About pneumonia in a newborn child
Features of bronchopulmonary system in fetus and newborn.
There is no air in the fetal lungs in utero. But he starts breathing from the 23rd week of pregnancy. However, before this period, gas exchange in the fetal lungs can not yet be carried out because of anatomical and functional immaturity.By the time of birth, the baby's lungs are filled with amniotic fluid. At the first inhalation in a full-term baby, the inspiratory volume is approximately 70 ml, with almost all the alveoli open. Amniotic fluid is rapidly absorbed into the blood and interalveolar space. In preterm infants, the first inhalation is more difficult, because in addition to immaturity respiratory system they are deficient in the nervous cardiovascular system and many metabolic processes substances.
The breathing of a born child is intermittent, uneven. There are pauses, in full-term children they last for 1-6 seconds, in premature infants - 5-12 seconds.
The causes of susceptibility of newborns to pneumonia:
- immaturity of pulmonary elements, few muscle fibers in the walls of the respiratory tract;
- a dense network of capillaries and lymphatic vessels, loose connective tissue between them;
- the ciliated epithelium is still weakly functioning, the cough reflex is reduced;
- the airways along the entire length are narrow, which causes difficulties in the passage of air;
- the ribs are located horizontally, the intercostal muscles are poorly developed, so the chest excursion is reduced;
- immaturity of the nervous system aggravates the insufficiency of the respiratory system.
These features, as well as a unique response of the immune system, make newborns particularly vulnerable to pneumonia.The vulnerability of babies exists, even if the pregnancy was good, the birth was not complicated, there is no hereditary pathology.
Causes of pneumonia in newborns
Pneumonia of newborns is treated by neonatologists. They define this disease as infectious, although sometimes it can develop as a result of aspiration, but sooner or later the infection still joins.
Pneumonia in newborns is an acute infectious lung disease that can develop as an independent disease or as a complication. It runs pretty hard. The death rate from illness in children 1 month is 30-40%. The frequency of occurrence in term infants ranges from -1%, in preterm infants to 10%.
Inflammation of the lungs in newborns is classified into the following forms:
- focal;
- segmental;
- interstitial.
By causal factor:
- hospital-acquired;
- out-of-hospital.
Depending on the circumstances of the infection, the following types of pneumonia are distinguished:
- congenital pneumonia (infection is transmitted from the mother through the placenta);
- intrauterine (when infected with amniotic fluid in the lungs);
- intranatal (bacteria fall during labor from the genital tract of the mother);
- postnatal (the disease developed after birth in the hospital or at home).
Causes of pneumonia in a newborn baby:
- bacteria;
- viruses;
- mushrooms;
- pneumocysts;
- mycoplasma;
- chlamydia.
In most cases, mixed pneumonia is observed, for example, bacterial-viral. The frequency among the viruses is dominated by adenoviruses, influenza viruses and parainfluenza. Among the bacteria - Staphylococcus aureus, pneumococcus, alpha-hemolytic streptococcus. The share of Klebsiella, bacteria of the intestinal group, and protease in the structure of pathogens has significantly increased.
Symptoms of pneumonia in a newborn
Pneumonia in newborns will manifest itself differently depending on the pathogen and the conditions of infection.
Congenital pneumonia is characterized by the development of suffocation at birth. The child is born with a cyanotic shade of the skin, does not cry at once, weakly or does not cry at all, little moves with hands and feet, reflexes are weak. When feeding in such children, there is abundant regurgitation. Breath weakened, on exhalation a groan is heard, sometimes there is a semblance of coughing. In addition to the respiratory system, cardiovascular, digestive (bloating, abdominal pain, enlarged spleen) of the child's system suffer. Body temperature is normal, or reduced. At full-term children there may be a fever from the second day of the disease. Symptoms last about 3-4 weeks. This type of inflammation is characterized by severe course and high mortality.
Pneumonia, which develops in the first days of a child's life, has a long hidden period. The first signs can be observed only on the 5th day of life and later. The severity of the course depends on the infection that caused the disease.
The diagnosis of viral pneumonia is difficult to put, because a microbial infection quickly joins it.Influenza pneumonia of the newborn is characterized by an unexpected beginning. Body temperature rises to 39 ° C or more, convulsions, anxiety, refusal to eat, meningeal symptoms appear. It is also possible atypical flow with a temperature of up to 38 ° C and without strong signs of intoxication. A feature of this type of pulmonary inflammation is the destruction of blood vessels and hemorrhage in all the organs of the child. Such children may have consequences in the form of encephalitis, meningitis, hemorrhages in vital organs, otitis, pyelonephritis.
Pneumonia caused by the parainfluenza virus develops in parallel with the inflammation of the pharynx. Clinically, it proceeds more easily than influenza, intoxication is less pronounced, the temperature rises slightly. But weakness, a decrease in reflexes, pale extremities are still present.
Staphylococcal pneumonia in children may be a complication of sepsis or arise as an independent disease. It flows heavily with high fever, severe toxicosis, hemorrhages, pleurisy. The heart, nervous system, kidneys are also affected.
Chlamydia and mycoplasmal pneumonia occur most often in utero. They not only hard to leak, but are also difficult to treat. For these pneumonia is characterized by cough, swelling, and sometimes an eruption. These diseases often lead to fatal outcomes.
What are the differences between the course of pneumonia in term and premature infants? In preterm infants:
- Symptoms such as dyspnea, cyanosis of the skin, respiratory depression predominate;
- increased temperature is rare;
- complications from both the lungs and other organs are more common;
- from the mouth a foamy liquid is released;
- pneumonia often causes sepsis;
- the disease lasts a long time and leaves behind irreversible consequences.
