Pediatric pneumonia

Pneumonia in a child - symptoms, treatment, causes

Inflammation of the lungs or pneumonia is one of the most common acute infectious and inflammatory diseases of a person. Moreover, the concept of pneumonia does not include various allergic and vascular lung diseases, bronchitis, and also impaired lung function, triggered by chemical or physical factors (injuries, chemical burns).

Especially often there are pneumonia in children, the symptoms and signs of which are reliably determined only on the basis of X-ray data and a general blood test. Pneumonia among all pulmonary pathologies in young children is almost 80%. Even with the introduction of advanced technologies in medicine - the discovery of antibiotics, improved methods of diagnosis and treatment - so far this disease is among the top ten most frequent causes of death. According to statistics in various regions of our country, the incidence of pneumonia in children is 0.4-1.7%.

When and why can a child develop pneumonia?

Lungs in the human body perform several important functions. The main function of the lungs is the gas exchange between the alveoli and the capillaries, which envelop them. Simply put, oxygen from the air in the alveolus is transported to the blood, and from the blood carbon dioxide enters the alveolus. They also regulate body temperature, regulate blood coagulability, are one of the filters in the body, promote purification, removal of toxins, decay products arising from various injuries, infectious inflammatory processes.

And if food poisoning, a burn, a fracture, surgical interventions, any serious injury or disease, there is a general decrease in immunity, it is easier to cope with the toxin filtration effort more easily. That is why very often after a child has suffered or is suffering from injuries or poisonings, pneumonia occurs.

The most common pathogens are pathogenic bacteria - pneumococci, streptococci and staphylococci, and recently cases of lung inflammation from such pathogens, legionella (usually after staying at airports with artificial ventilation), mycoplasma, chlamydia, which are not often mixed, associated.

Pneumonia in a child, as an independent disease that occurs after a serious, strong, prolonged hypothermia, it is extremely rare, as parents try not to allow such situations. As a rule, in most children, pneumonia occurs not as a primary disease, but as a complication after an acute respiratory viral infection or influenza, less often other diseases. Why is this happening?

Many of us believe that acute viral respiratory diseases in the last decades have become more aggressive, dangerous their complications. Perhaps this is due to the fact that both viruses and infections have become more resistant to antibiotics and antiviral drugs, so they are so hard for children and cause complications.

One of the factors contributing to the increase in the incidence of pneumonia in children in recent years has been the overall poor health of the growing generation - how many children are born with congenital pathologies, malformations, CNS lesions. Especially severe pneumonia occurs in premature or newborn babies, when the disease develops against the background of intrauterine infection with an insufficiently formed, not mature respiratory system.

In congenital pneumonia, the herpes simplex virus, cytomegalovirus, mycoplasmas are not infrequently causative agents, and when infected with childbirth - chlamydia, group B Streptococcus, conditionally pathogenic fungi, E. coli, Klebsiella, anaerobic flora, when infected with hospital infections, pneumonia begins on day 6 or 2 weeks after birth.

Naturally, pneumonia often happens in cold weather, when the organism is subjected to seasonal adjustment from heat to cold and vice versa, there are overloads for immunity, at this time there is a lack of natural vitamins in foods, temperature changes, damp, frosty, windy weather contribute to children's hypothermia and their infection.

In addition, if a child suffers from any chronic diseases - tonsillitis, adenoids in children, sinusitis, dystrophy, rickets (see. rickets in infants), cardiovascular disease, any severe chronic pathologies, such as congenital central lesions nervous system, malformations, immunodeficiency states - significantly increase the risk of developing pneumonia, aggravate its course.

The severity of the disease depends on:

• Extensibility of the process (focal, focal, draining, segmental, lobar, interstitial pneumonia).
• The child's age, the younger the baby, the narrower the airways, the less intense gas exchange in the child's body and the heavier the course of pneumonia.
• Places where and for what reason there was a pneumonia:
  - community-acquired: most often have an easier flow
  - hospital: more severe, because it is possible to infect bacteria resistant to antibiotics
  - Aspiration: when inhaled foreign objects, mixture or milk.
• The most important role in this is played by the general health of the child, that is, his immunity.

Improper treatment of influenza and ARVI can lead to pneumonia in the child

When a child falls ill with an ordinary cold, SARS, influenza - the inflammatory process is localized only in the nasopharynx, trachea and larynx. With a weak immune response, and also if the causative agent is very active and aggressive, and the treatment in the child is done incorrectly, the process of reproduction of bacteria descends from the upper respiratory tract to the bronchi, then bronchitis may occur. Further, the inflammation can affect the lung tissue, causing pneumonia.

What happens in the body of a child in a viral disease? The majority of adults and children in the nasopharynx always have various opportunistic microorganisms - streptococci, staphylococci, without causing harm to health, because local immunity inhibits their growth.

However, any acute respiratory disease leads to their active reproduction and with the correct action of the parents during the illness of the child, immunity does not allow their intensive growth.

