Bronchopneumonia in children: medication and alternative treatment at home. Why is bronchopneumonia dangerous in children: causes and symptoms of inflammation, treatment and prevention of the disease

You are a fairly active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle, and your body will delight you throughout your life, and no bronchitis will bother you. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and strong emotional overload.

The phrase “pneumonia” is very scary for parents. At the same time, it does not matter at all how old or months old the child is, this disease is considered one of the most dangerous among mothers and fathers. Is this really so, how to recognize pneumonia and how to treat it correctly, says the famous pediatrician, author of books and articles about children's health Evgeny Komarovsky.

About the disease

Pneumonia (this is what doctors call what is popularly called pneumonia) is a very common disease, inflammation of the lung tissue. By one concept, doctors mean several ailments at once. If inflammation does not occur infectious nature, the doctor will write “pneumonitis” on the card. If the alveoli are affected, the diagnosis will sound different - “alveolitis”; if the mucous membrane of the lungs is affected - “pleurisy”.

Inflammatory process in lung tissue are caused by fungi, viruses and bacteria. There are mixed inflammations - viral-bacterial, for example.

All illnesses included in the concept of “pneumonia” medical reference books are classified as quite dangerous, since out of the 450 million people from all over the world who get sick with them per year, about 7 million die due to incorrect diagnosis, incorrect or delayed treatment, as well as from the rapidity and severity of the disease. Among the deaths, about 30% were children under 3 years of age.

Based on the location of the source of inflammation, all pneumonias are divided into:

• Focal;
• Segmental;
• Equity;
• Drain;
• Total.

Also, inflammation can be bilateral or unilateral if only one lung or part of it is affected. Quite rarely, pneumonia is an independent disease; more often it is a complication of another disease - viral or bacterial.

Most dangerous pneumonia considered for children under 5 years of age and the elderly; among such patients the consequences are unpredictable. According to statistics, they have the highest mortality rate.

Evgeny Komarovsky claims that the respiratory organs in general are the most vulnerable to various infections. It is through the upper Airways(nose, oropharynx, larynx) most of the germs and viruses enter the child’s body.

If the baby’s immunity is weakened, if the environmental conditions in the area where he lives are unfavorable, if the microbe or virus is very aggressive, then the inflammation does not linger only in the nose or larynx, but goes down to the bronchi. This disease is called bronchitis. If it cannot be stopped, the infection spreads even lower - to the lungs. Pneumonia occurs.

However airborne infection is not the only one. If we consider that the lungs, in addition to gas exchange, perform several other important functions, it becomes clear why sometimes the disease appears in the absence of a viral infection. Nature has entrusted the human lungs with the mission of moisturizing and warming the inhaled air, purifying it from various harmful impurities (the lungs act as a filter), and also similarly filter the circulating blood, releasing many harmful substances from it and neutralizing them.

If the baby has undergone surgery, broken a leg, ate something wrong and got severe food poisoning, burned, cut, this or that amount of toxins, blood clots, etc. enters the blood in various concentrations. The lungs patiently neutralize this or remove it out with the help of defense mechanism- cough. However, unlike household filters, which can be cleaned, washed or thrown away, lung filters cannot be washed or replaced. And if one day some part of this “filter” fails, becomes clogged, the very disease that parents call pneumonia begins.

The causative agents of pneumonia can be the most various bacteria and viruses. If a child gets sick while in the hospital with another illness, then in a high degree of probability he will have bacterial pneumonia, which is also called hospital or sick leave. This is the most severe of pneumonia, since in conditions of hospital sterility, the use of antiseptics and antibiotics, only the strongest and most aggressive microbes survive, which are not so easy to destroy.

The most common occurrence in children is pneumonia, which arose as a complication of a viral infection (ARVI, influenza, etc.). Such cases of pneumonia account for about 90% of the corresponding childhood diagnoses. This is not even due to the fact that viral infections are “scary”, but because they are extremely widespread, and some children get them up to 10 times a year or even more.

Symptoms

To understand how pneumonia begins to develop, you need to have a good understanding of how the respiratory system generally works. The bronchi constantly secrete mucus, the task of which is to block dust particles, microbes, viruses and other unwanted objects that enter the respiratory system. Bronchial mucus has certain characteristics, such as viscosity, for example. If it loses some of its properties, then instead of fighting the invasion of foreign particles, it itself begins to cause a lot of “trouble.”

For example, mucus that is too thick, if the child breathes dry air, clogs the bronchi and interferes with normal ventilation of the lungs. This, in turn, leads to congestion in some parts of the lungs - pneumonia develops.

Often pneumonia occurs when the child’s body rapidly loses fluid reserves and thickens bronchial mucus. Dehydration of varying degrees can occur with prolonged diarrhea in a child, with repeated vomiting, high heat, fever, or with insufficient fluid intake, especially against the background of the previously mentioned problems.

Parents may suspect pneumonia in their child based on a number of signs:

• Cough has become the main symptom of the disease. The rest, who were present earlier, gradually disappear, and the cough only gets worse.
• The child became worse after improvement. If the disease has already subsided, and then suddenly the baby feels unwell again, this may well indicate the development of a complication.
• The child cannot take a deep breath. Every attempt to do this results in a severe coughing attack. Breathing is accompanied by wheezing.
• Pneumonia may manifest as severe pallor skin against the background of the symptoms listed above.
• The child has shortness of breath, and antipyretic drugs, which previously always quickly helped, ceased to have an effect.

It is important not to engage in self-diagnosis, since there is a 100% way to establish the presence mild inflammation It’s not even the doctor himself, but an X-ray of the lungs and a bacterial culture of the sputum, which will give the doctor an accurate idea of ​​which pathogen caused the inflammatory process. A blood test will show the presence of antibodies to viruses if the inflammation is viral, and Klebsiella found in the stool will lead to the idea that pneumonia is caused by this dangerous pathogen. At home, the doctor will definitely listen and tap the area of ​​the little patient’s lungs, listen to the nature of wheezing when breathing and during coughing.

Is pneumonia contagious?