Treatment of pneumonia in newborns
The main thing in therapy of pneumonia is antibacterial therapy. Most of the infectious agent at the time of antibiotic prescription is not yet known, so the doctor makes his assumptions. If the drug is selected correctly, then within 2-3 days there will come an improvement in the condition. Otherwise, you need to change the medication for others.Newborns use three groups of antibiotics: penicillins, cephalosporins and macrolides. The most effective for starting therapy are protected penicillins (amoksiklav, augmentin, fleumoclave, unazin). If there is a suspicion of chlamydia or mycoplasma, the choice falls on macrolides (azithromycin, clarithromycin, roxithromycin). Cephalosporins are used as alternative drugs. Treatment of a child with antibiotics is carried out at least 10-14 days.
When identifying the pathogen to antibiotic therapy, it is possible to attach treatment with specific immunoglobulins (antistaphylococcal, antigrippic, anti-syncope, etc.).
Inhalation is an integral part of the treatment of lung diseases. Oxygen is inhaled through aqueous solutions, sodium hydrogencarbonate, saline, acetylcysteine, lazolvan, trypsin, chymotrypsin. Oxygen reduces respiratory failure, and mucolytics dilute sputum.
The position of the child also matters. If the inflammation of the lungs is one-sided, then the kid is put on a healthy side, and if bilateral - change side every 2 hours. It is advisable that the mother or the medical personnel give the child a chest massage by tapping. This will also facilitate the departure of mucus. From physiotherapy in the acute phase is allowed only the microwave on the chest area.
What are the consequences of pneumonia for a child?
Time is of the utmost importance. The earlier treatment is started, the better the prognosis for the child.If the treatment is started in the first day, then pneumonia can be cured without a trace. But if antibiotic therapy is started late, the consequences can be very different. Infection can spread to healthy areas of the lungs, to the pleura, then pleurisy develops. Sepsis is a fairly frequent and formidable complication. With prolonged destruction of tissues in the lung cavities are formed. Features of children's lung tissue cause rapid development of pulmonary edema and respiratory failure.
The long-term consequences develop after months and years after the disease. This can be: transition to a chronic form, adhesions between the lungs and pleura, disruption of normal lung function, frequent soreness in a more adult age.
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Symptoms of pneumonia in infants. Treatment, consequences of the disease
Pneumonia is an infectious disease of the lungs caused by viruses and bacteria of several species. The lungs become inflamed and filled with fluid, resulting in a cough in the patient and it becomes difficult to breathe.
How to recognize the symptoms of pneumonia in infants?
The disease can proceed quickly and develop literally in one or two days, but in a number of cases the infection process is delayed and lasts for several days. Often, a layman can not distinguish pneumonia from an ordinary cold.
The very first sign of pneumonia is a cough. Call the district pediatrician at the house if the infant or infants:
- often occurs in attacks of severe cough with mucous discharge;
- clearly feels bad;
- lost his appetite.
Severe cases of pneumonia require adequate treatment in the hospital. Call an ambulance if you find the following symptoms of pneumonia in infants:
- cough gradually worsens, and mucus becomes yellow, brown or with bloody veins;
- the child's body temperature rises;
- the baby wheezes (or whimpers hoarsely when breathing);
- the baby refuses to drink water, and the total amount of liquid consumed in the last 24 hours does not exceed half of its norm;
- the child breathes often and shallowly, with each sigh his skin is drawn between the ribs, above the clavicles or under the rib cage;
- the child's lips and nails turned blue.
Risk factors
There are circumstances that increase the risk of developing some infectious diseases (which include pneumonia in the baby). Symptoms, reviews about childbirth, the behavior of the baby during feeding - all this information will allow the doctor to determine if the child is at risk.
The following groups of children are most susceptible to pneumonia:
- the youngest;
- daily exposed to cigarette smoke;
- left without vaccination or vaccinated in violation of the schedule;
- with diagnoses affecting the condition of the lungs (asthma, bronchiectasis - enlargement of the bronchi, cystic fibrosis);
- born prematurely;
- Pressed and coughing during feeding;
- suffering from chronic diseases (regardless of the lesion).
Diagnostics
At home examination it is very difficult to diagnose such a serious disease as pneumonia in the baby. Symptoms without fever can be misleading even doctors, since the first manifestations of pneumonia are in many ways similar to the usual, much more common cold. That is why it is necessary to show a small child to a pediatrician as soon as possible. He will listen to the lungs with a stethoscope and determine if there is liquid in the paired organ. The doctor will also check the heart rate of the infants, listen to breathing, check with the parents, what other symptoms of the disease they found.
If the child's condition appears to the district pediatrician to be unsatisfactory, he will suggest that you go to the hospital to take a chest x-ray. On an x-ray you will see how much the lungs are infected. You can also take a blood test or sputum to determine the causative agent of the infection and its nature (viral or bacterial).
Treatment
If the doctor discovers mild symptoms of pneumonia in the baby (without cough and complications), he will most likely prescribe treatment at home. With bacterial pneumonia, they fight with antibiotics. Viral illness can pass by itself - as the immune system of the child will suppress the impact of a harmful virus.
However, in order to accurately determine the type of infection, it is necessary to take the baby to the hospital for testing. In the case of mild infection, the doctor can prescribe antibiotics without testing to ensure that both the virus and bacteria are cured. There are other ways to alleviate the condition of a small child.
What can you do yourself?