What should not be done during ARVI in the child, so as not to cause complications:

• You can not use antitussives. Coughing is a natural reflex that helps the body to clear the trachea, bronchi and lungs from mucus, bacteria, toxins. If, for the purpose of reducing the intensity of dry cough, to use the antitussive drugs that affect the cough center in the brain, such as Stoptusin, Broncholitin, Libexin, Paxeladin, then sputum and bacteria may accumulate in the lower respiratory tract, which ultimately leads to pneumonia.
• It is not possible to conduct any preventive therapy with antibiotics for colds, with a viral infection (see. antibiotics for colds). Against the virus, antibiotics are powerless, and with opportunistic bacteria immunity should cope, and only when complications arise according to the doctor's appointment is shown their use.
• The same applies to the use of various nasal vasoconstrictors, their use contributes to a faster penetration virus in the lower respiratory tract, so galazolin, Naphthysine, Sanorin used in viral infection is not safe.
• Abundant drink - one of the most effective methods of removing intoxication, dilution of sputum and rapid cleansing of respiratory There are plenty of ways to drink, even if the child refuses to drink, parents should be very persistent. If you do not insist that your child drink enough fluids, in addition, the room will have dry air - it will be promote drying of the mucosa, which can lead to a longer course of the disease or complication - bronchitis or pneumonia.
• Permanent ventilation, lack of carpets and carpeting, daily wet cleaning of the room in which the child is, moisturizing and cleaning the air with a humidifier and air cleaner will help to quickly cope with the virus and prevent the development of pneumonia. As clean, cool, moist air helps to dissolve sputum, quickly remove toxins with sweat, cough, wet breath, which allows the child to recover faster.

Acute bronchitis and bronchiolitis - differences from pneumonia

With SARS usually the following symptoms:

• High temperature in the first 2-3 days of the disease (see Fig. antipyretics for children)
• Headache, chills, intoxication, weakness
• Qatar upper respiratory tract, runny nose, cough, sneezing, sore throat (it does not always happen).

In acute bronchitis with Orvy, the following symptoms may occur:

• Minor increase in body temperature, usually up to 38C.
• First the cough is dry, then it becomes wet, there is no shortness of breath, unlike pneumonia.
• Breathing becomes hard, on different sides there are variously scattered rales that change or disappear after coughing.
• On the roentgenogram, the intensification of the pulmonary pattern is determined, the structure of the roots of the lungs decreases.
• There are no local changes in the lungs.

Bronchiolitis occurs most often in children up to a year:

• The difference between bronchiolitis and pneumonia can be determined only by X-ray examination, based on the absence of local changes in the lungs. According to the clinical picture, the acute symptoms of intoxication and the increase in respiratory insufficiency, the appearance of dyspnoea - very much resemble pneumonia.
• With bronchiolitis, the breathing in a child is weakened, shortness of breath with the help of an auxiliary musculature, nasolabial triangle to become a bluish shade, a general cyanosis, a pronounced pulmonary-cardiac insufficiency, is possible. When listening to a boxed sound is detected, the mass of scattered small bubbling rales.

Signs of pneumonia in the child

With a high activity of the causative agent of the infection, or with a weak immune response of the body to it, when even the most effective preventive medical measures do not stop the inflammatory the process and the condition of the child deteriorates, the parents can for some symptoms guess that the child needs more serious treatment and urgent examination of the doctor. In this case, in no case should not begin treatment by any popular method. If it really is pneumonia, it will not only not help, but the condition may worsen and time for adequate examination and treatment will be missed.

Symptoms of pneumonia in a child 2 - 3 years and older

How to identify attentive parents with a cold or viral illness that it is necessary to urgently call a doctor and suspect a pneumonia in the child? Symptoms that require an X-ray diagnosis:

• After Orvi, influenza within 3-5 days there is no improvement or after a slight improvement again there is a temperature jump and increased intoxication, coughing.
• Lack of appetite, sluggishness of the child, sleep disturbance, capriciousness persist within a week after the onset of the illness.
• The main symptom of the disease remains a strong cough.
• The body temperature is not high, but the baby has shortness of breath. At the same time, the number of breaths per minute in a child increases, the rate of breaths per minute in children aged 1-3 years is 25-30 breaths, in children 4-6 years - a rate of 25 breaths per minute, if the child is in a relaxed calm state. With pneumonia, the number of breaths becomes larger than these figures.
• With the other symptoms of a viral infection - cough, temperature, cold, severe pallor of the skin is observed.
• If the temperature is high for more than 4 days and antipyretic agents such as Paracetamol, Efferalgan, Panadol, Tylenol are not effective.

Symptoms of pneumonia in infants, children under one year of age

The onset of the disease can be noticed by the mom by changing the behavior of the baby. If a child constantly wants to sleep, become listless, apathetic or vice versa, he is a lot naughty, cries, refuses from food, with a slight increase in temperature - mom should immediately contact the pediatrician.

Body temperature

In the first year of life, pneumonia in a child, a symptom of which is considered to be a high, not knocked down temperature, differs in that at this age it is not high, does not reach 37.5 or even 37.1-37.3. The temperature is not an indication of the severity of the state.

The first symptoms of pneumonia in an infant

This causeless anxiety, lethargy, decreased appetite, the baby refuses the breast, the sleep becomes restless, short, appears a loose stool, there may be vomiting or regurgitation, a runny nose and paroxysmal cough that increases during crying or feeding the baby.

