Croupous pneumonia

Common features of pneumonia

Pneumonia - the name of a group of acute focal infectious inflammatory diseases of the lungs with the defeat of the lower respiratory tract and sweating of inflammatory effusion into respiratory vesicles-alveoli.

The origin of the disease is caused by the ingress of microbes-saprophytes from the oropharynx into the lower respiratory tract - the alveoli and bronchioles. Less often, the spread of pathogens occurs through the lymphatic capillaries or blood vessels from foci of infection in neighboring organs.The causative agents of pneumonia are pneumococci (croupous pneumonia), staphylococci, streptococci and other microbes.

The clinical (external) manifestations of the disease are influenced by many factors:

properties of the microbe pathogen;
the nature of the course and stage of the disease;
structural (morphological) basis of the disease;
the prevalence of the process in the lungs;
the presence of complications - pulmonary suppuration, pleurisy or empyema.

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Classification of pneumonia

In real life, it is not always possible to accurately determine the causative agent of pneumonia. Therefore, they are usually divided into clinical groups that have similar patterns of flow and the same prognosis.

Modern classification of pneumonia:

out-of-hospital;
hospital (hospital-acquired);
immunodeficiency;
atypical pneumonia.

Community-acquired pneumonia (domestic, domestic, outpatient), that is, acquired outside the health care institution usually develops in violation of the protective mechanisms of the respiratory system. Often, pneumonia complicates the course of a respiratory viral infection, such as influenza. The main causative agent of community-acquired pneumonia is pneumococcus. The cause of it can also be streptococci or hemophilic rods.

Depending on the volume of organ damage, inflammation of the lungs is divided into the following types:

croupous pneumonia (pleuropneumonia) - with a lesion of the lobe;
focal pneumonia (bronchopneumonia) with the defeat of a group of alveoli adjacent to the inflamed bronchus;
interstitial pneumonia - inflammation of the lung tissue along the bronchi and pulmonary blood vessels.

Croupous pneumonia is only one of the forms of pneumococcal pneumonia, and does not occur with inflammation of the lungs caused by other microbial pathogens.

Clinic of croupous inflammation of the lungs

Pneumococcal croupous pneumonia has an acute onset: chills, a sharp increase in body temperature to +39 ° C +40 ° C and sweating. Simultaneously there are such symptoms of croupous pneumonia as pronounced general weakness and lethargy. With severe fever and intoxication, there may be signs of central nervous system damage: severe headache, confusion, deafness of the patient, vomiting and other meningeal signs (signs of irritation of the meninges).

Very early from the onset of the disease in the chest on the side of inflammation there are pains. With croupous inflammation of the lungs, the pleural reaction is very pronounced. Pain in the chest is the main complaint of patients and requires the provision of emergency medical care. A distinctive symptom of pleural pain is its connection with breathing and coughing. The intensity of pain sharply increases with inspiration and coughing. In the early days of the disease there is a cough with phlegm, rusty from the admixture of traces of blood. Sometimes there is neobylo hemoptysis.

When examining a patient with croupous pneumonia, the forced position of the patient is revealed: the patient lies on the side of the lesion. On the face of a patient with croupous pneumonia, feverish blush is often observed, brighter on the side of the lesion. Characteristic of the presence of symptoms: dyspnea up to 30-40 respiratory movements per minute, cyanotic lips, swelling of the wings of the nose. Often in the early period of the disease there are herpetic vesicle rashes on the red border of the lips.

When examining the chest, it is usually found that the lag in its affected half is behind in respiratory movements. Due to severe pleural pain, the patient spares the sick side of the chest during breathing.

Percussion of the chest determines the dullness of the percussion sound over the zone of inflammation of the lung. Here, respiration acquires a stiff bronchial hue. At an early stage of croupous pneumonia, a moist crepitating wheeze appears over the focus of inflammation, a sign of exudation in the alveoli. Characteristic manifestations of the heart are the increased heart rate to 100 beats per minute and lowering blood pressure.

The pronounced pleural pain reaction can be combined with reflex pain in the same half of the abdominal cavity, painful when palpation of the upper abdomen. Due to the destruction of red blood cells in the affected lung lobe, slight jaundice of the skin, visible mucous membranes and eyeballs can develop.

Diagnosis of croupous inflammation of the lungs

Croupous inflammation of the lungs is probably the only one of all forms of the disease, when the clinical diagnosis is equated with the etiological (pneumococcal infection). Her clinical, radiologic and laboratory signs are very characteristic, and the diagnosis of croupous pneumonia usually does not cause any special difficulties.