Whatever causes pneumonia, in almost all cases it is contagious to others. If these are viruses, they are easily transmitted to other family members through the air, if bacteria - by contact, and sometimes airborne. Therefore, a child with pneumonia should be provided with separate dishes, towels, and bed linen.

Treatment according to Komarovsky

Once the diagnosis is made, the doctor will decide where the child will be treated - at home or in the hospital. This choice will depend on how old the child is and how severe his pneumonia is. Pediatricians try to hospitalize all children under 2 years of age, since their immunity is weak, and for this reason the treatment process must be constantly monitored by medical personnel.

All cases of obstruction during pneumonia (pleurisy, bronchial obstruction) are the basis for hospitalization of children of any age, since this is additional factor risk, and recovery from such pneumonia will not be easy. If the doctor says that you have uncomplicated pneumonia, then with a high degree of probability he will allow you to treat it at home.

Most often, pneumonia is treated with antibiotics, and it is not at all necessary that you have to give a lot of painful and scary injections.

The doctor will determine antibiotics that can quickly and effectively help based on the results of a sputum culture test.

Two-thirds of cases of pneumonia, according to Evgeniy Komarovsky, are perfectly treated with tablets or syrups. In addition, expectorants are prescribed, which help the bronchi to clear accumulated mucus as quickly as possible. At the final stage of the child’s treatment, physiotherapy and massage are indicated. Also, children undergoing rehabilitation are advised to take walks and take vitamin complexes.

If treatment takes place at home, it is important that the child is not in a hot room, drinks enough fluids, vibration massage, promoting the discharge of bronchial secretions.

Treatment for viral pneumonia will be similar, with the exception of taking antibiotics.

Prevention

If a child gets sick (ARVI, diarrhea, vomiting and other problems), you must ensure that he consumes enough fluid. The drink should be warm so that the liquid can be absorbed faster.

A sick baby should breathe clean, moist air. To do this, you need to ventilate the room, humidify the air using a special humidifier or using wet towels hung around the apartment. The room should not be allowed to get hot.

Bronchopneumonia in children (focal, bronchial or bronchogenic pneumonia) is an inflammatory disease of the bronchi and the place where the main bronchus enters. Individual parts are affected respiratory organ, small foci of inflammation form. The disease most often occurs in children aged 2–5 years and is more severe than in adults.

Bronchopulmonary inflammation is dangerous due to complications: convulsions, lung abscess, heart and kidney damage, otitis media, oxygen and respiratory failure. The disease can recur and be fatal.

The causes of bronchial pneumonia are varied. One of them is inflammatory processes associated with infection. The causative agents of the disease in children in 90% of cases include the following bacteria:

• pneumococci (predominant);
• Staphylococcus aureus;
• Klebsiella;
• influenza stick;
• hemophilus influenzae;
• coli;
• mycoplasma.

In children, 10% of morbidity cases are due to viruses, fungi, and mycoplasma. Pathogenic microflora can come from the air, but small child the main reason for the development of the disease is the spread of infection from the bronchi and upper respiratory tract to the lungs. The infection does not always enter the body from the outside: pathogenic bacteria are activated in other pathologies:

• ARVI;
• whooping cough;
• angina;
• bronchitis;
• otitis;
• kidney diseases.

Another reason is the structural features of the respiratory tract. Children don't have everything sections of the lung have expanded completely, and the underdeveloped bronchial tree cannot perform the drainage and cleansing function in full. This, as well as the child’s shallow breathing, contributes to congestion in the lungs and the proliferation of bacteria.

Another reason for the development of bronchopneumonia in children is often low immunity. It is difficult for a weakened body to resist infection, so any disease can become the onset of focal pneumonia. For example, the flu causes changes in the bronchial mucosa. They become thinner, and pathogenic microflora easily enters the respiratory system, multiplying and provoking hilar inflammation of the lung.

The causes of bronchial pneumonia also include exposure to physical and chemical agents:

• dust;
• radiation;
• evaporation of harmful substances.

Symptoms of pneumonia

When a bacterial infection enters the lungs, the body's immune response initiates an inflammatory process. Pathology of the lung parenchyma leads to disruption of gas exchange. As a result, exudate containing pathogenic microflora. A violation occurs bronchial obstruction. At severe course The disease develops oxygen starvation, which poses a threat to the child’s life.

Bronchopneumonia in children can begin in two ways:

• Acute, with pronounced symptoms.
• As secondary, against the background of inflammation of the upper respiratory tract, or other pathologies. The disease is not diagnosed immediately: it may appear gradually.

Focal pneumonia is recognized by the following symptoms:

• In a child, at first it is dry. Becomes more intense in the evening.
• Shortness of breath, rapid breathing.
• . Can be unilateral or bilateral.
• Weakness, the child refuses to eat.
• Heat. Body temperature rises in the first days to 39 °C and above.
• Rapid heartbeat (up to 110 beats per minute).
• The skin becomes pale, with a grayish-blue tint.

If hilar pneumonia occurs as a secondary infection, parents should be alerted to the deterioration in the child’s well-being. Sometimes bronchopneumonia occurs without fever or cough. She is accompanied by lethargy, anxiety, unhealthy blush, and drowsiness. Any changes in the child’s behavior are a signal for a medical examination. It is impossible to recognize an atypical form of inflammation without medical diagnosis and tests.

Diagnosis of suspected bronchopneumonia

Diagnosis begins with examining the child and collecting anamnesis: the doctor needs to know the dynamics of the development of the disease. During the examination, attention is paid to the skin, body temperature, condition of the lymph nodes and oropharyngeal mucosa.

The doctor then performs auscultation (listening to the chest). He pays attention to the work of the heart (muffled sounds), the size of the liver, evaluates changes in breathing: shortened sound when tapping the lung, weakened and crunching (crepitus). Sometimes during auscultation the doctor does not detect breath sounds in the lung or part thereof.

During diagnosis, the type of disease is determined.