Child's breathing

Pain in the chest with breathing and coughing.
Sputum - with a damp cough, purulent or mucopurulent sputum (yellow or green) is secreted.
Shortness of breath or an increase in the number of respiratory movements in young children is a clear sign of pneumonia in a child. Dyspnoea in babies can be accompanied by nodding to the breath, as well as the baby blows his cheeks and extends his lips, sometimes there are foamy discharge from the mouth and nose. The symptom of pneumonia is considered to be the excess of the number of breaths per minute:

• In children up to 2 months - the norm is up to 50 breaths per minute, more than 60 is considered a high frequency.
• In children, after 2 months to a year, the norm is 25-40 breaths, if 50 or more, this is an excess of the norm.
• In children older than one year, the number of breaths more than 40 is considered a shortness of breath.

The skin relief during breathing changes. Attentive parents can also notice the retraction of the skin during breathing, more often on one side of the patient's lung. To notice this, it is necessary to undress the baby and observe the skin between the ribs, it retracts when breathing.

With extensive lesions, there may be a lag of one side of the lung with deep breathing. Sometimes you can notice periodic stopping of breathing, disturbance of rhythm, depth, breathing frequency and the child's desire to lie on one side.

Cyanosis of the nasolabial triangle

This is the most important symptom of pneumonia, when the blue skin appears between the lips and the spout of the baby. Especially this sign is pronounced when the child sucks the breast. With severe respiratory failure, a slight blueing can be not only on the face, but also on the body.

Chlamydia, mycoplasmal pneumonia in children

Among the pneumonias, the causative agents of which are not banal bacteria, but various atypical representatives secrete mycoplasmal and chlamydial pneumonia. In children, the symptoms of such pneumonia are slightly different from the course of the usual pneumonia. Sometimes they are characterized by a hidden sluggish current. Symptoms of SARS in a child can be as follows:

• The onset of the disease is characterized by a sharp rise in body temperature to 39.5C, then a stable low-grade fever -37.2-37.5 is formed or even a temperature normalization occurs.
• It is also possible the onset of the disease with the usual signs of ARVI - sneezing, choking in the throat, a bad cold.
• Persistent dry debilitating cough, shortness of breath may not be permanent. Such a cough usually occurs with acute bronchitis, and not pneumonia, which complicates the diagnosis.
• When listening to a doctor, scanty data are usually presented: rare variegated rattles, pulmonary percussion sound. Therefore, according to the nature of wheezing, it is difficult for a doctor to determine atypical pneumonia, since there are no traditional signs, which greatly complicates the diagnosis.
• In the analysis of blood in atypical pneumonia there may be no significant changes. But usually there is increased ESR, neutrophilic leukocytosis, a combination with anemia, leukopenia, eosinophilia.
• On the x-ray of the chest reveals a pronounced enhancement of the pulmonary pattern, non-uniform focal infiltration of the pulmonary fields.
• Both chlamydia and mycoplasma have a feature that exists for a long time in the epithelial cells of the bronchi and lungs, therefore, pneumonia usually has a prolonged recurrent character.
• Treatment of atypical pneumonia in the child is carried out by macrolides (azithromycin, josamycin, clarithromycin), since the causative agents to them are the most sensitive (to tetracyclines and fluoroquinolones, too, but they are contraindicated for children).

Indications for hospitalization

The decision on where to treat a child with pneumonia - in a hospital or at home, the doctor takes, while he takes into account several factors:

• The severity of the condition and the presence of complications - respiratory failure, pleurisy, acute disorders of consciousness, cardiac insufficiency, falling blood pressure, lung abscess, pleural empyema, infectious-toxic shock, sepsis.
• The defeat of several lobes of the lung. Treatment of focal pneumonia in the child at home is entirely possible, but with croupous pneumonia treatment is best done in a hospital.
• Social indications are poor living conditions, inability to perform care and doctor's prescriptions.
• Age of the child - if the infant is sick, this is the reason for hospitalization, because the pneumonia of the baby is a serious threat to life. If pneumonia develops in a child under 3 years of age, treatment depends on the severity of the condition and most often doctors insist on hospitalization. Older children can be treated at home provided that the pneumonia is not severe.
• General health - in the presence of chronic diseases, weakened overall health of the child, regardless of age, the doctor may insist on hospitalization.

Treatment of pneumonia in children

How to treat pneumonia in children? The basis of therapy for pneumonia is antibiotics. At a time when there were no antibiotics in the arsenal of doctors for bronchitis and pneumonia, a very frequent cause of death of adults and children was pneumonia, therefore, in no case can not refuse to use them, no folk remedies for pneumonia are effective. From the parents it is required to strictly follow all the doctor's recommendations, the proper care of the child, the observance of the drinking regime, nutrition:

