Inflammation of the lungs in children

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 commonplace 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 most often 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 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

Inflammation of the lungs - symptoms in children

The phrase "pneumonia" and the term "pneumonia" are synonyms. But in everyday life people prefer to call the disease just pneumonia. The term "pneumonia" is used, first of all, by physicians.

Causes of pneumonia in children

Inflammation of the lungs is a fairly common disease, frequent in children due to the peculiarities of the structure of the respiratory system. As a rule, the disease is secondary, that is, a complication after an acute respiratory viral infection, influenza, bronchitis, intestinal infection, the cause of it are numerous bacteria, such as streptococci and pneumococci.

This is a common opinion. But not everyone knows that pneumonia can also occur after a fracture, after a severe poisoning and a burn. After all, lung tissue, in addition to the respiratory function, also performs blood filtration, neutralizing the decay products and various harmful substances that are formed when tissues die. Inflammation of the lungs in infants can also occur as a result of congenital heart disease, immunodeficiency, and in newborns - due to the ingress of the amniotic fluid into the respiratory tract during childbirth.

Symptoms of pneumonia in children

In children, signs and course of pneumonia directly depend on age. The smaller the child, the less obvious they are, like older children. Any cold can develop into pneumonia due to the fact that the infant epithelium, lining the airways, has a loose, loose structure, and it easily hosts viruses.

Sputum, which is assigned the role of protector of lung tissue, ceases to perform its functions. It becomes more viscous, as the body loses fluid due to increased temperature, and begins to clog the bronchi, making breathing difficult. In the foci of obstruction accumulate pathogenic microbes, and in this place inflammation begins.

The temperature of the body can be in the range 3 ° - 3 °, but it can rise to 39 ° and higher.

A prolonged cough, at first dry, and then wet, is almost the main indicator of the disease. Sometimes there may be pain in the chest, but at an older age, an ache in the body.

So, if, against the background of a common cold, the baby persistently holds the temperature for more than three days, it is advisable to call a doctor who will direct the child to an X-ray. Because it is with his help that the diagnosis of "pneumonia" is made.

Treatment of pneumonia in children

As with the treatment of the bulk of colds, due consideration should be given to the conditions in which the affected child is in treatment of pneumonia.

The air should be cool and damp. If you do not have a household air humidifier, you can use the simple method of placing water containers in the room and hanging wet terry towels on the batteries. Air should in no case be overheated, because so much more liquid will lose the child. Daily wet cleaning should be done without the use of chemicals.

The drinking regime must be observed very strictly to avoid dehydration and intoxication of the body. You can drink any liquid in a warm form to your child.

The temperature is below 3 °, as a rule, does not get off, so as not to interfere with the production of interferon, which fights the disease.

Both bilateral and unilateral pneumonia in children are treated equally.

The main drug treatment for pneumonia is taking antibiotics. Assign them in the form of tablets, suspensions or intramuscular injections, depending on the severity of the disease.

Parents need to remember that pneumonia in children, especially the breast, is a serious illness. And, if it is treated incorrectly, it is fraught with complications. In general, the treatment of young children is carried out in a hospital.

WomanAdvice.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, within a year, it dies from pneumonia & g; about 1000 children. Basically, this terrible number unites infants who died from pneumonia in the age of 1 year.

The main causes of the fatal outcome of pneumonia in children:

• Later, parents applied for medical help.
• Later, the diagnosis and delay of the correct treatment.
• Presence of concomitant chronic diseases that worsen the prognosis.

In order to timely establish an accurate diagnosis and take measures to treat a dangerous disease, you need to know its external signs - symptoms.

The main symptoms of pneumonia in children:

• Fever - increase in body temperature to high figures (8 8 ° C).
• Dyspnoea - increased frequency of respiration more than 40 per minute (in children 1-6 years).
• Cough dry or with phlegm.
• Appearance of cyanotic coloring of the skin of the lips, nasolabial area, fingertips.
• Changes in respiratory noise in the lungs during listening (wheezing, hard breathing).
• Intoxication, expressed general weakness, refusal to eat.

The increase in body temperature in a child is the first symptom of many diseases, for example, a common viral infection (ARI). In order to recognize pneumonia, we must remember: an important role is played not by the height of the fever, but by its duration. For microbial inflammation of the lungs it is characteristic continuation of fever for more than 3 days against the background of competent treatment of viral & g; infection.

If we evaluate the significance of the symptoms for the diagnosis of pneumonia in children, the most terrible sign will be the appearance of dyspnea. Shortness of breath and tension of additional muscles are more important signs than having wheezing when listening to the chest.