No matter what type of pneumonia the infant is, the symptoms of the disease are always extremely unpleasant and can disrupt the sleep, nutrition and the regimen of the child. In order to minimize the discomfort experienced by the baby and contribute to an early cure, try to follow the following medical recommendations:
- Create a baby all the conditions for a good rest.
- To reduce the temperature, give the child child paracetamol or ibuprofen ("Nurofen"), strictly adhering to the instructions for the use of the drug. Paracetamol can be given to babies starting from two months if it was born at 37 weeks and later and weighs more than four kilograms at the moment. Ibuprofen ("Nurofen") is safe in treating children from three months weighing at least five kilograms. If you are in doubt about the correct dosage of the drug, strictly follow the instructions of the instructions or consult a treating pediatrician.
- Pneumonia in the infant, the symptoms of which are expressed in the obstruction of the respiratory tract and cough, can lead to dehydration of the body, since with the listed manifestations of infection to a small child difficult to drink. Constantly offer the baby a breast or a bottle with a mixture, regardless of the established mode of feeding, and give additionally pure boiled water. If there is a financial possibility, it is advisable to buy special water for babies, intended for babies and sold in the departments of baby food.
Precautionary measures
Do not give a small child any medications for cough or cold, sold in pharmacies on a non-prescription vacation. Almost all medicines of this kind are intended for children over the age of six due to the increased risk of side effects in the youngest patients.
If a pediatrician diagnoses severe pneumonia in the baby, the symptoms (treatment with folk remedies in such cases almost never helps) gradually worsen, and antipyretic medicinal drugs have a very limited period of action, should go to the hospital and go to hospital. Remember that a dangerous condition does not always develop quickly - sometimes it takes several days before the baby's well-being worsens. Be sure to go to the hospital if the child has difficulty with absorption of food or breathing.
In the hospital
On inpatient treatment, doctors will provide the child with a full volume of fluids and oxygen. If necessary, the baby will be delivered a dropper, through which antibiotics will be introduced or, in case of severe dehydration, special fluids. In cases when pneumonia develops in the infant, symptoms, treatment with methods of alternative medicine, ignoring pediatrician recommendations and insufficient attention to the patient from relatives can lead to serious complications disease. If a baby has difficulty breathing and the blood oxygen level has reached a critical level, a special oxygen mask will be placed on his face.
Effects
Usually, in such a common disease as pneumonia in the baby, the consequences do not represent any Dangers: most young children are successfully cured, and the former excellent state of health. However, in a number of cases, pneumonia is accompanied by complications that require special therapy and extreme attention to the condition of the baby.
Dangerous consequences of pneumonia in the child
- Bacteremia (the presence of microbes in the patient's blood). Penetrating from the lungs into the bloodstream, bacteria are able to spread the infection to other internal organs and thereby cause dysfunction of these organs.
- Abscess of the lung. Abscess means accumulation of pus in the lung cavity. This condition is treated with antibiotics. Sometimes for the removal of pus requires a surgical operation or installation of drainage with a long needle or tube, which is placed in the abscess.
- Pleural effusion (exudative pleurisy) - accumulation of fluid around the lungs. Pneumonia can cause accumulation of fluid in a narrow space between layers of tissue, lining the lung cavity and chest (pleura). If bacteria get into this liquid, you will most likely need to pump it out with the help of drainage or remove it with the help of a surgical operation.
- Labored breathing. With severe pneumonia, there are problems with breathing, and the sick child is unable to breathe enough oxygen. In this case, treatment in stationary conditions is necessary, where a small patient will be connected to special equipment that will minimize the most terrible symptoms of pneumonia in the baby.
Prevention
To provide a small child with all the conditions for a healthy life and to minimize the risk of inflammation of the lungs, take the following preventive measures in time:
- Do not give up vaccinations. Pneumococcal vaccine (Prevenar 13) protects the baby from pneumonia, meningitis and sepsis (blood poisoning). In order not to seek out the symptoms of pneumonia in a babe who has fallen ill with an ordinary cold, it is also useful to put inoculations from a hemophilic infection of type b, diphtheria and whooping cough. The last two vaccines are part of the DTP.
- Do not forget about the rules of personal hygiene. Cover your mouth and nose during a cough, and often wash your hands and your baby to prevent the spread of bacteria and viruses - the causative agents of infection.
- Do your best to minimize the negative impact of cigarette smoke on the health of the baby. If you or your partner smoke, think about giving up bad habits. Infants living with smokers are more likely to get sick and more likely to suffer from such ailments as pneumonia, colds, asthma and ear infections.
If you are attentive to your baby, you can not only suspect the disease at an early stage, but also prevent it altogether.
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Pneumonia in a child - symptoms, treatment, causes
Inflammation of the lungs or pneumonia is one of the most common acute infectious and inflammatory diseases of a person. Moreover, the concept of pneumonia does not include various allergic and vascular lung diseases, bronchitis, and also pulmonary function disorders, caused by chemical or physical factors (injuries, chemical burns).
Especially often there are pneumonia in children, the symptoms and signs of which are reliably determined only on the basis of X-ray data and a general blood test. Pneumonia among all pulmonary pathologies in young children is almost 80%. Even with the introduction of progressive technologies in medicine - the discovery of antibiotics, improved methods of diagnosis and treatment - until now this disease is among the top ten most frequent causes of death. According to statistics in various regions of our country, the incidence of pneumonia in children is, %.
When and why can a child develop pneumonia?