• Admission of antibiotics must be carried out strictly in time, if the appointment of the drug 2 times in day, this means that there should be a break between meals at 12 o'clock, if 3 times a day, then a break of 8 hours (see. 11 rules how to take antibiotics correctly). Antibiotics are prescribed - penicillins, cephalosporins for 7 days, macrolides (azithromycin, josamycin, clarithromycin) - 5 days. The effectiveness of the drug is estimated within 72 hours - an improvement in appetite, a decrease in temperature, dyspnea.
• Antipyretics are used if the temperature is above 39C, in infants above 38C. Initially, antibiotic treatment of antipyretics is not prescribed, as the evaluation of the effectiveness of therapy is difficult. It should be remembered that during a high temperature in the body produces the maximum number of antibodies against the causative agent of the disease, so if the child can tolerate the temperature of 38C, it is better not to knock it down. So the body quickly cope with the microbe that caused pneumonia in the baby. If the child had at least one episode of febrile seizures, the temperature should be knocked down already at 37.5C.
• Nutrition of the child with pneumonia - lack of appetite in children during illness is considered natural and the child's refusal to admit food is explained by the increased burden on the liver when fighting infection, so you can not force a child to feed. If possible, prepare light food for the patient, exclude any ready-made chemical products, fried and fatty, try to feed the child simple, easily digestible food - cereals, soups on a weak broth, steamed cutlets from low-fat meat, boiled potatoes, various vegetables, fruits.
• Oral hydration - in water, natural freshly diluted juices - carrot, apple, slightly boiled tea with raspberries, rose hips infusion, water-electrolyte solutions (Regidron and others) are added.
• Airing, daily wet cleaning, use of air humidifiers - ease the condition of the baby, and the love and care of parents works wonders.
• No restorative (synthetic vitamins), antihistamines, immunomodulating agents are not used, as often lead to side effects and do not improve the course and outcome of pneumonia.

Reception of antibiotics for pneumonia in a child (uncomplicated) usually does not exceed 7 days (macrolides 5 days), and if bed rest is observed, follow all recommendations doctor, in the absence of complications, the child quickly recovers, but for a month there will still be residual effects in the form of a cough, minor weakness. With atypical pneumonia, treatment can be delayed.

In the treatment of antibiotics in the body, the intestinal microflora is broken, so the doctor prescribes probiotics - RioFlora Immuno, Acipol, Bifiform, Bifidumbacterin, Normobakt, Lactobacterin. Analogues of Linex - a list of all probiotics). To remove toxins after the end of therapy, the doctor can prescribe sorbents, such as Polysorb, Enterosgel, Filtrum.

With the effectiveness of treatment for general regimen and walks, it is possible to transfer the child from the 6th to the 10th day of the disease, the hardening to resume after 2-3 weeks. With a mild pneumonia, large physical exertion (sport) is allowed after 6 weeks, with complicated after 12 weeks.

zdravotvet.ru

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, pneumonia> up to , 00 children dies within a year. 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 digits (> 38 ° 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 a viral 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 children

Treatment 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:

• Increases in the number of breaths> 60 in 1 min for babies under the age of one year, and for children older than the year, dyspnea> 50 per 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.

ingalin.ru

Signs of pneumonia in the child

Very often children's colds can be complicated by pneumonia. This is a very serious disease that is difficult to diagnose and treat, pneumonia can be different, they depend on which zone of inflammation is covered. The most common form of pneumonia affects children who have not yet reached the age of three, they are atypically leaking, because children can not cough up phlegm and do not say in which area they feel pain. In young children, pneumonia is almost not audible, because children are restless, cry. It is very important to identify this disease in advance so that there are no serious complications.

Causes of pneumonia in children

Most often pneumonia occurs due to microbes - pneumococci. In children under 3 years old, pneumonia can cause staphylococcus, very rarely a chlamydial or microplasma pathogen, as well as pneumonia in children occurs due to several microbes.

Very rarely, children have pneumonia on their own, most often it is the result of a viral infection or a complication after the flu. This is due to the fact that the cold reduces immunity in the respiratory tract and immunity ceases to fight. Due to the fact that viruses affect the mucous membranes in the airways, microbes that are in the upper and lower respiratory ways are not completely destroyed, they start multiplying more strongly, and form a microbial process and pneumonia.

Often, pneumonia runs the risk of getting sick of children who are very tired and overcooled when they have frozen their legs. The cold becomes complicated when the baby is surrounded by pneumococci and other microbes, both children and adults can bear them. Also, pneumonia develops if germs or other infectious foci, kidney or intestinal, have been introduced into the bloodstream. When lung tissue is dominated by heat and humidity, microbes rapidly multiply, and pneumonia develops.

Danger of pneumonia for children

For infants, this is a deadly disease, when microbes begin to enter the lungs, they begin to destroy tissues, and there may be swelling and inflammation. Thus, the permeability of the lungs to oxygen is violated, that is, the baby begins to suffocate, while there is a marked disturbance in the metabolism, carbon dioxide is removed from the tissues, and they are no longer supplied with oxygen.

When there is inflammation, a lot of toxins start to appear, because of this the child intoxication and disrupted general health, this further worsens the patient's well-being. It is important to consider how much tissue in the lung is affected, it depends on it, how serious the disease is.

Types of pneumonia in children

1. Focal pneumonia occurs when a small area of ​​the lung becomes inflamed.

2. Segmental pneumonia occurs when only a certain segment of the lung is inflamed, this lesion is more extensive than the previous one.

3. Fracture pneumonia is considered a very severe form, because breathing is disturbed, due to the fact that a large section of the lung tissue can fall out.

4. Very dangerous for the child is total pneumonia, it affects the entire lung, it can be of two types - one-sided and two-sided. This is a serious disease.

