialists are already treated at a late stage of the disease, that is, at the moment when pneumonia spread to the second lung.

The forms of the course of atypical pneumonia. The first case is quite critical. The disease manifests itself very rapidly, rapidly and acutely. The human body temperature can reach very high marks. Often, nausea starts, sometimes irritation of the central nervous system may occur. After 3-4 days, there may appear a perspiration in the throat, and cough becomes frequent and irritable.

An x-ray photograph can only indicate that an inflammatory process is occurring in the human body. At this point, the lung tissue begins to become covered with a fine mesh.

In the second case, even at the initial stage of the disease, acute catarrhal symptoms appear. The mucous throat becomes inflamed, which causes severe pain.

In the third case, that is, in the acute form of the disease, a cardiovascular insufficiency appears in a person. Initially, the person, who was struck by this disease, experiences shortness of breath, and after a certain period of time his breathing rhythm is lost.

Symptoms of SARS

If a person has atypical pneumonia, the symptoms manifested in this case may be different. Often, all the symptoms of this ailment are smoothened. The clinical picture emerges and is characterized by the following symptoms: headaches, noticeable weakness, perspiration and sore throat. The disease is very unpredictable. Sometimes it can pass without any symptoms, and some patients may have sufficiently severe signs and forms of complications that threaten not only health, but also life rights.

The incubation period has a duration of 3 to 10 days, and it is during this period that the symptomatology is practically not manifested. Only after this time there are real signs of the disease. At carrying out of the laboratory analysis weak leucocytosis is revealed.

Significantly decreases the amount of sputum. At the initial stage of the disease there is a minor inflammation process. But at the moment of progression of atypical pneumonia the share variant of pathology develops.

The signs of the disease directly depend on a particular pathogen. For example, mycoplasmas cause a sufficiently high temperature, there is a chill, shortness of breath, a runny nose and severe swelling in the throat.

Chlamydia is also manifested by a strong cough, fever. All the common symptoms of the disease in the course of the development of the disease are supplemented by rapid heartbeats, pains in the lungs.

In order to prevent atypical pneumonia, carefully observe the rules of personal hygiene. This disease is transmitted not only by airborne droplets, but also through contaminated household items.

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Prepare your immunity in order to fight diseases of the respiratory system. Do not risk your health!

respiratoria.ru

Lung inflammation in adults treatment and symptoms | How to cure pneumonia in adults

The cause of this disease is pathogenic microorganisms, whose activities is catalyzed by an incorrect way of life, bad habits, and disregard for own health. Inflammation of the lungs is a serious disease of the respiratory system, triggered by the development of lung pathogens.

Symptoms of developing pneumonia in adults

As a rule, the disease quickly gives in to the pressure of antibiotics. However, that the disease does not leave after itself consequences, it is necessary, as soon as possible to diagnose it and begin therapy. Significant role in this process is played by the patient himself, who should consult a doctor at the first symptoms of pneumonia. And for this he must know them well.

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The first symptoms of the disease in adults are significantly different from the signs of the disease in children. Such signs are considered to be a slight increase in temperature, wet cough, chest pain, shortness of breath, weakness, significant sweating.

The disease begins acutely. The disease is characterized by symptoms such as

1. The raised temperature of a body - 3, -39 degrees, badly reacting to antipyretics. It is worth noting that with slow inflammation of the lungs, there may be a different clinical picture - a low temperature of -3, -3, against the background of general weakness.

2. A prolonged dry cough, wheezing when breathing.

3. Pain under the breastbone, which is intensified with deep inspiration, coughing or inclinations.

4. Shortness of breath, sensation of lack of air

5. Intoxication of the body - nausea, vomiting, stool. The patient, as a rule, refuses food, feels dizzy and weak.

6. With severe forms of pneumonia, a lung infarction can lead to hemoptysis.

It should be noted that these signs correspond not only to pneumonia, but also tuberculosis and other serious diseases. Therefore, I would like to emphasize once again that the inflammation of the lungs, whose symptoms and treatment are controversial, can only be diagnosed by a doctor.

Types of inflammatory phenomena in the lungs in adults and their signs

Consider the classification of pneumonia:

1. croupous;

2. focal;

3. interstitial.