Lungs in the human body perform several important functions. The main function of the lungs is the gas exchange between the alveoli and the capillaries, which envelop them. Simply put, oxygen from the air in the alveolus is transported to the blood, and from the blood carbon dioxide enters the alveolus. They also regulate body temperature, regulate blood coagulability, are one of the filters in the body, contribute to the purification, removal of toxins, disintegration products arising from various traumas, infectious inflammatory processes.
And when food poisoning, a burn, a fracture, surgical interventions occur, in case of any serious injury or disease, there is a general decrease in immunity, it is easy to cope with the filtration load toxins. That is why very often after a child has suffered or is suffering from injuries or poisonings, pneumonia occurs.
The most common pathogens are pathogens - pneumococci, streptococci and staphylococci, and recently cases of lung inflammation from such pathogens as pathogenic fungi, legionella (usually after staying at airports with artificial ventilation), mycoplasma, chlamydia, which are not often mixed, associated.
Pneumonia in a child, as an independent disease that occurs after a serious, strong, prolonged hypothermia, it is extremely rare, as parents try not to allow such situations. As a rule, in most children, pneumonia occurs not as a primary disease, but as a complication after an acute respiratory viral infection or influenza, less often other diseases. Why is this happening?
Many of us believe that acute viral respiratory diseases in the last decades have become more aggressive, dangerous their complications. Perhaps this is due to the fact that both viruses and infections have become more resistant to antibiotics and antiviral drugs, so they are so hard for children and cause complications.
One of the factors contributing to the increase in the incidence of pneumonia in children in recent years has been the overall poor health in the younger generation - how many children are born with congenital pathologies, malformations, lesions of the central nervous system. Especially severe pneumonia occurs in premature or newborn babies, when the disease develops against the background of intrauterine infection with insufficiently formed, not mature respiratory system.
In congenital pneumonia, the herpes simplex virus, cytomegalovirus, mycoplasmas are not infrequently causative agents, and with infection during labor, chlamydia, group B streptococci, opportunistic fungi, E. coli, Klebsiella, anaerobic flora, when infected with hospital infections, pneumonia begins on day 6 or 2 weeks after birth.
Naturally, pneumonia often happens in cold weather, when the organism is subjected to seasonal adjustment from heat to cold and vice versa, there are overloads for immunity, at this time there is a lack of natural vitamins in foods, temperature changes, damp, frosty, windy weather contribute to children's hypothermia and their infection.
In addition, if a child suffers from any chronic diseases - tonsillitis, adenoids in children, sinusitis, dystrophy, rickets (see. rickets in infants), cardiovascular disease, any severe chronic pathologies, such as congenital lesions central nervous system, malformations, immunodeficiency states - significantly increase the risk of developing pneumonia, weighed down its course.
The severity of the disease depends on:
- Extensibility of the process (focal, focal, draining, segmental, lobar, interstitial pneumonia).
- The child's age, the younger the baby, the narrower the airways, the less intense gas exchange in the child's body and the heavier the course of pneumonia.
- Places where and for what reason there was a pneumonia:
- community-acquired: most often have an easier flow
- hospital: more severe, because it is possible to infect bacteria resistant to antibiotics
- Aspiration: when inhaled foreign objects, mixture or milk. - The most important role in this is played by the general health of the child, that is, his immunity.
Improper treatment of influenza and ARVI can lead to pneumonia in the child
When a child falls ill with an ordinary cold, SARS, influenza - the inflammatory process is localized only in the nasopharynx, trachea and larynx. With a weak immune response, and also if the causative agent is very active and aggressive, and the treatment in the child is carried out incorrectly, the process of reproduction of bacteria descends from the upper respiratory tract to the bronchi, then bronchitis. Further, the inflammation can affect the lung tissue, causing pneumonia.
What happens in the body of a child in a viral disease? Most adults and children in the nasopharynx always have different opportunistic microorganisms - streptococci, staphylococci, without causing harm to health, because local immunity holds them back growth.
However, any acute respiratory disease leads to their active reproduction and with the correct action of the parents during the illness of the child, immunity does not allow their intensive growth.
What should not be done during ARVI in the child, so as not to cause complications:
- You can not use antitussives. Coughing is a natural reflex that helps the body to clear the trachea, bronchi and lungs from mucus, bacteria, toxins. If for the treatment of a child, in order to reduce the intensity of dry cough, use antitussives that affect the cough center in the brain, such as Stoptosin, Broncholitin, Libexin, Paxeladin, then sputum and bacteria may accumulate in the lower respiratory tract, which ultimately leads to inflammation lungs.
- It is not possible to conduct any preventive therapy with antibiotics for colds, with a viral infection (see. antibiotics for colds). Against the virus, antibiotics are powerless, and with opportunistic bacteria immunity should cope, and only when complications arise according to the doctor's appointment is shown their use.
- The same applies to the use of various nasal vasoconstrictors, their use contributes to a faster penetration of the virus into the lower respiratory tract; therefore, galazoline, naphthysine, sanorin should not be used in case of a viral infection safely.
- Abundant drink - one of the most effective methods of removing intoxication, dilution of sputum and rapid cleansing respiratory tract is an abundant drink, even if the child refuses to drink, parents should be very persistent. If you do not insist that the child drink enough fluids, in addition, the room will have dry air - this will help to dry the mucosa, which can lead to a longer course of the disease or complication - bronchitis or pneumonia.
- Permanent ventilation, lack of carpets and carpeting, daily wet cleaning of the room in which the child is, Humidification and air purification with the help of a humidifier and an air cleaner will help to cope faster with the virus and prevent development pneumonia. As clean, cool, moist air helps to dissolve sputum, quickly remove toxins with sweat, cough, wet breath, which allows the child to recover faster.