X-ray signs of croupous pneumonia, confirming the diagnosis:

uniformity of darkening of the lobe or segment of the lung;
distinct response of the pleural membrane of the lung;
convex boundaries of the affected fraction.

Laboratory signs of croupous pneumonia:

a sharp increase in the number of white blood cells in the peripheral blood - neutrophilic leukocytosis> 15 thousand. in 1 cu. mm with the number of young cells> 15%
toxic granularity in the cytoplasm of leukocytes - white blood cells
absence of eosinophilic leukocytes in peripheral blood
increase in the level of fibrinogen protein in blood plasma
the presence of protein and protein cylinders in the urine, a small amount of excreted urine
detection in the analysis of sputum lanceolate paired microbe-cocci, colored in violet
isolation of the pneumococcus culture from the sputum of the patient
isolation of pneumococcal culture from patient's blood in 15-20% of cases.

Complications of croupous inflammation of the lungs

Inflammation of the lungs is considered a deadly disease due to the high risk of complications. Complications of croupous pneumonia are a number of severe conditions requiring treatment in the intensive care unit.

Conditions complicating the course of croupous pneumonia:

infectious-toxic shock
infection of blood with the spread of infection throughout the body - sepsis
inflammation of the lining of the lung - exudate pleurisy
empyema of the pleura - purulent pleurisy
suppuration of the lung - abscess
pericarditis - inflammation of the cardiac sac.

Croupous pneumonia in children is an indication for treatment in a children's hospital due to the danger of complications.

Principles of treatment of croupous inflammation of the lungs

The main rule of successful treatment of any pneumonia is the correct choice of antibiotic. The cause of croupous inflammation of the lungs is pneumococcus - a microbe that is sensitive to penicillin. Therefore, benzylpenicillin or its derivatives are most often used as the first drug. Fortunately, in Russia pneumococcus in most regions of the country retains high sensitivity to penicillin and amoxicillin.

If the patient has risk factors for the probable resistance of the pathogen to penicillin, then drugs from the group of "protected" penicillins are used. Most often it is amoxicillin / clavulanate. If the starting schedule of treatment is ineffective within 72 hours, the antibiotic is changed to a drug from another group.

Additional means for the treatment of croupous inflammation of the lungs can be expectorants, bronchodilators medicines, inhalation of an oxygen-air mixture, infusion of medicinal solutions intravenously. The choice of additional medicines is made by the attending physician, based on the severity of the symptoms and the patient's condition.

Given the severity of the symptoms and the danger of complications, treatment of croupous pneumonia is best performed in a hospital, that is, in a hospital.

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Causes and treatment of croupous pneumonia

Pneumonia croupy is a dangerous infectious allergic disease, the causative agents of which are pneumococci I, II, less often of type III and IV. As practice shows in recent years, croupous inflammation of the lungs more often occurs as a result of exposure to the body of streptococci or staphylococci.

Causes of the disease

The reasons for the development of this unpleasant and dangerous disease is, as a rule, quite weak immunity, who can not fully cope with the infection that has got into the body of an adult or a child. In addition, the bronchial cleansing function is broken in such cases, and the permeability of the alveolar membranes is too high, which can not protect the lungs from getting into them dangerous viruses.

Croup pneumonia in children or adults can occur as a result of hypothermia, a cold, so most of all cases of the disease can be attributed to the winter and spring season.The more severe course of pneumonia will be affected by the fact that the human body can be intoxicated as a result of taking alcohol, drugs, smoking. Factors that provoke pneumonia can be severe fatigue, poor ecology, poor working conditions. All this makes the human body weaker and defenseless.

Recently, statistics show that the disease has spread throughout the world and now it can be found in all latitudes. At the same time in places with a cold or constantly changing climate, the risk of getting pneumonia is several times higher. At the same time, the number of patients with croupous pneumonia decreased somewhat, the same can be said about the number of deaths resulting from this disease. People can get sick of different ages, but, as a rule, the causative agent of croupous pneumonia more often affects people aged 18 to 40 years.

Stages of development of the disease

Pneumococcus is the causative agent of croupous pneumonia

Croupous pneumonia, unlike usual, affects completely the entire lobe of the lung. Very rarely, the localization takes place in a separate segment or part of the lungs. The spread of the inflammatory process, in most cases, does not go on only because antibiotics are taking place. If the body is infected with a virus, the human lungs pass through four stages of the disease:

The tide lasts one or two days. In this period there is a very sharp hyperemia and serous exudation begins to appear.
Stage of red curing. At this stage, the alveoli of the affected lung are filled with a mass of fibrin in which there are a lot of erythrocytes. The affected area of the lung acquires a brown color with a reddish tinge, you can note some seals that make this lung similar to the human liver.
The stage of gray curing. In the alveoli, the number of leukocytes increases very rapidly. In turn, the red blood cells begin to disappear. This stage is observed in the patient already on the fifth day of the course of pneumonia of the croup type.
Stage of destruction. At this stage, resorption of fibrin occurs in the alveoli, and leukocytes disappear.