Focal inflammation of the lungs is an inflammatory process that seizes certain areas of the lung tissue - the alveoli. Croupous pneumonia is characterized by the instantaneous involvement of the lung and adjacent pleura with high fibrin content in the exudate into the inflammatory process. Interstitial pneumonia is a lesion of interstitial lung tissue.

Also introduced additional characteristics of the disease, which allow to optimize etiotropic treatment of pneumonia: immunodeficiency, aspiration, community-acquired, nosocomial (nosomial).

Diagnosis of pulmonary inflammation in adults

If suspected inflammation should immediately contact a specialist. Diagnosis of the disease includes:

1. Inspection, in which the affected area of ​​the lung is revealed: shortening of percussion sound, amplification voice jitter, changes in breathing (hard breathing, dry or wet raznochalernye rattles, crepitus).

2. Laboratory diagnostics, revealing inflammatory changes in blood tests.

3. Radiography of the lungs in a straight line and (if necessary) in the lateral projections, which reveals a focus of inflammation in the lung tissue.

To establish the correct diagnosis, it is necessary to collect all laboratory tests. If the above signs you have appeared in the cold period of the year, when the catarrhal diseases are at their height, then you can be sure that these are the first signs of pneumonia. Often the disease manifests itself as a sharp deterioration in the state of health in the most common cold or ARVI. This is most often observed 5-7 days after the onset of a cold.

When the diagnosis is made, they indicate the localization of the inflammatory process (segment, proportion), etiology (staphylococcal, streptococcal, pneumococcal), complication (respiratory failure, pleurisy, infectious-toxic shock, pericarditis). In terms of severity, pneumonia is divided into mild and severe forms.

Complications of pneumonia

The most frequent complications of the disease are:

1. Chronical bronchitis

2. Bronchial asthma

3. Pleurisy, lung infarction

4. Tuberculosis

5. Fibrosis and atrophy of lung tissue

6. Dysbacteriosis, hepatitis.

Pneumonia in patients can clinically proceed in different ways. Features of the course of the disease depend on the initial state of the organism, the characteristics of the immune system, the presence or absence of concomitant pathology and etiology of the disease itself.

In adult patients with immune system defects, suffering from alcoholism or drug addiction, with severe concomitant diseases there may be a prolonged course of pneumonia as a result of the addition of a "new" pathogenic microflora to an already existing outbreak pneumonia.

How can traditional pneumonia cure pneumonia in adults?

Treatment of the disease is stationary. Antibiotics, as well as mucolytics and other symptomatic agents are indicated.

The main goal of the therapy for pneumonia is to destroy the infection and stop the inflammatory process. With this, antibiotics, which are prescribed, both in the form of tablets, and in the form of injections, cope well. In parallel with antibiotics prescribed symptomatic drugs that lower the temperature, ease cough, remove intoxication.

In the treatment of pneumonia in adults, physiotherapy, warming and massages are also used. The therapeutic effect of these procedures is based on the inflow of blood to the affected area, its increased nutrition and warming. Special massage techniques in addition to the above, have an expectorant effect and contribute to a more intensive output of phlegm from the respiratory tract.

At the end of the treatment, experts recommend getting a consultation with the gastroenterologist, since a prolonged intake of antibiotics is detrimental to the intestinal microflora and digestion.

Most often, the treatment of this disease requires hospitalization and constant medical supervision. This is especially true for such severe and neglected forms as cerebellar and focal pneumonia, which are treated in intensive care units. All without exception, patients are prescribed a restriction of physical activity, and in severe forms of the disease - strict bed rest.

For the treatment of inflammation, modern antiviral, antimicrobial and anti-inflammatory drugs are used. In parallel with the main treatment, symptomatic remedies are used that lower the temperature, relieve coughing attacks, improve the tone and improve the overall well-being of the person.

Treatment with antibiotics for pneumonia

Reception of antibiotics very quickly (within two to three days) affects the patient's condition - cough disappears, weakness passes and an appetite appears. At this stage, patients make a common mistake. Feeling relieved, they feel completely healthy and prematurely stop taking medications, and whose lung inflammation treatment has not yet been completed, comes back again. Often the disease comes in a more serious and aggressive form and no longer takes the chosen course of treatment.