Occurs most often. The reason lies in the structural features of the main right bronchus: it is wider and shorter. This makes it easier for bacteria to enter bottom part lung

It occurs less frequently in children. Diagnosed more difficult due to the proximity of the heart. Symptoms of left-sided bronchopneumonia are less pronounced than with right-sided bronchopneumonia, so treatment may not begin in a timely manner. This form of the disease is dangerous because in 5% of cases it is fatal. Left-sided bronchopneumonia is characterized by aching pain on the left side of the chest, aggravated by inhalation.

It is often diagnosed in children. Colds are caused by chronic diseases, reduced immunity, allergies.

Additional Research

For diagnosis, laboratory and instrumental studies. The first include blood and sputum tests (if wet cough). A culture is made from bronchial secretions to determine the pathogen.

A general blood test determines the nature of the infection: an increased number of leukocytes occurs with bacterial infection, and lymphocytes - with viral infection. Determine the presence of antibodies to mycoplasma. Pay attention to the ESR: this indicator confirms the presence of an inflammatory process. If there are suspicions of complications in the liver and kidneys, a biochemical blood test is performed.

The main thing in the diagnosis of pneumonia is x-ray examination. It is carried out in two projections: direct and lateral. At the beginning of the disease, a change in the pulmonary pattern is noticeable in the affected lobe with normal transparency of the lung. As the disease progresses, the affected pulmonary segment appears darkened.

IN as a last resort In case of severe inflammation in children, computed tomography is also performed.

Drug treatment of pneumonia in children

Bronchopneumonia in children can be treated at home, provided that it occurs without complications. Considering that the patients are small children, it is better to be treated in a hospital under the supervision of a doctor who daily monitors the effectiveness of medications.

In the treatment of bronchopneumonia bacterial etiology Antibiotic therapy is the mainstay. It's not always possible to find the right drug the first time. If positive dynamics in treatment are not observed within 2-3 days, the medicine is changed. The course of treatment with a properly selected antibiotic is 5–10 days.

There are several lines of antibiotic agents. Treatment begins with the use of protected penicillins (Amoxiclav, Augmentin - orally, Ampiox, Ampisulbin - injections).

If treatment is insufficiently effective, medications are prescribed wide range belonging to the following line:

• cephalosporins (Cefuroxime, Zinnat);
• semisynthetic penicillins (Amoxicillin,);
• carbapenems (Cilastatin, Meropenem);
• macrolides (, Clarithromycin).

The third line of antibacterial agents is fluoroquinolones (rarely used in pediatrics). These synthetic drugs, while not antibiotics, have strong antimicrobial activity. According to indications, other types of antibiotics can be used: tetracyclines and aminoglycosides (Penicillin,).

Treatment of inflammation of a viral or fungal nature is carried out:

antiviral drugs (Oseltamivir, Ingavirin, Saquinavir, Didanosine, Acyclovir);

antimycotic drugs (Ketoconazole, Fluconazole).

Ancillary drugs

In parallel with antimicrobials a variety of treatments are used in treatment drug therapy:

• Antipyretic.
• Preparations for thinning sputum.
• At long-term use antibiotics are prescribed probiotics (Bifidumbacterin, Linex) and antifungals (Nystatin, Futsis, Levosin).
• Vitamins: A, P, B 2, B 12.
• in the form of nasal drops to prevent re-infection.

Children who are treated at home are given medications in the form of tablets, suspensions, and syrups. And the child who is on inpatient treatment, give intramuscular or intravenous injections.

Focal pneumonia, or bronchopneumonia, is inflammatory disease, which affects small areas of the lung. Bronchopneumonia most often develops in children younger age(up to 2-3 years). In today's article we'll talk more about this disease, consider the symptoms, causes and methods of treating the pathology. Recommendations for the treatment of bronchopneumonia from such a famous children's doctor and TV presenter as Evgeniy Olegovich Komarovsky will also be given.

Bronchopneumonia in children requires adequate and timely treatment, otherwise the outcome of the disease can be tragic. Therefore, parents should take this seriously this disease and take action at the first symptoms of the disease.

Bronchopneumonia, or focal pneumonia, develops in children when exposed to various bacteria and viruses. Most often, this disease is preceded by an upper respiratory tract infection. For example, the disease can be provoked by bronchitis or ARVI. The most common pathogens are streptococci, pneumococci and many viruses.

Pneumonia can also develop when food enters the respiratory tract, compression of the lungs by a tumor, inhalation of toxic gases, and also due to surgery.

Bronchopneumonia: symptoms

In children, this pathology is manifested by the following symptoms:

• pale skin;
• weakness;
• increased fatigue;
• headache;
• cough (both wet and dry) with sputum;
• shortness of breath;
• rapid heartbeat up to 110 beats per minute;
• wheezing when listening with a stethoscope;
• leukocytosis (increased white blood cells);
• increased ESR (erythrocyte sedimentation rate);
• an increase in body temperature to 39 ºС.

Foci of inflammation are usually concentrated in the bronchioles and are present either in both lungs (most often) or in one of them. Based on this, the child is diagnosed with right-sided bronchopneumonia, left-sided or bilateral. Foci of inflammation can only be detected using radiography. Most often in pediatrics, bilateral bronchopneumonia occurs in a child. With timely treatment, this pathology can be successfully treated.

Bronchopneumonia is the most dangerous in children without fever, although this condition is quite rare. The point is that exactly this form The disease most often goes unnoticed by parents. Due to the lack of adequate treatment, the process is delayed and aggravated. Parents should be alert to any deviations in the child’s behavior and well-being. This is the only way to detect the disease and begin treatment on time, thus protecting the baby from serious consequences.

Possible complications

Provided timely and high-quality treatment, the child will recover after 2-3 weeks. If treatment is delayed or carried out incorrectly, bronchopneumonia can provoke serious complications, namely:

• purulent otitis media;
• serous, or purulent, pleurisy;
• pericarditis;
• myocardial dystrophy;
• nephritis.

Bronchopneumonia in children: treatment

In such a difficult period, the baby needs special attention And proper care. This disease is very serious, so parents should definitely know how to treat bronchopneumonia in children.