Acute bronchitis and bronchiolitis - differences from pneumonia
With SARS usually the following symptoms:
- High temperature in the first 2-3 days of the disease (see Fig. antipyretics for children)
- Headache, chills, intoxication, weakness
- Qatar upper respiratory tract, runny nose, cough, sneezing, sore throat (it does not always happen).
In acute bronchitis with Orvy, the following symptoms may occur:
- Minor increase in body temperature, usually up to 38C.
- First the cough is dry, then it becomes wet, there is no shortness of breath, unlike pneumonia.
- Breathing becomes hard, on different sides there are variously scattered rales that change or disappear after coughing.
- On the roentgenogram, the intensification of the pulmonary pattern is determined, the structure of the roots of the lungs decreases.
- There are no local changes in the lungs.
Bronchiolitis occurs most often in children up to a year:
- The difference between bronchiolitis and pneumonia can be determined only by X-ray examination, based on the absence of local changes in the lungs. According to the clinical picture, the acute symptoms of intoxication and the increase in respiratory insufficiency, the appearance of dyspnoea - very much resemble pneumonia.
- In bronchiolitis, the breathing in a child is weakened, shortness of breath with the help of an auxiliary musculature, nasolabial the triangle becomes a bluish hue, a common cyanosis is possible, a pronounced pulmonary-cardiac failure. When listening to a boxed sound is detected, the mass of scattered small bubbling rales.
Signs of pneumonia in the child
With a high activity of the causative agent of the infection, or with a weak immune response of the body to it, when even the most effective preventive medical measures do not stop inflammatory process and the child's condition worsens, parents can for some symptoms guess that the child needs more serious treatment and urgent examination doctor. In this case, in no case should not begin treatment by any popular method. If it really is pneumonia, it will not only not help, but the condition may worsen and time for adequate examination and treatment will be missed.
Symptoms of pneumonia in a child 2 - 3 years and older
How to identify attentive parents with a cold or viral illness that it is necessary to urgently call a doctor and suspect a pneumonia in the child? Symptoms that require an X-ray diagnosis:
- After Orvi, influenza within 3-5 days there is no improvement or after a slight improvement again there is a temperature jump and increased intoxication, coughing.
- Lack of appetite, sluggishness of the child, sleep disturbance, capriciousness persist within a week after the onset of the illness.
- The main symptom of the disease remains a strong cough.
- The body temperature is not high, but the baby has shortness of breath. In this case, the number of breaths per minute in a child increases, the rate of breaths per minute in children aged 1-3 years 25-30 breaths, children 4-6 years - a rate of 25 breaths per minute, if the child is in a relaxed calm condition. With pneumonia, the number of breaths becomes larger than these figures.
- With the other symptoms of a viral infection - cough, temperature, cold, severe pallor of the skin is observed.
- If the temperature is high for more than 4 days and antipyretic agents such as Paracetamol, Efferalgan, Panadol, Tylenol are not effective.
Symptoms of pneumonia in infants, children under one year of age
The onset of the disease can be noticed by the mom by changing the behavior of the baby. If the child constantly wants to sleep, become sluggish, apathetic or vice versa, a lot of naughty, crying, refuses to eat, while the temperature may slightly increase - mom should urgently turn to pediatrician.
Body temperature
In the first year of life, pneumonia in a child, a symptom which is considered to be high, not knocked down temperature, is different in that at this age it is not high, does not reach 3, or even 3, -3,. The temperature is not an indication of the severity of the state.
The first symptoms of pneumonia in an infant
This causeless anxiety, lethargy, decreased appetite, the baby refuses from the breast, the sleep becomes restless, short, there is a loose stool, there may be vomiting or regurgitation, a runny nose and a paroxysmal cough that worsens during crying or feeding child.
Child's breathing
Pain in the chest with breathing and coughing.
Sputum - with a damp cough, purulent or mucopurulent sputum (yellow or green) is secreted.
Shortness of breath or an increase in the number of respiratory movements in young children is a clear sign of pneumonia in a child. Dyspnoea in babies can be accompanied by nodding to the breath, as well as the baby blows his cheeks and extends his lips, sometimes there are foamy discharge from the mouth and nose. The symptom of pneumonia is considered to be the excess of the number of breaths per minute:
- In children up to 2 months - the norm is up to 50 breaths per minute, more than 60 is considered a high frequency.
- In children, after 2 months to a year, the norm is 25-40 breaths, if 50 or more, this is an excess of the norm.
- In children older than one year, the number of breaths more than 40 is considered a shortness of breath.
The skin relief during breathing changes. Attentive parents can also notice the retraction of the skin during breathing, more often on one side of the patient's lung. To notice this, it is necessary to undress the baby and observe the skin between the ribs, it retracts when breathing.
With extensive lesions, there may be a lag of one side of the lung with deep breathing. Sometimes you can notice periodic stopping of breathing, disturbance of rhythm, depth, breathing frequency and the child's desire to lie on one side.
Cyanosis of the nasolabial triangle
This is the most important symptom of pneumonia, when the blue skin appears between the lips and the spout of the baby. Especially this sign is pronounced when the child sucks the breast. With severe respiratory failure, a slight blueing can be not only on the face, but also on the body.
Chlamydia, mycoplasmal pneumonia in children
Among the pneumonias, the causative agents of which are not banal bacteria, but various atypical representatives secrete mycoplasmal and chlamydial pneumonia. In children, the symptoms of such pneumonia are slightly different from the course of the usual pneumonia. Sometimes they are characterized by a hidden sluggish current. Symptoms of SARS in a child can be as follows:
- The onset of the disease is characterized by a sharp rise in body temperature to 3, C, then a stable subfebrile temperature of -3, -3 is formed, or even a temperature normalization occurs.