For treatment previously often used Ampicillin in combination with Clavuanic acid - Augmentin, which protects the antibiotic against the enzymatic degradation of beta-lactamase. Practice is evidence of the resistance to these antibiotics. The first place in the treatment of pneumonia is occupied by macrolides of new generations (sumamed, rulit). In the severe course of the disease, hospitalization is necessary, and cephalosporins, preferably of the third generation, or ampiox with shintomycin are prescribed for treatment. The effectiveness of treatment is checked after two days. Of clinical signs, regression of intoxasic manifestations is of great importance, the disappearance infiltration, sputum discharge in control radiographic examinations, which are installed laboratory way.

Treatment of the disease in adults, and especially hospital pneumonia, the main pathogens of the disease anaerobes and gramotropic microorganisms, and therefore attention is paid to aminoglycosides for treatment disease. Aminoglycosides include: ciprofloxacin, ofloxacin (quinolones), although to date they are resistant to it. High efficiency quinolones of the latest generation - Sparfloxacin.

Despite the fact that modern medicines are ultra-strong antibiotics, treatment is difficult. The thing is that many young people rarely go to the doctor, trying not to miss work and on the possibility of "walking" the disease on their feet, removing unpleasant symptoms. This leads to the fact that the disease is diagnosed in a very neglected stage, which, unfortunately, is not always successfully cured.

Therapy of atypical forms of inflammation in the lungs

Atypical pneumonia is treated mainly with drugs of the tetracycline group. Apply the active macrolides of the latest generations - Spiramycin, Sumamed, Roelit, Rovamycin. The reserve antibiotic for the treatment of atypical inflammations is Linkomycin. In patients with weakened immunity, the choice of antibiotic depends on the causative agent of the disease.

• In pneumocystis pneumonia, sulfonamides are prescribed,
• in patients with neuropathy, aminoglycosides and Augmentin are prescribed.
• For fungal pneumonia use Nitrosalum, Amphotoricin.

Clinic and treatment of inflammation depends on

• severity of the course of the disease,
• lesions of lung tissue,
• virulence of the pathogen,
• associated diseases,
• the instability of the macroorganism,
• age of the patient.

Why does pneumonia develop in adults?

Pneumonia is the most common disease. It occurs so often, because the respiratory system and lungs are very vulnerable to infectious diseases. Infection by airborne droplets is diagnosed most often. Infectious process for colds is not localized in the upper respiratory tract, but spreads downward, causing a complication - pneumonia. Provoking conditions for the disease are weakened immunity, high activity of microbes, polluted air. It often happens that the inflammatory process ends with inflammation of the mucosa - bronchitis, and in other cases, inflammation of the lung tissue - pneumonia.

The disease is most often caused by a hemophilic rod or pneumococcus, in more rare cases - klebsiella or escherichia. Of the atypical forms of pneumonia for adults, legionellosis is a common inflammation of the lungs. Mycoplasmal, chlamydial, viral and other atypical forms are extremely rare. In persons who have certain risk factors (episodes of impaired consciousness, seizures, gastroesophageal reflux disease, alcoholism, drug addiction and others) there is a risk of developing aspiration inflammation lungs.

Risk factors for pneumonia in adults:

1. chronic lung diseases;

2. smoking, chronic bronchitis;

3. endocrine pathology;

4. heart failure;

5. surgical interventions on the organs of the chest or abdominal cavity;

6. immunodeficiency states;

7. long-term presence in a horizontal position (for example, bed rest with various diseases, after surgical interventions);

8. bad habits (alcoholism, drug addiction).

How does infection with inflammation occur in adults?

Infection with pneumonia can occur in several ways:

1. Airborne droplets. This is the most common way to get the infection into the body. When talking, shaking hands, using one utensil or hygiene items with an infected person, the virus enters the nasopharynx of an adult and begins to develop there.

2. With blood flow (hematogenous method). As a rule, this way develops secondary inflammation of the lungs, as a result of the inflammatory process in the body - hepatitis or sepsis.

3. Endogenous mechanism. With this method, inflammation arises from the activity of pathogens that enter the body earlier. Typically, the endogenous mechanism begins to work during the weakening of the immune system, when its protective functions are reduced.