Based on the results of blood tests and x-rays, the doctor will be able to make an accurate diagnosis and prescribe appropriate treatment. Therapy is aimed primarily at resolving inflammatory foci. Antibiotics should only be prescribed when severe cases- this is precisely what the famous children's doctor E. O. Komarovsky insists on. Bronchopneumonia in children, if provoked viral diseases should be treated with antiviral drugs. Antibiotics in this case will not only be ineffective, but can also cause serious complications. But in some situations you still cannot do without such potent medications. If the child’s temperature is very high, signs of intoxication are observed, the child is weakened, the use of antibiotics is justified. However, only a specialist should prescribe the required dose of medication. Self-medication can threaten not only the health, but also the life of the child. Dr. Komarovsky also points out the advisability of physiotherapeutic procedures and adherence to a diet. Regardless of whether the child has right-sided, left-sided or bilateral bronchopneumonia, treatment should be comprehensive and symptomatic, depending on the cause of the disease.

Therapy at home

Treatment of a typical form of bronchopneumonia can be carried out at home; more complex cases should be treated in a hospital. This is due to the fact that the outcome of some forms of the disease can be fatal, so constant monitoring by a specialist is very important. If bronchopneumonia is diagnosed in children, treatment should begin by contacting a pulmonologist (a specialist who deals with lung diseases). After consultation with a doctor, folk remedies can also be used to treat the disease.

Alternative medicine

Recipes will help improve your child’s well-being and speed up the healing process. traditional medicine.

Honey and birch buds

750 g buckwheat honey(if there is no such thing, you can use a regular one) heat over low heat, bring it to a boil. Add 100 g of birch buds to honey. Stir the mixture thoroughly and keep on low heat for 7-8 minutes. Afterwards, strain the mixture and cool. In glass boiled water dilute a teaspoon of the resulting mixture and give it to the child 30 minutes before bedtime.

Plantain

Collect plantain leaves, wash them thoroughly, squeeze and dry for some time. Then spread a large towel or sheet on the bed and spread plantain leaves on top in an even layer. Place the baby on top of them with his back, and attach the remaining leaves to his chest. Then wrap the child well in a woolen blanket and leave it there all night. Conduct this procedure should be done as many times as necessary.

Tar water

Pour 500 ml of medical tar into a sterile 3-liter jar, add boiling water to the top, close tightly and leave for 9 days in a warm place. Give a teaspoon of the resulting composition to the child before bedtime. The taste of the product is not very pleasant, so the baby can eat something sweet after it, the main thing is not to drink the medicine with water.

Use an awl to make several holes in a clean plastic cup. Peel the head of garlic and finely chop it. Place the mixture in a glass and let the child breathe over it for 15 minutes. It is recommended to carry out this procedure as often as possible.

Honey compress

The child's skin in the lung area should be well smeared with honey. Soak a clean cloth in a solution of water and vodka (1:3 ratio) and place on top. Then wrap the treated area cling film and wrap it in woolen cloth. The compress should be replaced with a new one twice a day.

Regime and diet

On initial stage illness, it is recommended to remain in bed. Be sure to ventilate and do wet cleaning daily in the room where the child is. After the body temperature has returned to normal, you are allowed to walk in the fresh air. However, it is important to be careful and prevent your baby from becoming hypothermic. 2-3 weeks after recovery, you can resume hardening procedures, physical exercise- no earlier than 5-6 weeks.

There are no food restrictions. It is important that the diet is balanced, with a high content of vitamins and proteins. It is necessary to ensure that meals are frequent and small. You should know that children are more susceptible to dehydration than adults. This threat is especially high against the background of elevated body temperature. Therefore, it is necessary to provide the child with a sufficient amount of fortified liquid, this can be warm fruit drinks, compotes, herbal teas, non-cold mineral water.

Physiotherapeutic treatment is recommended to begin after body temperature has normalized. Inhalations with medications that facilitate breathing and promote mucus discharge, as well as chest massages, will be useful.

Preventive measures

To prevent diseases such as bronchopneumonia in children, it is important to early childhood observe the rules of personal hygiene and lead a healthy lifestyle:

• wash your hands regularly with soap;
• maintain a balanced diet;
• devote enough time to physical activity;
• maintain a sleep and rest schedule.

Conclusion

Bronchopneumonia in children is, of course, serious illness, but it can be successfully treated provided all the specialist’s recommendations are followed. Parents always need to be alert and pay attention to the slightest changes in the child’s condition. Take care of your children and be healthy!

Left-sided bronchopneumonia in children (other names - focal, bronchial) is a hilar inflammation of the lungs, in most cases segmental, which is characterized by a small focus (usually in the bronchial region, which is where the name comes from), typical symptoms and diagnostic options. It is possible to provide qualified medical care for bronchopneumonia in children only after a final diagnosis has been established; this is important to understand.

Microorganisms and external causes that lead to the occurrence of this disease

The etiology of this type of pneumonia is the most common - pneumococci, streptococci, staphylococci, and very rarely - hemophilus influenzae. As a rule, bronchopneumonia (especially bronchial) is not an independent infection, but occurs as a complication of an already ongoing acute respiratory viral process (usually acute bronchitis). In addition, factors such as constant exposure to harmful gases, dust, and, in addition, viral infections that help reduce the body’s immune forces can contribute to the development of the inflammatory process.

Many microorganisms can lead to left-sided bronchopneumonia in children, and the symptoms of this disease will be the main point on which a preliminary diagnosis will be made, and then empirical treatment will begin.

Symptoms

Left-sided bronchopneumonia manifests itself acutely. The main symptoms include:

1. Signs of an increase in body temperature to febrile levels (above 38.0 Celsius) are an intoxication symptom.
2. Cough with large amounts of sputum.
3. Sometimes there may be pain in chest(unfavorable prognostic sign).
4. Signs of weakness, lethargy, apathy - asthenovegetative syndrome.

Foci of infection under a microscope.