- It is also possible the onset of the disease with the usual signs of ARVI - sneezing, choking in the throat, a bad cold.
- Persistent dry debilitating cough, shortness of breath may not be permanent. Such a cough usually occurs with acute bronchitis, and not pneumonia, which complicates the diagnosis.
- When listening to a doctor, scanty data are usually presented: rare variegated rattles, pulmonary percussion sound. Therefore, according to the nature of wheezing, it is difficult for a doctor to determine atypical pneumonia, since there are no traditional signs, which greatly complicates the diagnosis.
- In the analysis of blood in atypical pneumonia there may be no significant changes. But usually there is increased ESR, neutrophilic leukocytosis, a combination with anemia, leukopenia, eosinophilia.
- On the x-ray of the chest reveals a pronounced enhancement of the pulmonary pattern, non-uniform focal infiltration of the pulmonary fields.
- Both chlamydia and mycoplasma have a feature that exists for a long time in the epithelial cells of the bronchi and lungs, therefore, pneumonia usually has a prolonged recurrent character.
- Treatment of atypical pneumonia in the child is carried out by macrolides (azithromycin, josamycin, clarithromycin), because the pathogens to them are most sensitive (to tetracyclines and fluoroquinolones, too, but they are children contraindicated).
Indications for hospitalization
The decision on where to treat a child with pneumonia - in a hospital or at home, the doctor takes, while he takes into account several factors:
- The severity of the condition and the presence of complications - respiratory failure, pleurisy, acute disorders of consciousness, heart failure, falls AD, lung abscess, pleural empyema, infectious-toxic shock, sepsis.
- The defeat of several lobes of the lung. Treatment of focal pneumonia in the child at home is entirely possible, but with croupous pneumonia treatment is best done in a hospital.
- Social indications are poor living conditions, inability to perform care and doctor's prescriptions.
- Age of the child - if the infant is sick, this is the reason for hospitalization, because the pneumonia of the baby is a serious threat to life. If pneumonia develops in a child under 3 years of age, treatment depends on the severity of the condition and most often doctors insist on hospitalization. Older children can be treated at home provided that the pneumonia is not severe.
- General health - in the presence of chronic diseases, weakened overall health of the child, regardless of age, the doctor may insist on hospitalization.
Treatment of pneumonia in children
How to treat pneumonia in children? The basis of therapy for pneumonia is antibiotics. At a time when there were no antibiotics in the arsenal of doctors with bronchitis and pneumonia, a very frequent cause of death of adults and children there was pneumonia, therefore, in no case should one refuse to use them, no folk remedies for pneumonia are effective. From the parents it is required to strictly follow all the doctor's recommendations, the proper care of the child, the observance of the drinking regime, nutrition:
- Reception of antibiotics must be carried out strictly in time, if the appointment of the drug 2 times per day, this means that there should be a break of 12 hours between meals, if 3 times a day, then a break of 8 hours (cm. 11 rules how to take antibiotics correctly). Antibiotics are prescribed - penicillins, cephalosporins for 7 days, macrolides (azithromycin, josamycin, clarithromycin) - 5 days. The effectiveness of the drug is estimated within 72 hours - an improvement in appetite, a decrease in temperature, dyspnea.
- Antipyretics are used if the temperature is above 39C, in infants above 38C. Initially, antibiotic treatment of antipyretics is not prescribed, as the evaluation of the effectiveness of therapy is difficult. It should be remembered that during a high temperature in the body, the maximum amount antibodies against the causative agent of the disease, so if the child can tolerate the temperature of 38C, it is better not to knock down. So the body quickly cope with the microbe that caused pneumonia in the baby. If the child had at least one episode of febrile seizures, the temperature should be knocked down already at 3, C.
- Nutrition of the child with pneumonia - lack of appetite in children during illness is considered natural and the child's refusal from food intake due to increased strain on the liver when fighting infection, so you can not force a child to feed. If possible, prepare light food for the patient, exclude any ready-made chemicals, fried and fatty, try to feed child simple, easily assimilated food - cereals, soups on a weak broth, steam cutlets from low-fat meat, boiled potatoes, various vegetables, fruit.
- Oral hydration - in water, natural freshly diluted juices - carrot, apple, weakly boiled tea with raspberries, rose hips infusion, water-electrolyte solutions (Regidron and etc).
- Airing, daily wet cleaning, use of air humidifiers - ease the condition of the baby, and the love and care of parents works wonders.
- No restorative (synthetic vitamins), antihistamines, immunomodulating agents are not used, as often lead to side effects and do not improve the course and outcome of pneumonia.
Reception of antibiotics for pneumonia in a child (uncomplicated) usually does not exceed 7 days (macrolides 5 days), and if bed rest is observed, perform all the doctor's recommendations, in the absence of complications, the child quickly recovers, but for a month there will still be residual effects in the form of a cough, slight weakness. With atypical pneumonia, treatment can be delayed.
In the treatment of antibiotics in the body, the intestinal microflora is broken, so the doctor prescribes probiotics - RioFlora Immuno, Acipol, Bifiform, Bifidumbacterin, Normobakt, Lactobacterin. Analogues of Linex - a list of all probiotics). To remove toxins after the end of therapy, the doctor can prescribe sorbents, such as Polysorb, Enterosgel, Filtrum.