Pneumonia is characterized by the fact that the metabolism is disturbed, because the inflammation of the lung begins to affect all the systems of the body. Microbes at the same time secrete toxins, can affect the nerve tissue, while the mind is depressed and the person is overexcited. There may be hypoxia, because of this, blood circulation increases, while a person feels a heavy load on the cardiovascular system, because of this very much loses weight and he develops neurasthenia. It is very important to recognize the symptoms of pneumonia in time and start treatment on time, if it is not treated in time it can have serious and deplorable consequences for the child.

How is pneumonia manifested in children of different species?

Pneumonia depends on which area of ​​inflammation, if it is large and active, means the disease will be severe. Most often pneumonia in children is treated well.

Bronchopneumonia or focal pneumonia is a complication of ARVI, it can begin with the common cold, runny nose, cough and drowsiness, then the infection goes very deep. The virus begins to affect the bronchi, then the lung tissue, microbes join it and the disease worsens.

Signs of pneumonia in children

1. Sharp deterioration in the health of the baby.

2. The appearance of a very dry or wet cough that is deep.

3. There may be shortness of breath when sucking, crying and exercising, and even in a dream.

4. In the breath begin to participate thoracic cellular muscles.

5. The temperature rises from 38 to 39 degrees, and almost does not go astray.

6. If the baby has problems with immunity, there may be no fever and body temperature on the contrary decreases.

7. The body temperature with pneumonia lasts for several days, even after the active treatment has begun.

8. The baby is pale when examined, blue may appear around the mouth and nose.

9. The child is restless, does not eat well and sleeps a lot.

10. When listening to the bronchi can be observed hard breathing, this indicates the inflammation of the upper respiratory tract.

11. Over the lungs small rattles are heard, they are damp, they do not disappear after the baby coughs.

12. In the heart there may be tachycardia, vomiting and nausea, stomach aches, a loose stool appears, because of this, intestinal infection also joins.

13. With pneumonia, the liver is enlarged.

14. The child comes in serious condition.

So, it is very important to diagnose the lung disease of a child in time and begin timely treatment, so you can get rid of complications and help the child cope with the disease. Diagnosis of the disease can be with the help of an X-ray, in the picture visible darkened areas of the lung, this indicates inflammation and tissue tightening. A general blood test has an increased amount of white blood cells, which also indicates an inflammatory process.

medportal.su

Do antibiotics prescribe for pneumonia in children?

Pneumonia (pneumonia) is a dangerous disease that does not spare an adult or a child. Antibiotics for pneumonia in children belong to the category of effective drugs that help cope with the most neglected of its forms. Thanks to the use of antibiotics, the effectiveness of treatment is always at a high level.

In a number of countries, pneumococci, which are the causative agents of pneumonia, have become resistant to this type of medical preparations, which can not be said about the Russian regions and countries of the former post-Soviet space in which most strains retained sensitivity to them.

Symptoms of pneumonia

In children of different age categories, this disease appears and develops in its own way. In children under six years of pneumonia causes a hemophilic rod. Schoolchildren have mycoplasma and chlamydia pneumonia. But most often these are bacteria that constantly inhabit the nasopharynx - pneumococci.

In order to assign an effective treatment for pneumonia to a child, the pediatrician conducts clinical tests and an X-ray examination that allows the appointment of an effective medical product. Despite the fear of parents to make a baby X-ray, in the treatment of pneumonia this is today the only accurate diagnosis.

The main symptoms of the disease in young children are:

• The presence of body temperature above 380C, which lasts more than three days;
• hard breath;
• Dyspnea with a respiration rate per minute more than 40 times;
• blue lips, skin;
• complete refusal to eat;
• a state of persistent drowsiness.

When observing these symptoms in their babies, parents should immediately contact the pediatrician. In no case should self-medication be performed. Some types of lung disease, including pneumonia, begin with a demonstration of symptoms similar to the usual colds: runny nose, sneezing, dry cough. Recognize this pneumonia can only be in the presence of dyspnea and fever.

In children, this disease is also characterized by the fact that their skin is drawn into the intercostal spaces from the side of the sick lung. You can see this sign only by undressing the child and carefully observing how the relief of his skin changes in intercostal spaces during breathing. It should also be counted how many breaths per minute it makes.

Treatment with antibiotics

The danger of pneumonia in children is that the immature baby organism is very sensitive to all sorts of side effects after the illness. The disease sharply disturbs the heart activity, the work of many other organs. Particularly dangerous complication, which causes inflammation of the pleura - pleurisy, leading to the formation of a light purulent cavity.

Many parents can not immediately recognize pneumonia, go to a doctor late or think that a cough or high fever is a sign of a cold. Heavy forms of pneumonia are treated in hospital settings, but more often with the disease cope and at home. In order to determine the severity of the disease, the doctor can refer the child to the hospital for a more complete examination and accurate diagnosis.

For children, home treatment has a number of advantages: a familiar setting, around familiar people, and there is no likelihood of re-infection because of being in an environment where it is full of pathogens resistant to antibacterial agents that treat pneumonia. At home, children are provided with a comfortable and quiet environment, high-calorie, easily assimilated, rich in vitamins.

The main factor in the effective treatment of pneumonia is considered to be antibacterial treatment. With simple stages of pneumonia, antibiotics of the penicillin group (phenoxymethylpenicillin, amoxicillin) or macrolides (erythromycin, azithromycin) are prescribed.In more complex cases of the disease, doctors prescribe an antibiotic in injections.In the treatment of antibiotics, third-generation drugs can be used: Cefix, Cedex, Cefodox, Augmentin and others, but only in accordance with the recommendations of physicians.