As mentioned above, bronchopneumonia rarely occurs and develops as separate disease. From the anamnesis it will be possible to find out that more than one child in the children's group has fallen ill. Initially, manifestations of the most common cold(mild catarrhal and intoxication syndromes), and then deterioration occurs general condition sick. Appears very strong paroxysmal cough, with the release of a large amount of greenish-yellow sputum, severe fever appears (often against the background of an already normalized temperature). It is this sequence that indicates probable occurrence specifically bronchopneumonia.

Diagnostics

The entire diagnostic algorithm for focal pneumonia is not particularly complicated. It consists of clear, generally accepted points, namely:

Therapy

In the treatment of pneumonia in children, as well as in the treatment of a number of others pathological conditions organs of the respiratory system, antibiotic therapy is of leading importance. Naturally, the question immediately becomes, which antibiotic to choose? To which group should an antibiotic belong that can be prescribed to children under one year of age? According to all generally accepted standards, treatment of bronchopneumonia must begin with protected penicillins - these are the antibiotics Augmentin or Amoxiclav, one tablet (500 mg) or (if in suspension) 1-2 teaspoons 3 times a day (course of treatment - 10 days). Possibly intramuscular intravenous administration drugs of this group - antibiotics ampiox or ampisulbin, 3 injections per day, in a dosage adjusted to body weight (course of treatment - 7 days).

If the treatment of pneumonia with these antibiotics (protected with penicillins) turned out to be insufficiently effective, then it is necessary to include in the treatment regimen a cephalosporin series of antibiotics - ceftriaxone or cefuroxime, injections should be made twice a day, having previously calculated the dose based on the body weight and age of the child ( course of treatment – ​​7 days). You can also use a macrolide antibiotic here (one tablet once a day, course of treatment – ​​5 days), since the effectiveness of beta-lactam antibiotics is already in great doubt among many practicing doctors, such as Komarovsky. An antibiotic is the drug of choice No. 1 in this case.

It is imperative that a sick child undergoing antibiotic therapy against pneumonia be prescribed maintenance treatment with probiotics (yogurt, Linex or Laktovit) and prebiotics (Enterozermina), the course of treatment is 15 days. The essence of their difference is that when consuming probiotic capsules, the child receives ready-made microflora, while using a prebiotic, the child’s own intestinal microflora is stimulated.

Regarding how many days a child will be sick while receiving an antibiotic - no more than 7-10 days, despite the fact that an improvement in symptoms will occur on the 2nd day with rational antibiotic therapy. It is necessary, among other things, to prescribe expectorants and antitussives - flavamed and erespal, 1 tablet 3 times a day for each drug, course for 10 days.

As an important addition to the main course of treatment, nebulizer therapy is recommended: inhalations with Borjomi mineral water for 5 minutes 3 times a day (potentiate expectorant effect therapy used), inhalation with dioxidine for 5 minutes 3 times a day (disinfecting effect on the respiratory tract), inhalation with ambrobene (solution) for 5 minutes 3 times a day.

A similar scheme is effective for the treatment of pneumonia of any classification category, with the exception of severe hospital infections and atypical forms - in these cases, the antibiotics mentioned above will not be effective.

conclusions

Bronchopneumonia in children (focal) is not the most dangerous of all pneumonias found in children, and therefore it can be completely cured both in a hospital setting and on an outpatient basis. The main point in the management of this disease is the correctly selected antibiotic. In no case should you try to cure bronchopneumonia (bronchopulmonary inflammation) with folk remedies, herbal infusions and so on - you only need a proven antibiotic. And then it is quite possible to cure even at home, within seven to eight days. Another important point that the child’s parents need to understand is that in case of the slightest suspicion of pneumonia (or even just the presence of an acute respiratory viral infection that does not go away for a long time), they need to consult a doctor, and not bring the child to such a state where manifestations of respiratory failure will be visible. Untimely medical care provided in this case, may cause the patient to be admitted to the intensive care unit and intensive care– this is in best case scenario. So parents just need to be responsible.

Video: Pneumonia - School of Dr. Komarovsky

Bronchopneumonia in children is an inflammatory process of lung tissue, which is called small focal bronchial pneumonia. The disease most often affects children under 3 years of age. The inflammation affects one or more small areas of the respiratory organ. In the absence of adequate treatment, there is an increased risk of death and asphyxia.

Causes of the disease

Bronchial pneumonia occurs in a child due to viral damage to the alveolar parts of the lungs. The alveoli are responsible for the immune properties of the organ. Viral agents entering the body allow bacteria of various etiologies to enter the bronchi.

Causes of bronchopneumonia:

1. Bacteria of pathogenic, opportunistic flora, such as staphylococci, streptococci, pneumococci and others.
2. Previous influenza, ARVI, acute respiratory infections, parainfluenza.
3. Whooping cough disease.
4. Formation of malnutrition.
5. Pathologies of rickets.
6. Congenital or acquired HIV.
7. Weakened immunity due to any pathologies or diseases.

Most often, bronchopneumonia develops in a child due to the penetration of pathogenic bacteria. Sometimes this happens in maternity hospital, hospital or kindergarten. The main danger is the pneumococcal bacterium, which can infect a large number of children in in public places. Due to the nature of the device children's immunity The child’s body is not able to cope with the disease on its own. Subject to timely treatment, careful observation by specialists.

Quiz: How susceptible are you to pneumonia?

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• You lead a healthy lifestyle and you are not at risk of pneumonia

  You are a fairly active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle, and your body will delight you throughout your life, and no bronchitis will bother you. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and strong emotional overload.

• It's time to think about what you are doing wrong...

  You are at risk, you should think about your lifestyle and start taking care of yourself. Physical education is required, or even better, start playing sports, choose the sport that you like most and turn it into a hobby (dancing, cycling, gym, or just try to walk more). Do not forget to treat colds and flu promptly, they can lead to complications in the lungs. Be sure to work on your immunity, strengthen yourself, and be in nature and fresh air as often as possible. Do not forget to undergo scheduled annual examinations; it is much easier to treat lung diseases in the initial stages than in advanced stages. Avoid emotional and physical overload; if possible, eliminate or minimize smoking or contact with smokers.