Cough is a symptom of pneumonia in children. In the early days of the disease, cough can be dry. With the resolution of acute inflammation of the lung tissue, the cough will become productive, moist.

If a child with a respiratory viral infection (ARI) has similar symptoms, an urgent call for a doctor is necessary. Underestimation of the severity of the baby's condition can lead to sad consequences - the development of acute respiratory failure and death from pneumonia.

The doctor will examine the small patient, prescribe an examination and an effective treatment. Listening to the lungs in the early days of the disease may not reveal characteristic signs of inflammation. The presence of disseminated wheezing when listening is often a symptom of bronchitis. To clarify the diagnosis for suspected pneumonia, an X-ray of the lungs is necessary. X-ray symptoms of pneumonia are darkening (infiltration) of pulmonary fields, which confirms the diagnosis.

Laboratory Symptoms of Pneumonia

Valuable information about the fact of inflammation in the body carries a general blood test. Signs that increase the presence of pneumonia: a high content of white blood cells in 1 cu. mm blood (more than 15 thousand) and an increase in ESR. ESR is the sedimentation rate of red blood cells. This analysis reflects the amount of inflammatory metabolic products in the liquid part of the blood. The magnitude of ESR shows the intensity of any inflammation processes, including inflammation of the lungs.

How to determine the risk of a child with pneumonia?

The following factors are identified that increase the risk of lung inflammation in children:

• Delayed physical and mental development of the child.
• Low weight of a newborn baby.
• Artificial feeding of a baby under the age of 1 year.
• Refusal of vaccination against measles.
• Pollution of air (passive smoking).
• Overcrowded dwelling, where the baby lives.
• Smoking of parents, including mother's smoking during pregnancy.
• Lack of microelement of zinc in the diet.
• Mother's inability to care for an infant.
• Presence of concomitant diseases (bronchial asthma, heart disease or digestive system).

What forms can the disease have?

Pneumonia in children is different for reasons and mechanism of occurrence. The disease can affect the entire lobe of the lung - this is a shared pneumonia. If the inflammation occupies a part of the lobe (segment) or several segments, it is called segmental (polysegmental) pneumonia. If the inflammation is covered by a small group of pulmonary vesicles, this variant of the disease will be called "focal pneumonia".

In inflammation, passed to the respiratory tissue of the bronchi, the disease is sometimes called bronchopneumonia. The process, caused by viruses or intracellular parasites such as chlamydia, is manifested by swelling (infiltration) of the perivascular tissue of the lungs from both sides. This type of disease was called "bilateral interstitial pneumonia." These symptoms of difference can be determined by medical examination and X-ray examination of sick children.

Inflammation of the lungs in children doctors are divided according to the conditions of origin for domestic (out-of-hospital) and hospital (hospital). Separate forms are intrauterine pneumonia in newborns and pneumonia with a pronounced lack of immunity. Community-acquired (home) pneumonia is called inflammation of the lungs, which has arisen in ordinary home conditions. Hospital (nosocomial) pneumonia is a case of illness that occurs after 2 or more days of the child's stay in the hospital for another reason (or within 2 days after discharge from there).

Mechanism of the development of pneumonia

The entry of a microbial pathogens into the respiratory tract can occur in several ways: inhalation, swallowing of nasopharyngeal mucus, dissemination through the blood. This way of introducing a pathogenic microbe depends on its kind.

The most frequent causative agent of the disease is pneumococcus. The microbe enters the lower parts of the lungs by inhaling or swelling of mucus from the nasopharynx. Intracellular parasites, such as mycoplasma, chlamydia and legionella, enter the lungs by inhalation. The spread of infection through the blood is most typical for infection with Staphylococcus aureus.

The type of causative agent that causes pneumonia in children depends on several factors: the age of the child, the place of origin of the disease, and also from the previous treatment with antibiotics. If within 2 months before the present episode the baby has already taken antibiotics, then the causative agent of the current inflammation of the respiratory tract can be atypical. In 30-50% of cases, community-acquired pneumonia in children can be caused by several types of microbes at the same time.

General rules for the treatment of pneumonia in 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:

• Increasing the number of breaths & g; 0 in 1 min for infants under the age of one year, and for children older than the year, shortness of breath & g; 0 in 1 min.
• The retraction of the intercostal spaces and the jugular fossa (fossa at the beginning of the sternum) with respiratory movements.
• Moaning breathing and violation of the right rhythm of breathing.
• Fever that does not respond to treatment.
• Violation of the child's consciousness, the appearance of convulsions or hallucinations.