The cause of the disease is the defeat of pathogenic pathogens respiratory areas of the lungs, the spectrum of pathogens depends primarily on the type of pneumonia.

Frequent pathogens of community-acquired pneumonia are: mycoplasma, streptococci, chlamydia, legionella, staphylococci. The causative agents of nosocomial pneumonia are anaerobes, staphylococcus, streptococcus, various viruses.

With aspiration pneumonia, pathogens are anaerobes, which are often found when aspirating vomit masses and in the masses of virulent microcloflora. If the cough reflex is disturbed, the risk of the disease increases.

AstroMeridian.ru

To date, community-acquired pneumonia remains a widespread and potentially life-threatening disease.

The disease is common not only among adults, but also among children. For 1000 healthy persons, there are 3 to 15 cases of pneumonia. Such a spread of figures is due to the different prevalence of the disease in the regions of the Russian Federation. 90% of deaths after 64 years are due to community-acquired pneumonia.

If a patient finds pneumonia in 50% of cases, doctors will decide to hospitalize him, because the risk of complications and deaths from this disease is too great.

So, what is community acquired pneumonia?

Community-acquired pneumonia is defined as an acute infectious process in the lungs that occurs outside a medical institution or within 48 hours from the moment of hospitalization, or developed in people who were not in the departments of long-term medical observation for 14 days and more. The disease is accompanied by symptoms of infection in the lower respiratory tract (fever, cough, shortness of breath, sputum, chest pain. Radiologically it is characterized by "fresh" foci of changes in the lungs, provided that other possible diagnoses are excluded.

Symptoms

To diagnose pneumonia is difficult, because there is no specific symptom or combination of symptoms specific to this disease. Community-acquired pneumonia is put on a set of nonspecific symptoms and objective examination.

Symptoms of community-acquired pneumonia:

• fever;
• cough with or without phlegm;
• difficulty breathing;
• pain in the chest;
• headache;
• general weakness, malaise;
• hemoptysis;
• severe sweating at night.

Less common:

• pain in muscles and joints;
• nausea, vomiting;
• diarrhea;
• loss of consciousness.

In elderly people, symptoms from the bronchopulmonary system are not expressed, in the first place common signs appear: drowsiness, sleep disturbance, confusion, exacerbation of chronic diseases.

At children of early age at presence of a pneumonia there are following signs:

• temperature increase;
• cyanosis;
• dyspnea;
• general signs of intoxication (lethargy, tearfulness, violation of sleep, appetite, rejection of the breast);
• cough (may not be).

In older children, the symptoms are similar to those in adults: malaise, weakness, fever, chills, cough, chest pain, abdominal pain, increased respiratory rate. If the child is older than 6 months, there is no fever, then according to the latest clinical recommendations, community-acquired pneumonia can be excluded.

Absence of a fever in children under 6 months with pneumonia is possible if the causative agent is C.trachomatis.

Treatment in adults and children

The main method of treatment is antibacterial therapy. At the first stages of outpatient and inpatient treatment, it is carried out empirically, that is, the doctor prescribes the drug, based only on his assumptions about the causative agent of the disease. This takes into account the age of the patient, the concomitant pathology, the severity of the disease, the patient's independent use of antibiotics.

Treatment of community-acquired pneumonia of mild degree is carried out by tablet preparations.

In the treatment of pulmonary pneumonia with a typical course in an outpatient setting, in persons up to 60 years old without concomitant diseases, therapy can begin with amoxicillin and macrolides (azithromycin, clarithromycin).If there is an allergy to penicillin or an abnormal course of pneumonia is observed or there is no effect from penicillins, then macrolide antibiotics should be preferred.

Patients older than 60 years with the presence of concomitant diseases are treated with protected penicillins (amoxicillin / clavulanate, amoxicillin / sulbactam). Alternatively, antibiotics from the respiratory fluoroquinolones group (levofloxacuin, moxifloxacin, hemifloxacin) are used.

Severe community-acquired pneumonia requires the appointment of several antibiotics. Moreover, at least 1 of them should be administered parenterally. Treatment begins with cephalosporins of the third generation in combination with macrolides. Sometimes prescribed amoxicillin / clavulanate. Alternatively, respiratory fluoroquinolones are used in combination with third-generation cephalosporins.