Symptoms of the disease

Treatment of croupous pneumonia in hospital

Croupous type of pneumonia in most cases occurs in the lower lobe of the right lung. It is worth noting that the inflammatory process also develops on the pleura of the lung. The first symptoms appear quickly enough, the person has a strong chill.

As practice shows, in the morning a person feels perfectly healthy, but already in the second half he very sharply begins to feel cold and chills, there is a sharp malaise, which makes you immediately leave all the cases and lie down. Chills are observed for a maximum of an hour, then a very high fever occurs. As a rule, the temperature jumps sharply to 39-40 degrees. Fever for several days, fever is observed, all the time chills are replaced by a very sharp increase in temperature.

If you do not use antibiotics for treatment, it will become a little easier only on the 10th day after the first signs of croupous pneumonia have appeared. It is then that a very sharp and critical drop in body temperature occurs, which remains so throughout the day. If you use antibiotics, you can get rid of the problem in the first phase of its development. Already literally in three days the temperature will return to normal, and well-being will again become good.

Treatment of croupous pneumonia with antibiotics

In the first few hours after the onset of pneumonia, the sick person can feel quite severe pain in the side, the intensity of which increases during breathing or with a strong dry cough. On the third day, very thick sputum appears, which is difficult to separate. Characteristic symptoms of croupous pneumonia - the allocation of "rusty" sputum in an amount of up to 200 ml per day and too rapid breathing. Breathing is superficial, because deep breathing is unrealistic due to dry pleurisy, which also occurs when croupous pneumonia develops.

In some cases, the patient, especially in children, may experience nausea and even vomiting. The appetite disappears, and the tongue becomes a little swollen and becomes very dry. There may be constipation or flatulence. In addition, there is a noticeable increase in the blood of bilirubin, which stains the skin in a yellowish color. This means that there was a malfunction of the liver.

Treatment of croupous pneumonia

A person who is ill with croupous pneumonia, as a rule, is sent by doctors to a hospital. If the disease is very difficult, the patient becomes delusional, then constant monitoring of specialists is necessary. A very important role is played by proper and very careful care of a person. During the time that there is fever, in no case can not get out of bed. At the same time the bed is also served by the ship, so that the patient does not get up even to the toilet.

A person should be in a slightly elevated position. This can be done only with the help of a special bed or, if you put several large pillows. It is necessary to air the room so that the air is fresh and of course in sufficient quantity. The diet of a person who has more croupous pneumonia should include light, but still high-calorie food. In addition, you need to use as much liquid as possible: teas, juices, coffee, milk, broths. In addition, eat soft-boiled eggs, rusks and vitamin C in any of its manifestations.

The fastest way to get rid of this disease is to take sulfonamide drugs and various kinds of antibiotics. In this case, it is necessary to observe the dosage as prescribed by the attending physician as accurately as possible. Otherwise, the effectiveness of treatment can be reduced, or there will be a variety of complications.

In order that the medications do not cause intoxication of the body, each time they need to drink at least half a glass of liquid. Ideally, if the patient is given alkaline mineral water.

Thus, you can reduce not only the frequency of taking the drug, but also its dose, which has a positive effect on the state of human health.

In addition, along with antibiotics that can trigger the growth of yeast-like fungi such as Candida, and can become a cause of intoxication, the occurrence of an allergic reaction, experts prescribe treatment Nystatin.

In the past few years, in order to remove swelling of the lungs with croupous pneumonia, specialists use exclusively sulfanilamides, which last for a long time.

If the case is severe enough, the patient urgently needs oxygen therapy, which is carried out with the help of a special oxygen tent. If you do this procedure for ten minutes, then during this time you can eliminate the arterial hypoxemia. In addition, in this way, you can remove the dyspnea from the patient, normalize blood pressure by saturating the blood with oxygen, make the pulse slower.

A prerequisite in the treatment is taking medications that improve the tone of the vessels. If the case is quite severe, then a special drug is injected intravenously - strophanthin.

Once you have the first signs of the development of croupous pneumonia, you must immediately begin treatment, because everything can to end with serious complications and even death, especially if it is a question of children or people of advanced age.

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