With the effectiveness of treatment for general regimen and walks, it is possible to transfer the child from the 6th to the 10th day of the disease, the hardening to resume after 2-3 weeks. With a mild pneumonia, large physical exertion (sport) is allowed after 6 weeks, with complicated after 12 weeks.
zdravotvet.ru
Pneumonia: symptoms without fever. Symptoms of Hidden Pneumonia
High temperature is a classic sign of the inflammatory process in the lungs. It signals a serious illness such as pneumonia. Symptoms without fever are rarely taken for its manifestation. It's a pity. After all, they indicate the latent course of the disease.
Main reasons
Symptoms of latent pneumonia are intense sweating and weakness. Even in the case of minimal loads. What do these signs mean? They signal a weakened immunity. After all, the body does not give a normal response to the inflammatory process. That is why, even in the case of severe lung damage, the body temperature rises slightly, and sometimes remains at a normal level.
At the same time, high sweating and weakness speak of the strongest poisoning. Malicious bacteria are not restrained by immune cells and spread a lot of toxic substances. The excretory system simply does not have time to get rid of them. As a result, the functioning of internal organs is disrupted. And this leads to an even greater oppression of immunity. In the end, the body completely ceases to resist infection.
Remember, pneumonia without temperature is a sign of impaired immunity. Such a patient needs prompt medical assistance. Because without it, the patient can die.
Symptoms of pneumonia with a cough
The situation is typical for a patient who has had a long cold. The patient's condition improved significantly. The doctor does not observe wheezing in the lungs. There was only a small cough. For example, after a strong bronchitis such a residual phenomenon is considered the norm. However, only if it lasts no more than 2 weeks.
When is there reason to suspect that pneumonia develops in the body? Symptoms without fever, but with the presence of a cough should be alarmed in the following cases:
- the presence of general weakness;
- duration of cough more than 2 weeks;
- decreased appetite;
- expectoration of a large amount of sputum or, on the contrary, minimal;
- shortness of breath, chest at this time asymmetrically expanding;
- painful discomfort in the lower ribs;
- strong heat and profuse sweating at any load.
These are the most common signs. These are very serious, characterizing such a disease as pneumonia, symptoms. Temperature of 37 C, and sometimes normal, in combination with the above signs may indicate a latent form of pulmonary tuberculosis.
That is why it is recommended to consult a doctor immediately.
Hidden pneumonia without coughing
Unfortunately, such a disease is characterized by different forms of manifestation. Is there pneumonia without fever and cough? Symptoms (signs of a hidden ailment) indicate a complete inactivity of the body before an insidious disease.
The following persons are subject to this form of manifestation of the disease:
- patients with alcoholism;
- persons who do not have a permanent place of residence;
- HIV-infected;
- aged people;
- weakened children;
- patients who have a different form of depression of the immune system.
In addition, symptoms of latent pneumonia without a cough can be observed in people who have a busy schedule. Such people, most of whom are office employees, spend a working day in a room depleted of oxygen. In this case, they are often delayed after a day's work. They do not pay attention to malaises of moderate and mild severity. Thus, most of the infections are carried on the legs.
Against the background of the weakening of immunity they develop pneumonia. Symptoms without fever and cough greatly complicate the possibility of correct diagnosis of the disease. But the whole danger lies in the fact that a good standard of living and nutrition gives the body the power to suppress the pathogen independently. At the same time, the connective tissue forms on the site of the former inflammation. As a result, the lungs lose their ability to gas exchange. The patient develops a respiratory failure.
Pneumonia in children
Breasts and newborns are most susceptible to the latent course of pneumonia. This is due to low respiratory activity in the absence of physical exertion. In children, stagnation of fluid in the pleural cavity is observed. In this regard, hard breathing is accepted as the norm of physiology. Meanwhile, pneumonia develops without temperature in children.
Symptoms of childhood pneumonia are of this nature:
- the duration of sleep increases;
- the regime of wakefulness and rest;
- increased nervous excitability;
- there is a flabbiness of the skin;
- there are causeless vagaries;
- there is a violation of breathing;
- increased sweating;
- nasolabial triangle turns pale and acquires a bluish tinge.
Undress the baby and carefully look at the chest during breathing. Hidden pneumonia is indicated by uneven movement in this area. One side may lag far behind the other when inhaled.
Possible reasons
Physicians identify several factors that can provoke pneumonia.
Inflammation of the lungs without temperature, causes:
- Weakened immunity, which does not repel the ailment.
- Complications after a viral infection.
- Adapting the body to an antibiotic or antibacterial drug of a certain action.
- Intracellular pathogens (chlamydia, mycoplasma).
Correctly diagnose the ailment is capable only of the doctor. After listening to the lungs of a small patient, he can suspect a serious illness. Finally, to make sure of the diagnosis, X-rays can be used. In addition, the baby will be assigned a blood test. This study will determine the causative agent of the disease.
Caution - pneumonia!
In the case of the above described symptoms, the only true solution will be a referral to the therapist. It is recommended to reduce psychological and physical stress. If you suspect pneumonia, symptoms (without temperature) fully indicate it, do not yourself do the following things yourself.
- Take medication. Some bacterial infections react to drugs by abrupt reproduction and growth.
- Warm the chest. Gorchichniki, banks will only contribute to the spread of infection.
- Take antitussive drugs. Blocking the reflex, drugs lead to stagnation of phlegm in the lungs.
- To visit baths, saunas. A high temperature will trigger the spread of infection in the lower ways.
- To use antipyretic, anesthetizing medicines. Such drugs negatively affect the immune system.
Home methods
After you discuss with your doctor the symptoms of pneumonia without fever, folk remedies are allowed to be connected as additional fighting measures. Initially, it must be said that no home methods can not defeat this disease on their own.