When prescribing antibiotics, the weight of the child, the age and the causative agent of the disease are taken into account. If the improvement has come and the temperature has dropped to below 380 ° C, intramuscular administration of the drugs is discontinuing and medication is continued with tablets.

There are cases when the action of an antibiotic does not give a proper result, then the doctor prescribes another drug. With antibacterial therapy, the main indicator is a decrease in body temperature, so when taking antibiotics at the same time it is not recommended to give the baby antipyretics. The first few days, while the temperature is holding, the appetite of children is lowered, during this period it is necessary to give him as much liquid as possible in the form of broths, juices, compotes or vitamin teas.

Not the least role in improving the therapeutic effect is played by the situation where the patient is. The room should be cool, clean and constantly ventilated, as the child in such conditions is easier to breathe. To bathe a child in the presence of high temperature is impossible, but water procedures in the form of wiping with warm water should be mandatory. Once the temperature is normal, the general hygiene procedures should return to normal mode. With mild forms of pneumonia, antibiotics are not required.

Treatment without antibiotics

If the parents when the symptoms of colds on time turned to the doctor, conducted all the necessary tests and Diagnosis of the disease, doctors can attribute sparing therapy - nasal drops and anti-cold medicines. Effective means are those that improve expectoration of sputum, including mucolytic drugs that relieve spasm of the bronchi.

A good way to normalize the breathing muscles is breathing exercises, especially for children who have undergone pleurisy. It is important to conduct warming procedures in the presence of low temperature, body massage and exercise therapy.

Infants after normalization of body temperature can visit the street, provided that the air temperature is not lower than five degrees. Older children can walk outside after three weeks from the onset of the illness, provided that the main symptoms of the disease are absent. Doctors recommend that children of school age refrain from sports activities and do not overload the body, so as the complete restoration of blood circulation in the affected lung occurs only after a two-month rehabilitation.

In order not to provoke a repeated course of the disease in children susceptible to inflammatory processes, doctors recommend avoiding their presence in smoky, overcrowded rooms. As is known, passive smokers absorb harmful substances from cigarette smoke more than the smoker himself.

Prevention of pneumonia

To date, infant mortality from this disease is a very rare phenomenon, but it is present in medical practice. There are many reasons for this: chronic diseases, late treatment of parents to a doctor, an incorrect way of life and many others. In order to reduce the child mortality rate for this disease, doctors developed a special strategy. One of its effective directions is immunization against pneumococcus, measles and whooping cough, which contribute to the development of pneumonia in children.

One of the important areas of prevention of pneumonia is considered to increase the protective properties of the child's body.

For this purpose, during the year, children are given hardening procedures. For babies is particularly important adequate nutrition, which is the source of the defenses of the body. We should not forget about folk remedies that increase the body's resistance, possess anti-inflammatory properties, as well as the need to include in the diet of the child vitamin juices, vegetables, fruits, rich in vitamins A, B, R.

Reduces the risk of the disease and the need to adhere to the rules of personal hygiene. Parents should take care of that the kid was in ecologically clean conditions of residing.

respiratoria.ru

What can be dangerous inflammation of the lungs?

Inflammation of the lungs (pneumonia) is an ailment that affects people of any age. Not everyone knows about the dangerous inflammation of the lungs. Although many will call the symptoms of the disease, they say that it is treated with antibiotics, and after the illness the body will recover for a long time.

To make sure of the danger of pneumonia, you must first understand what it is.

What is pneumonia?

This disease is caused by fungi, bacteria or viruses.Normally, for each person, pathogenic microorganisms live on the pharyngeal mucosa, nose, and lungs. But as soon as the body's immunity decreases, pathogenic microbes begin to multiply at a tremendous rate, causing pneumonia. Inflammation can begin directly in the lungs or get there gradually, starting its "journey" from the throat or nose. In such cases, doctors explain that "the infection has subsided."

Inflammation can be exposed to the whole lung or part of it.

Symptoms of this disease are: pain in the side, intensifying with deep inspiration or cough, very high body temperature, dry or wet cough, shortness of breath, chills. For the correct diagnosis, you will need a radiographic examination of the lungs, a blood test and sputum. These studies will help establish the nature of the disease and begin adequate therapy.

When treating pneumonia, doctors usually prescribe antibacterial drugs. Depending on the severity of the disease, the patient can be placed in the hospital, where he is injected several times a day. With properly selected antibiotic, the patient's condition improves after 5-6 days from the beginning of treatment. If no improvement occurs, doctors usually prescribe a different drug to the patient. Further it is important to dilute and withdraw from the lungs formed sputum. To this end, the patient may be prescribed inhalation, massage. In parallel, the patient is prescribed antiviral and immunomodulating drugs. Complete recovery usually occurs 3-4 weeks later.

Inflammation of the lungs is a very serious disease, from which, despite a wide range of modern antibiotics, people continue to die. About self-treatment speech can not even go. This is fraught with serious consequences.