In uncomplicated course of the disease, body temperature decreases within the first 3 days after initiation of treatment with antibiotics. External symptoms of the disease gradually decrease in intensity. X-ray signs of recovery can be seen in the pictures of the lungs no earlier than 21 days after the start of antibiotic treatment.

In addition to antimicrobial treatment, the patient must comply with bed rest, plenty of drinking. Expectorants are prescribed if necessary.

Prevention of pneumonia

Protection from respiratory viral infection plays an important role in preventing the incidence of pneumonia.

It is possible to carry out vaccination against the main pathogens of pneumonia in children: a hemophilic rod and pneumococcus. At present, safe and effective vaccine-tablets are developed against microbes that cause pneumonia and bronchitis. Preparations from this class "Bronchovax" and "Ribomunil" have a children's dosage. They are appointed by the doctor to prevent such a dangerous disease as pneumonia.

ingalin.ru

Pneumonia in children, its causes, symptoms and treatment principles

Pneumonia is an acute inflammatory infectious disease that affects the lower parts of the respiratory tract - the lungs themselves. Pneumonia in children under 6 years of age often develops as a result of a viral infection, complicated by the attachment of bacterial flora, after angina, bronchitis and other colds.

In childhood, especially in children younger than 1 year old, this disease can be severe enough and even cause respiratory failure or severe intoxication of the body, so even a suspicion of this disease should be the reason for seeking medical help and for diagnostics.

Etiology and pathogenesis

Inflammation of the lungs or pneumonia in children usually develops as a result of the entry of pathogenic microorganisms into the lower respiratory tract from the upper ones. Weakened by the illness of the child's body can not cope with the causative agent of the disease and then the inflammatory process begins in the alveoli and small bronchioles. Bacteria that enter the lungs actively multiply and release toxins that cause intoxication body - increased body temperature, headache, general deterioration and other similar symptoms.

Then the alveoli gradually fill with mucus, pus and other inflammatory fluids that appear as a result of vital activity microorganisms, because of this, normal gas exchange in the lungs is disrupted, respiratory failure develops, and the following appear symptoms of the disease - a strong cough, shortness of breath, blunting percussion sound, wheezing in the lungs and the emergence of foci of inflammation in chest radiograph.

The patient's condition is in direct proportion to the size of the affected area - with focal lesions of severe respiratory failure not there is a cough and a slight shortness of breath and the patient's condition is satisfactory and the disease is easily cured by admission antibiotics. If the whole or whole of the lung is affected by inflammation, the clinical picture of the disease completely changes, the condition of the sick child can be very difficult, up to a menacing life.

In most cases, pneumonia develops as a complication after the flu, bronchitis, sore throat or cold. The causative agents of the disease in children are often bacteria, less often viruses or other microorganisms - fungi or protozoa. Since it is necessary to start treatment, as soon as a suspicion of a disease appears, it is very important to at least approximately determine the pathogen - this determines the success of the therapy in the treatment of the child.

The causes of the development of the disease in children can be different - from massive infectious infection to hypothermia, which caused a drop in immunity. Diagnosis of the disease should include the determination of the type of pathogen, but since this takes a long time, the treatment starts with the empirical application of broad-spectrum antibiotics.

1. Most often pneumonia in children develop at the age of 6 months to 6 years - the causative agents of the disease in this case in children in 50% of cases is pneumococcus, about 10% - a hemophilic rod, less often - other pathogens - staphylococcus, mycoplasma, chlamydia or mushrooms.

2. In 7-15 years, children from pneumonia suffer much less often, pneumococcal causes about 30% of infections, less often - the causative agent is streptococcus, and more than 50% of all diseases cause atypical pathogens - mycoplasma, chlamydia.

3. Pneumonia in newborn infants and children up to 6 months of age - at this age from pneumonia preterm infants, children with developmental defects of the respiratory system, or those born with immunodeficiency. The causes of the development of the disease at this age are insufficiently formed respiratory organs, weakened organism and problems in the work of the immune system.

Signs of pneumonia

The first signs of the disease appear usually a few days after the onset of a viral infection or a cold. Acute pneumonia in children is broken fast enough, the deterioration of the condition can develop within a few hours and therefore even a suspicion of pneumonia should be the reason for contacting a doctor.