Every patient with pneumonia is required to make bacteriological examination of sputum. Based on its results, select an antibiotic that is sensitive to the detected pathogen.

If suspected of pneumonia caused by legionella, rifampicin must be added parenterally.

If pneumonia is caused by Pseudomonas aeruginosa, combinations of cefipime or ceftazidime or carbopenems with ciprofloxacin or aminoglycosides are used.

In pneumonia caused by Mycoplasma pneumoniae, it is best to prescribe macrolides, or respiratory fluoroquinolones or doxycycline.

With Chlamydia pneumoniae, the disease is also treated with fluoroquinolones, macrolides and doxycycline.

Principles of antibacterial therapy in children differ in groups of antibiotics. Many drugs are contraindicated.

The selection of an antibiotic is also carried out presumably until the microorganism that caused the disease has been determined.

For mild and moderate pneumonia, children from 3 months to 5 years of age are prescribed protected penicillins (amoxicillin / clavulanate, amoxicillin / sulbactam, ampicillin / sulbactam) inside. In severe current in the same age category - they are the same, but parenterally for 2-3 days with the subsequent transition to tablet form. Antibiotics with the prefix "Solutab" are more effective.

If you suspect a hemophilic infection, amoxicillin / clavulanate is selected with a high content of amoxicillin (1: 3 months. up to 12 years and 1: from 12 years).

In children older than 5 years, in the absence of the effect of amoxiclav therapy, macrolides (josamycin, midecamycin, spiramycin) can be added to the treatment.

The use of fluoroquinolones in children is contraindicated up to 18 years.The possibility of their application should be approved only by a consultation of doctors in a life-threatening situation.

What other antibiotics can I use in children under 3 months? If pneumonia is caused by enterobacteria, aminoglycosides are added to the protected penicillins. In addition to amoxicillin in children of this age, ampicillin and benzylpenicillin can be used parenterally. In severe cases, in the presence of resistant bacteria, carbapenems, doxycycline, cefotaxime or ceftriaxone can be used.

Rules of antibacterial therapy

• the earlier antibiotic treatment is initiated, the better the patient's prognosis;
• The duration of antibiotics in adults and children should not be less than 5 days;
• with mild pneumonia and a prolonged normalization of temperature, treatment can be stopped ahead of schedule on day 3-4;
• the average duration of antibiotic treatment is 7-10 days;
• if pneumonia caused chlamydia or mycoplasma, the treatment is prolonged to 14 days;
• intramuscular injection of antibiotics is not advisable, because their availability is less than with iv introduction;
• evaluation of the effectiveness of treatment can be carried out only after 48-72 hours;
• efficiency criteria: decrease in temperature, decrease in intoxication;
• X-ray picture is not a criterion by which the duration of treatment is determined.

Among the child population, community-acquired pneumonia can be caused not by a bacterium, but by a virus. In such cases, the use of antibiotics will not produce any result, but only worsen the prognosis. If pneumonia developed 1-2 days after the initial manifestations of a viral disease (especially influenza), then treatment can be initiated with antiviral drugs: oseltamivir, zanamivir, umifenovir, inosine pranobex, rimantadine.

In severe cases, in addition to fighting the pathogen, infusion therapy is carried out to eliminate intoxication, high temperature, oxygen therapy, vitamin therapy, mucolytics.

The most common mucolytic among adults and children is ambroxol. It not only dilutes sputum and facilitates its excretion, but also promotes better penetration of antibiotics into the lung tissue. It is best to use it through a nebulizer. Children can also use bromhexine from birth. From the age of 2, ACC is allowed, and from the age of 1, Flumucil. Carbocysteine ​​is allowed for children from 1 month.

Forecast

The outlook for community-acquired pneumonia is mostly good. But severe pneumonia can end up lethal in 30-50% of cases. The forecast deteriorates if:

• people over 70;
• the patient is on artificial ventilation;
• there is a sepsis;
• pneumonia bilateral;
• there is arrhythmia with an increase or decrease in the pulse;
• causative agent - Pseudomonas aeruginosa;
• initial antibiotic treatment is ineffective.

If there is a high temperature on the background or after a cold, you should always consult a doctor and make an X-ray of the lungs.

ingalin.ru

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