It is recommended (only after discussion with the doctor) to introduce into the diet: garlic, onion, propolis, honey, elderberry, raspberry, hips. Of course, provided there is no allergy to these products.
Adult patients should stop smoking. The diet should be enriched with carbohydrates, proteins. It is advisable to eat foods containing a large number of vitamins A, B, C.
The patient should drink plenty of clean water. The room should be constantly well ventilated. It is useful to use an air humidifier.
Conclusion
Never ignore the signals that your body gives you. In fact even about the latent form of a pneumonia he necessarily signals the strongest weakness and the raised sweating. Remember, inflammation of the lungs without temperature is the situation in which an attentive attitude towards health (one's own or loved ones) can save a life.
syl.ru
Pneumonia without cough
Can there be pneumonia without a cough?
Whether there can be a pneumonia without a cough, such question many are set recently. Often doctors give an affirmative answer. Since all those common symptoms, for a particular disease, are usually described in the majority of a certain number of observed patients, but there are exceptions. In view of the fact that in every organism the reaction of response to any of the aggressive media will be individual, although in the majority of cases they are similar among many people, nevertheless, this is so. And the course of the disease with pneumonia, which is not accompanied by a cough or changes in temperature is a direct proof of that, even when X-ray studies are powerless, anything to detect. A special risk group for asymptomatic pneumonia is, unfortunately, children. When the vigilance of the parents is blunted by the absence of obvious signs of the disease, and they come late to see a doctor for reasons of incomprehensible deterioration of the baby's well-being. And the difficulty of detecting pneumonia of this kind and, as a rule, treatment with delay can promise severe and irreversible consequences for the health of the child.Pneumonia without cough: causes
Pneumonia without a cough causes its own and they are very likely to lie in the fact that the child:
- The immune status is broken;
- For him, inadequate antibiotic treatment was conducted;
- The cough reflex was systematically suppressed.
In addition to childhood, it is difficult to recognize the disease of pneumonia in elderly people. After all, their immunity already has a decreased reactivity because, and the symptoms of the ongoing disease can be poorly expressed. The weakening of the immune system leads to foci of chronic infections that occur in the body. This can gradually reduce its protection for the simple reason that the presence of pathogens is permanent and occurs the moment when habitual addiction is created, which nullifies the whole reaction, even to new incoming pathogens infection. An important role is played, and uncontrolled independent treatment with antibiotics for each occasion, which contributes to the loss of sensitivity to their action of bacteria and viruses due to their adaptation in the body.
Pneumonia without cough: symptoms
Pneumonia without a cough symptoms can manifest as a rise in temperature, which at least indicates the presence of inflammation in the body. The main difficulty in this situation will be the detection of the inflammatory process in the lungs. Diagnosis should be carried out in a differentiated manner, excluding links to other systemic diseases. Diagnose inflammation of the lungs, paying close attention to the presence of nonspecific signs that can be expressed:
- Pale skin;
- Presence of an unhealthy blush;
- Low tolerance to physical activity;
- Occurrence of dyspnea;
- Manifestations of tachycardia;
- Pain in the chest area accompanying any movement.
The special difficulty of conducting a diagnosis for hidden pneumonia is the examination of a young child. After all, he is not able to give a clear explanation for his well-being and often can simply get confused in his description. The following symptoms should become the cause for concern and visit to a doctor:
- The onset of severe weakness and fatigue gradually becoming permanent;
- Inability to physical loads, which do not exceed the usual;
- Loss of appetite;
- Drowsiness;
- Causeless whim.
After carrying out the necessary laboratory tests and X-ray, the doctor can prescribe the appropriate treatment when making an accurate diagnosis.
Pneumonia without fever (with a cough)
Pneumonia without temperature, but with a cough can also manifest itself with weakness, the appearance of dyspnea and excessive sweating. This condition may be due to the fact that the activity of immunity is too low. It requires a thorough medical examination with additional diagnostic methods, since the patient's condition can only get complicated. Sometimes pneumonia occurs because of not treated bronchitis smoothly flowing into it. It is difficult for an organism to respond to an outbreak of a new infection, because it is still under the influence of anti-inflammatory drugs. Suspect anomalies and conduct a thorough examination should the patient have a cough duration of more than two weeks, or its increasing dynamics, not accompanied by febrile state.
Pneumonia without cough: treatment
Treatment of pneumonia without coughing is usually very difficult. After all, the cough reflex is nothing more than a kind of protection of the body from all kinds of pathogens of the respiratory tract infection. When it is suppressed, the functionality of the bronchial tree is disrupted, which leads to a violation of the spontaneous elimination of the inflammatory secretion. And this only aggravates the course of the disease. If it is not possible to resume the cough reflex, bronchial cleansing is performed by the method of sanation with the procedure of bronchoscopy. As auxiliaries, as a rule, bronchodilator and mucolytic drugs are prescribed. To a considerable extent, healing is facilitated by physical exercises and physiotherapy. The use of folk remedies and alternative medicine is welcomed. Cope with the disease of pneumonia is possible only with the use of an integrated approach to treatment, where mandatory specific antimicrobial therapy and the use of anti-inflammatory drugs, regardless of whether there is a temperature reaction. It should be remembered that pneumonia is not the case where it is appropriate to use self-medication, especially antibacterial medication. Because the wrong choice of the drug is likely that the causative agent of the disease is simply not sensitive to its action. As a result, the treatment will not yield results, and the disease, continuing to progress, will move into a more complex form.
kashelb.com