Acute pneumonia is manifested by the following symptoms:

1. A rise in body temperature is a symptom of pneumonia with a sharp increase in body temperature to 39-41 degrees and this temperature does not fall for several days, unlike acute respiratory disease and colds.
2. Deterioration of the general condition of the patient is a symptom of the disease pneumonia is characterized by a sharp weakness, fatigue, refusal to eat, there is increased sweating, pallor of the skin or cyanosis nasolabial triangle.
3. Cough - one of the most characteristic signs of the disease - cough can be dry or wet, with the separation of purulent sputum. Coughing attacks greatly deplete the patient, especially at night. Cough with pneumonia is permanent, painful, less often the cough can be paroxysmal or even with blood streaks in the sputum.
4. Shortness of breath and respiratory failure - increased respiration, lack of air, pale skin - all these are characteristic symptoms of pneumonia.
5. When breathing in the child, one can notice the retraction of the intercostal spaces or the lag of one half of the thorax from the other.

Clinical picture of the disease in children under 1 year old

In newborns and children under 1 year old, the symptoms of pneumonia may be very different from the usual ones and it is not so easy to recognize the disease. In young children, the characteristic signs of pneumonia are cough, an increase in body temperature may be absent or mild.

At this age, the changes in the state of the nervous system and the general deterioration of the child's condition come to the fore - it becomes sluggish, capricious, refuses food and constantly cries. Gradually, signs of respiratory insufficiency are getting worse - shortness of breath, cyanotic nasolabial triangle, quickening of breathing, coughing and entraining of intercostal spaces.

Diagnosis of the disease

Diagnosis of the disease includes examining the sick child, collecting anamnesis, percussion and auscultation of the chest, and for confirmation of the diagnosis is X-ray examination of the lungs, sputum and mucus analysis and examination of respiratory function in child. Diagnosis of pneumonia is not particularly difficult - the characteristic clinical symptoms and X-ray examination allows you to quickly diagnose. If the diagnosis is impossible - the diagnosis is made based on the clinical picture, percussion and auscultation.

Treatment of pneumonia

To start to treat a pneumonia it is necessary at the first signs of disease. Where the treatment will be performed - in a hospital or at home, is determined by the doctor and depends on the following conditions:

1. age of the child - all children of the first year of life with pneumonia are subject to compulsory admission;
2. severity of the child's condition;
3. presence or absence of concomitant diseases.

Treatment of pneumonia in children includes: proper child care, proper nutrition and drinking regimen, taking antibiotics and inhalation with medications to cough.

Care for a sick child

After the diagnosis of the disease was carried out, the child should be assigned bed rest and organize proper nutrition. The diet for pneumonia should include a sufficient amount of fresh vegetables and fruits, lean meat, cereals and dairy products. Nutrition during illness should be easy and, at the same time, rich and rich in vitamins and nutrients.

In addition, it is very important to adhere to the drinking regime - this will avoid dehydration and improve the condition of the sick child. For children over 2 years old - the norm of the drunk liquid is 2, -25 liters per day, it is best to give the sick child the juices, fruit drinks, compotes, warm milk or still mineral water. Warm alkaline drink is a good way to soften and relieve cough and reduce body temperature.

Drug therapy

1. Antibiotics - the appointment of a course of antibiotics - the gold standard for the treatment of pneumonia. For mild and moderate forms of the disease, antibiotics are given orally, in more severe forms, as injections. Most commonly used are the following antibiotics: penicillins (ampicillin, ammox, amoxiclav), cephalosporins (ceftriaxone, cefuroxine, cephalexin), macrolides (aziromycin, erythromycin). When carrying out antibiotic therapy, it is necessary to prescribe pro and prebiotics for the prevention of dysbacteriosis (linex, hilakforte, bifidum bacterin, lactobacterin). If after the start of antibiotics, within 24-48 hours there was no improvement, it is required to change the way of administration of drugs or to change the group of antibiotic. Depending on the severity of the disease, the course of treatment is from 5-7 to 10-14 days.
2. To get rid of cough and restore normal airway patency appoint inhalation and taking mucolytics and expectorants. Inhalations with antiseptic solutions or bronchodilators are prescribed in the early days of the illness, such inhalations facilitate breathing, help liquefy and facilitate the excretion of phlegm. In addition, inhalations are prescribed during the recovery period - to completely free the respiratory tract from microorganisms and faster regeneration of the mucous membrane. Cough with pneumonia can still a few weeks after recovery to torment the patient and then inhalations with medications will be the best way to get rid of it.
3. After the state of the sick child improves, he is given a general restorative treatment - appoint vitamins, immunostimulants, physiotherapy, therapeutic massage and respiratory gymnastics. This helps to get rid of cough and stagnant phenomena in the lungs.

Prevention of pneumonia in young children includes timely treatment of all colds and foci of infection, increasing the overall immunity of the child - intake of vitamins, nutrition with sufficient vitamins and nutrients, hardening, physiotherapy, outdoor exercise and sufficient physical activity.

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