• It's time to sound the alarm! In your case, the likelihood of getting pneumonia is huge!

  You are completely irresponsible about your health, thereby destroying the functioning of your lungs and bronchi, have pity on them! If you want to live a long time, you need to radically change your entire attitude towards your body. First of all, get examined by specialists such as a therapist and a pulmonologist; you need to take radical measures, otherwise everything may end badly for you. Follow all the doctors’ recommendations, radically change your life, perhaps you should change your job or even your place of residence, completely eliminate smoking and alcohol from your life, and reduce contact with people who have such bad habits to a minimum, toughen up, strengthen your immunity as much as possible spend more time in the fresh air. Avoid emotional and physical overload. Completely eliminate all aggressive products from everyday use and replace them with natural, natural remedies. Do not forget to do wet cleaning and ventilation of the room at home.

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• Yes, daily
• Sometimes
• Seasonal (eg vegetable garden)

1. Task 2 of 20

   How often do you undergo a lung examination (eg fluorogram)?

   • I don’t even remember when was the last time
   • Every year, without fail
   • Once every couple of years

2. Task 3 of 20

   Do you play sports?

   • Yes, professionally and regularly
   • It happened in the past
   • Yes, amateur

3. Task 4 of 20

   Do you snore?

   • When I'm sick
   • Sometimes

4. Task 5 of 20

   Are you treating acute respiratory infections, ARVI, Bronchitis and other inflammatory or infectious diseases?

   • Yes, at the doctor's
   • No, it goes away on its own after some time
   • Yes, I self-medicate
   • Only if it's really bad

5. Task 6 of 20

   Do you carefully observe personal hygiene (shower, hands before eating and after walking, etc.)?

   • Yes, I wash my hands all the time
   • No, I don't follow this at all
   • I try, but sometimes I forget

6. Task 7 of 20

   • Only when sick
   • I find it difficult to answer

7. Task 8 of 20

   Have any relatives or family members suffered from serious lung diseases (tuberculosis, asthma, pneumonia)?

   • Yes, parents
   • Yes, close relatives
   • I can not say for sure

8. Task 9 of 20

   • Yes, I live permanently
   • Yes, I work in such conditions
   • Previously lived or worked

9. Task 10 of 20

   Do you have heart disease?

   • Yes, chronic
   • Rarely, but it does happen
   • If you have any doubts, you need an examination

10. Task 11 of 20

    • Constantly
    • I'm not there
    • Previously was
    • Rarely, but it happens

11. Task 12 of 20

    Do you often get sick with acute respiratory infections or acute respiratory viral infections?

    • I'm constantly sick
    • Rarely, no more than once a year
    • Often, more than 2 times a year
    • I never get sick or once every five years

12. Task 13 of 20

    Do you or any of your relatives have diabetes?

    • Yes, I have
    • I find it difficult to answer
    • Yes, with close relatives

13. Task 14 of 20

    Do you have any allergic diseases?

    • Yes, one
    • Not sure, needs testing
    • Yes, even a few

14. Task 15 of 20

    What kind of life do you lead?

    • Sedentary
    • Active, constantly on the move
    • Sedentary

15. Task 16 of 20

    Does anyone in your family smoke?

    • Happens sometimes
    • Used to smoke

16. Task 17 of 20

    Do you smoke?

    • Yes, I smoke regularly
    • No and never smoked
    • Rarely, but it happens
    • Previously smoked, but quit

17. Task 18 of 20

    Do you have air purification devices in your home?

    • Yes, I change filters all the time
    • Yes, we use it sometimes
    • Yes, but we don’t monitor the devices

18. Task 19 of 20

    Do you often get more bronchitis?

    • Often, more than 2 times a year
    • I'm constantly sick
    • Rarely, no more than once a year
    • I don’t get sick at all, at most once every five years

19. Task 20 of 20

    Do you have congenital pathologies bronchopulmonary system?

    • Yes, even a few
    • There is one thing
    • Difficult to answer, I need an examination

Symptoms

Foci of inflammation range in size from 2 to 4 mm. Depending on which lung the inflammatory process is localized, right-sided and left-sided bronchopneumonia are distinguished. Both are equally dangerous. If right-sided focal pneumonia develops, then there is a high risk of complications in the internal organs child.

The most dangerous symptom is the absence of fever during illness. Due to his age little patient cannot talk about his health.

The main signs of bronchopneumonia in children:

1. The appearance of shortness of breath, shallow breathing at rest.
2. Blueness of the skin around the nose, lips, blue fingers.
3. The appearance of hoarseness, a dry cough, which after some time turns into a wet one.
4. The discharge of purulent sputum, sometimes having an unpleasant odor.
5. Most often, the temperature rises to 39-40 degrees.
6. If the child can talk, he may complain of dizziness and headache.
7. Even in a very young baby, one can notice a decrease in activity, apathy, irritability, and tearfulness.
8. Frequent regurgitation of food just eaten.
9. The skin becomes pale and a bluish tint appears in some areas. This is caused by severe oxygen starvation. The child suffers from lack of air. The nasal passages may be clear, but the swollen walls of the airways significantly impede the flow of oxygen.
10. On the background severe cough Nausea and vomiting occur.

Developmental bronchopneumonia in children and the symptoms at the first stage of the disease are very similar to a viral infection. This manifestation of the disease leads to late diagnosis and complications.

Consequences of the disease

The consequences caused by bronchopneumonia in children are very depressing. The main danger is death. During the action of bacteria, the vessels of the respiratory tract swell, interfering with normal air flow, which can result in asphyxia.

To prevent it, you need the help of a specialist who is able to relieve the edematous reaction, prescribe necessary treatment bronchopneumonia in children.

Long-term lack of treatment results in various lung diseases of a purulent, chronic nature: nephritis, purulent otitis media, pleurisy and others. In addition, focal pneumonia in children leads to severe intoxication of the body.