Danger of pneumonia for children

For a child's organism pneumonia is a very serious test, even if the child has received medical help on time. Most often, infirmity affects children of preschool age. Doctors believe that up to 6 years the child is developing immunity. During this period, they are very vulnerable to all kinds of infections, including streptococcal, which in most cases causes babies pneumonia.

In addition to the symptoms of pneumonia listed above, the nasolabial triangle (cyanosis) is often marked in children. This is a very serious indicator, indicating that the disease is not all right with the cardiovascular system of the child.

The danger of pneumonia is also that during the course of the disease, the lungs can not continue to function full: the baby's breathing becomes shallow, he has a feeling of lack of air. Therefore sick children sleep very badly, eat, show constant concern.

The following factors aggravate the situation:

1. Later, seek medical help.
2. Presence of concomitant chronic diseases in the baby.
3. Incorrect treatment of the child.

Each of these factors increases the risk of illness for the child several times. At the initial stage, the disease is very similar to the usual viral infection, so doctors prescribe antibiotics not immediately. If antiviral treatment did not work for 3 days (high fever persists and cough does not stop), this is an excuse to contact the doctor again. Such a picture of the disease means its bacterial nature. At this stage, the intake of antibiotics is mandatory. Not all mothers know this. Many continue to treat the child according to the original scheme prescribed by the doctor, losing valuable time. Within a few days the child may develop acute respiratory failure, sometimes death occurs. This is the danger of pneumonia.

Another dangerous consequence of untreated pneumonia in children is neurotoxicosis. It is characterized by first increased activity of the child, his excitement, frequent crying, whims. This state is smoothly replaced by the opposite: the child is apathetic, does not eat, sleepy, muscle tone is reduced. At the third stage, the temperature rises, the child has convulsions, develops pulmonary insufficiency (until the breath stops).

To reduce the risk of developing a baby's inflammation of the lungs, my mother has to adhere to a few simple rules:

1. Try to breast-feed at least 1 year.
2. Do not give up vaccinating the baby.
3. Ensure the child's diet of foods rich in zinc.
4. Engage in tempering a child, spend a lot of time walking in the open air.
5. Observe the basic rules of home hygiene: more often to ventilate the premises and conduct wet cleaning.

Effects of pneumonia in adults

No less dangerous is pneumonia and for adults. The most common consequences:

1. Abscess of the lung.
2. Fibrosis of the lung.
3. Bronchial asthma.
4. Heart failure.
5. Respiratory failure.

Especially dangerous are the first two diseases.

Abscess of the lung is the decomposition (decay) of the lung tissue in the part where there was inflammation. The hearth can be one. Sometimes there are several. During the period of abscess formation, the patient's fever rises, weakness, lack of appetite, difficulty breathing, severe pain in the chest, cough. In the next stage, the formed abscess is opened, sputum in large quantities (up to 1 liter per day) exits through the respiratory tract. With the right treatment for several years, the tissue of the lung becomes scarred, and a full recovery comes.

Fibrosis of the lung is a condition of the patient, in which the connective tissue begins to form on the site of the damaged pulmonary tissue. Lungs can not work at full power, breathing becomes difficult, chest pain occurs. The disease progresses very quickly, so it requires immediate treatment in a medical institution. It is impossible to get rid of lung fibrosis completely. Treatment is usually aimed at alleviating the symptoms and preventing the further development of the disease. In extreme cases, the patient is shown lung transplantation.

How to avoid the negative consequences of pneumonia?

The mortality from pneumonia in our country, despite the sufficient level of development of medicine, remains quite high.

To quickly recover and avoid negative consequences, you need to be very attentive to health.

In Russia it is accepted to go to the doctor when there are already very serious problems. It is not right. In the case of pneumonia, this can lead to death. Medical care should be handled as soon as the first symptoms of the disease have appeared, and the temperature is still not so high. Do not neglect and analysis, which appoints the doctor. Their results will help the doctor immediately make a scheme for effective treatment.

Mom, caring about the health of her baby, should know that at the slightest suspicion of any disease she must show the child to the doctor. Statistics show that the largest infant mortality from pneumonia is observed among toddlers under the age of 1 year. In the case of children's pneumonia, do not neglect hospitalization.

Both adults and children can be protected from pneumonia by physical training, proper nutrition, saturated with vitamins and microelements, hardening, frequent stay in the open air and close attention to one's health.

respiratoria.ru

Symptoms and Treatment of Destructive Pneumonia

Destructive pneumonia is a severe form of pneumonia, the development of which provokes a wide range of various microorganisms.The disease is characterized by the appearance of destructive changes in the underlying lung tissue. In the process of development of this ailment in the lung tissues, abscesses and bullae develop, which break into the pleural region, which provokes the appearance of complications.

The emergence of this disease is due to the penetration into the human body of microorganisms related to staphylococci. Earlier this type of ailment was called staphylococcal destruction, but recently this infection began to be combined with viral and other pathogenic flora. Staphylococcus remains the main microorganism, which plays a leading role in the development of destructive pneumonia.

Peculiarities of destructive pneumonia

In the process of disease occurrence, infection of the lungs through the bronchi or as a result of transportation of a pathogenic microorganism with blood flow occurs. Infection of lung tissue is accompanied by the process of formation of abscesses and bullae, which with further progression of the disease breaks into the pleural region. Depending on the nature of pathogenesis, this type of disease can be primary and secondary. With the first variety, the most common development of pneumonia is one-sided, with single individual inflammatory foci. In the case of developing a secondary form of the disease, bilateral respiratory damage is observed with the formation of numerous small foci of inflammation.

The clinical picture of the development of destructive pneumonia depends entirely on the etiology, pathogenesis and form of the disease. The primary form of destructive pneumonia is characterized by the appearance of unilateral intrapulmonary changes. The development of the latter occurs most often in one lobe of the lung. Those that arise in several parts of the organ are observed very rarely. If the destructive processes are represented by the appearance of purulent foci, the patient's condition worsens to a considerable extent during the progress of the disease. With the formation of dry foci - bull, deterioration of the person's health is poorly expressed. The progress of suppurative processes in the event of the development of destructive pneumonia is accompanied by the following symptoms:

• temperature increase;
• an increase in the number of leukocytes in the blood of the patient.

Progression of destructive pneumonia in children leads to the development of intestinal paresis. If a bilateral septic secondary destruction occurs in the body, the patient develops a cardiovascular insufficiency. The ailment in the body begins most often acute. The progress of the disease leads to severe consequences in the patient's body. This type of disease is most often recorded in childhood. The incidence of pneumonia in children is about 8-12% of all recorded pneumonia.

The emergence of this type of pathology requires emergency hospitalization, rapid and correct diagnosis. After this, one should immediately start treatment, since untimely carrying out of therapeutic measures can threaten with serious consequences for the organism, up to a lethal outcome.

Etiology of children's destructive pneumonia

As risk factors for the development of destructive forms of pneumonia in children are:

• the factor of prematurity;
• the emergence of long acute forms of respiratory ailments of a viral nature;
• development of congenital or acquired immunodeficiencies;
• use of glucocorticosteroids;
• damages received by the child in the process of delivery;
• the occurrence of asphyxia with the placental fluid;

In addition to these factors, the likelihood of developing a disease in a child is increased when used in treatment diseases of inadequate antibacterial therapy, as well as when the child is living in poor living conditions. In addition to staphylococcus, the following pathogens are of particular importance in the development of this type of pneumonia:

• tabloid proteus;
• pseudomonas;
• enterobacterial infections;
• influenza virus;
• viruses that cause the appearance of parainfluenza;
• adenoviral infections.

These microorganisms, using a decrease in the protective properties of the organism, penetrate into it and in the process of their vital activity aggravate the state of the organism.

Signs and classification of the disease

When the causative agent enters the lung tissue, it begins to multiply very quickly.

In the process of reproduction of pathogenic organisms, small cavities filled with air, or encapsular abscesses, form.

When the latter are located near the visceral pleura, a rupture of the formation may occur with the appearance of pleural empyema, dry pleurisy, or pneumothorax.

There are several forms of destructive pneumonia:

1. Bronchogenic is characterized by respiratory infection. This form is determined in four out of five cases of human ailment. Variety is a primary independent disease. If a disease is detected, local damage to the lung tissue is observed.
2. Hematogenous form is characterized by the fact that infection occurs through the circulation of infected blood. In children, the cause of the secondary type of disease can be the development of phlegmon of the newborn. When diagnosing a child, a generalized lesion of the underlying lung tissue is detected.

Signs in the progression of the primary form of the disease are as follows:

• a sharp rise in body temperature;
• fall in the level of human efficiency;
• the appearance of a headache;
• attacks of nausea and vomiting;
• the appearance of pain in the joints;
• dry cough, which quickly passes into the mucous or purulent-mucous;
• hemoptysis, which appears in rare cases.

With the progression of the secondary form of destruction in humans, respiratory and cardiovascular insufficiency is revealed. In addition to high body temperature, weakness and the appearance of a feeling of nausea and vomiting, the patient is diagnosed with acrocyanosis, the pallor of the covers appears, and loss of consciousness and shortness of breath can occur.

Treatment of destructive pneumonia

Destructive pneumonia in children is much more difficult to tolerate than in adults, for this reason, the former often have side-effects as a result of the progression of the disease.

If a destructive pneumonia develops in the primary form in the human body, then, first of all, medical measures are taken to rid the body of intoxication. For this purpose, potassium-sparing diuretics and rheopolyglucin are used. With the aim of introducing these medications into the body, the parenteral route is used. In addition, 20% glucose solution and "Contrikal" are injected into the patient's body. Additionally, the use of multivitamin complexes and antihistamines such as "Diphenhydramine" and "Diazepam" is recommended.

To get rid of the pathogenic flora, drugs with antibacterial action are used. When using antibiotics should be selected the most effective drug in relation to the causative agent, which triggered the development of the disease. Before using antibiotics, bacterial analysis should be performed to identify the specific pathogen against which an effective agent should be selected. The course of treatment with antibacterial drugs is about 2 weeks.

However, if after a destructive pneumonia cavities with purulent contents are observed, the course of treatment with antibiotics should be continued until complete recovery.

In the secondary form of the disease at the initial stage, it is necessary to conduct drug therapy aimed at curing the primary source the infectious process that triggered the development of the disease, and only after that, pneumonia is treated. The method of healing the disease in identifying a secondary form of the disease depends on the source of the infectious process and the individual characteristics of the human body.

respiratoria.ru

Similar articles