Pathogenic bacteria can cause harm with their metabolic products. Due to the presence of infectious and bacterial agents, gas exchange in the lungs is significantly disrupted, which leads to intoxication, oxygen starvation, the appearance of seizures.

An unpleasant symptom that accompanies mainly newborn children is convulsions. At this moment, the child experiences pain and severe shortness of breath. With the onset of such a symptom, immediate assistance is required. Specialists will conduct an examination and prescribe how to treat bronchopneumonia in children. An advanced disease most likely causes heart failure, which is accompanied by tachycardia.

Extensive areas of inflammation lead to a large amount of scarring of the lung tissue. IN childhood this pathology will be especially unnecessary. Scarred tissue does not cause physical discomfort, but the protective functions of the bronchi may be impaired. There is a possibility of private diseases of the respiratory system.

Diagnosis of bronchopneumonia

Before starting treatment, focal pneumonia in children requires careful diagnosis. Measures to determine the type of disease and its causative agent can only be carried out in a hospital setting. This requirement must be observed, since the child may need emergency medical care and resuscitation measures at any time.

Diagnostics may include:

• general and biochemical tests blood, the level of ESR, leukocytes, erythrocytes is determined;
• identifying the pathogen, conducting a study of its sensitivity to antibacterial therapy, determining the dosage of the drug;
• An x-ray is not always informative; MRI or CT may rarely be required;
• listening to the lungs and palpating the intercostal areas, these measures make it possible to determine the extent of the disease and partially its localization.

When going to the hospital, the doctor examines the patient and listens to the existing symptoms. Then he is sent to the X-ray room to take an image. An x-ray image can reveal the location of the inflammation. Right-sided bronchopneumonia, left-sided or bilateral is determined.

If necessary, a scraping is performed from the laryngeal cavity to determine the type of pathogen. A similar analysis is taken with the contents of coughed up sputum, which is sometimes induced artificially.

Using a special spatula, the root part of the tongue is pressed and a coughing attack with phlegm appears.

Treatment and prevention

After necessary diagnostics the doctor determines how focal pneumonia develops in children and treatment. Drug therapy is inevitable, which, in turn, will be aimed at eliminating inflammation, removing toxins and destroying the pathogen.

The attending physician’s actions occur in the following direction:

1. Prescription of antibiotics, removal correct dosage and the time of taking the course. This allows you to destroy the cause of the disease, allowing the body to begin to restore the affected areas of the lung tissue.
2. Carrying out strengthening activities for the baby’s immunity. Restoring immunity is one of the main components of treatment.
3. Creating a gentle diet. The patient's body is weakened and busy fighting the disease, so light but nutritious food is recommended. You need to drink more liquid, preferably plain water.
4. Prescribing a course of multivitamins. It is selected for each patient depending on the age group.

Focal pneumonia in a child is very difficult to tolerate. A small organism is not able to cope with the onset of the disease without the help of the attending physician. Bilateral bronchopneumonia takes longer to treat and recover. Occurs as often as left-sided focal pneumonia. In severe cases, the child is prescribed artificial ventilation lungs. This procedure is prescribed already in the intensive care unit, when the child loses most of his respiratory activity and a lack of oxygen prevails.

To prevent such an illness, there are some recommendations that are easier to follow than treating a child for a serious illness:

1. Activities to harden a child. They are carried out taking into account the age of the patient. You should start with regular ventilation of the room and maintaining the temperature there a couple of degrees lower than usual. Then you can connect rubbing with a wet towel. Any such manipulations should be carried out only after the permission of a specialist.
2. Timely detect inflammatory processes and infectious diseases. This approach will reduce the likelihood of a severe weakening of the immune system and eliminate the occurrence or exacerbation of bronchopneumonia.
3. Support general recommendations to strengthen and maintain immunity. Follow integral part nutrition, hygiene and physical activity.

Once the doctor has identified all the symptoms, he will prescribe treatment according to clinical picture. After carrying out all the necessary medication measures, you must strictly adhere to all recommendations.

A weak body may experience a relapse of the disease, which will require a new examination and the use of more powerful and severe antibiotics. If there is any suspicion that the child is not feeling well, it is necessary to urgently contact medical care. Early diagnosis allows you to reduce the dosage heavy drugs and quickly get rid of the disease. After simply listening to the baby, the doctor will determine whether there are any abnormalities in breathing or the presence of an inflammatory process.

Often bronchopneumonia is caused by various aspirations, which can occur due to unsuccessful swallowing of food or regurgitation. It is necessary to prevent the possibility of regurgitation while lying down.

Under no circumstances should you take on self-treatment pneumonia. The use of herbs will not help get rid of the disease; the disease will progress at a high rate. Taking the wrong antibiotics with the wrong dosage leads to poisoning of various nature, disorders of the flora of the stomach, mucous membranes. In addition, pathogens easily develop addiction to antibacterial drugs. For proper treatment a test will be required in order to prescribe the right group effective drugs.

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• Congratulations! You are completely healthy!

  Your health is fine now. Don’t forget to take good care of your body, and you won’t be afraid of any diseases.

• There is reason to think.

  The symptoms that concern you are quite extensive and are observed when large quantities diseases, but we can say with confidence that something is wrong with your health. We recommend that you contact a specialist and undergo medical examination to avoid complications. We also recommend that you read the article on how to recognize pneumonia at home.

• You have pneumonia!

  In your case, there are clear symptoms of pneumonia! However, there is a possibility that it could be another disease. You need to urgently contact a qualified specialist; only a doctor can make an accurate diagnosis and prescribe treatment. We also recommend that you read the article about whether pneumonia can be cured without antibiotics and how to do it.

1. With answer
2. With a viewing mark

Task 1 of 17

Does your lifestyle involve heavy physical activity?

• Yes, daily
• Sometimes
• Seasonal (eg vegetable garden)

1. Task 2 of 17

   Do you take care of your immunity?

   • Only when sick
   • I find it difficult to answer

2. Task 3 of 17

   Do you live or work in an unfavorable environment(gas, smoke, chemical emissions from enterprises)?

   • Yes, I live permanently
   • Yes, I work in such conditions
   • Previously lived or worked

3. Task 4 of 17

   How often are you in damp, dusty or moldy environments?

   • Constantly
   • I'm not there
   • Previously was
   • Rarely, but it happens

4. Task 5 of 17

   Have you been feeling physically or mentally unwell lately?

   • Yes, pronounced
   • No more than usual
   • No, that didn't happen

5. Task 6 of 17

   Does fever bother you?

   Task 7 of 17

   Do you smoke?

   • Used to smoke
   • Sometimes
   • No, and never smoked

6. Task 8 of 17

   Does anyone in your family smoke?

   • Used to smoke
   • It happens sometimes
   • No and have never smoked

7. Task 9 of 17

   Do you suffer from congenital disorders of the bronchopulmonary system?

   Task 10 of 17

   Have you been out in cold air for an extended period of time recently?

   Task 11 of 17

   Do you suffer from diseases of the cardiovascular system?

   • Yes, innate
   • No, my heart is fine

8. Task 12 of 17

   Have you been bothered by a dry cough lately?

   • Yes, and the cough is severe
   • Worried, but the cough is wet

9. Task 13 of 17

   Have you been worried about weakness, malaise, or headaches lately?

   • Yes, I feel terrible
   • Mild fatigue, not critical
   • No, I feel great

10. Task 14 of 17

    Have you recently had colds and viral diseases in the form of bronchitis?

    Task 15 of 17

    Have you been bothered by pain in the chest area lately?

    • Yes, and very much so
    • There is a slight feeling of discomfort

11. Task 16 of 17

    Does shortness of breath bother you?

    • Yes, very strong
    • No more than usual

12. Task 17 of 17

    Have you been experiencing fevers and chills lately?

Bronchopneumonia is acute inflammation walls of bronchioles, and this disease is mainly diagnosed in children under 3 years of age. Parents should take this illness seriously, because in the absence of effective treatment Possible death.

Often the cause of the development of pathology is the entry of viruses and bacteria into the child’s body, and the precursor can be bronchitis or acute viral infection. Treatment of bronchopneumonia in children depends on the severity and clinical manifestations, and on early stage The pathology is successfully treated with antibacterial drugs.

There are many factors that can cause the development of bronchopneumonia. Most often, the development of such a disease occurs under the influence of viruses, bacteria, fungi, chlamydia and mycoplasma.

Medical practice shows that the main role in starting the inflammatory process belongs to pneumococcus, especially if the child is under 3 years of age. Such a microorganism enters the child’s body through inhalation, but it can enter the lung tissue through lymph, blood or bronchi. In fact, such pneumococcus is also detected in the body of completely healthy children, but for its active development a decrease in protective functions is necessary.

If your immune system is compromised child's body due to ARVI, poor nutrition or rickets, streptococcus, staphylococcus or E. coli can provoke the development of bronchopneumonia.

In young children or those born prematurely, viral pneumonia can occur under the influence of other viruses.

In most cases, such pathologies are predisposing factors that can cause the activation of a bacterial infection. The inflammatory process can also develop against the background of pathologies such as measles and.

In some cases, the development of bronchopneumonia is caused by exposure to various physical and chemical factors on the body. Bronchopneumonia in children can develop when food gets into the respiratory tract or when aggressive gases are inhaled.

Symptoms of the disease

For bronchopneumonia characteristic symptoms can develop gradually or, conversely, rapidly. Every parent should know the signs of the disease, which will allow him to promptly seek help from a specialist and avoid the development of many complications.

What symptoms may occur in a child with bronchopneumonia:

• A characteristic sign of the pathology is an increase in body temperature to 39 degrees, which, if left untreated, persists for several days. In addition, the child’s general condition worsens, that is, he refuses to eat, becomes weak, restless and sleeps poorly. In young children, a rise in temperature is combined with regurgitation or vomiting.
• Bronchopneumonia is accompanied by severe intoxication of the body, so the skin becomes pale or acquires a gray color. The supply of sufficient oxygen to the body is disrupted, and the result is the formation of a cyanotic nasolabial triangle.
• With this pathology, breathing changes, that is, it becomes too painful and resembles groans. When the child is in a lying position, he experiences shortness of breath, and his nostrils dilate greatly when breathing. Retraction of the skin between the ribs or retraction of the jugular fossa is possible.
• Bronchopneumonia is accompanied by the appearance of wet or, which can be so strong that it is accompanied by vomiting. During coughing, active spread of infection can occur.

More information about bronchopneumonia can be found in the video:

In childhood, much more often than in adults, bronchopneumonia causes the development of heart failure. The most common type of this disease is considered to be right-sided bronchopneumonia, which is accompanied by the appearance of pronounced symptoms. The left-sided form is not detected so often and is more difficult to diagnose due to its close location to the heart and smooth manifestations.

Parents should be aware that any form of bronchopneumonia can occur without fever and cough. In some cases, such symptoms may be mild and may not attract the attention of adults. Danger signal It is considered that the child has difficulty breathing, a deterioration in his general condition and an acute respiratory infection that has lasted too long.

Possible complications

In the absence of effective treatment, the child's condition may worsen even more. Bronchopneumonia can provoke the development of various complications, among which the most dangerous are serous pleurisy and.

If the child is not feeling well and there is no positive dynamics during long-term treatment, it is necessary to change therapeutic measures. Incorrect treatment causes an even greater deterioration in the child’s condition, that is, his body is weakened.

In some cases, bronchopneumonia can cause general intoxication of the body.

One of the complications of this pathology is tachycardia, which occurs both during movement and at rest. The child may develop toxic syndrome due to the accumulation of cellular decay products and bacterial toxins in the body.

IN last years The mortality rate among children from pneumonia has decreased markedly and this is due to the improvement of treatment. It is possible to avoid the development of complications after bronchopneumonia with timely consultation with a specialist and effective treatment.

Diagnosis of pathology

The diagnosis of bronchopneumonia is made to a child based on the appearance of clinical symptoms. The specialist finds out the signs of illness in the parents and conducts a thorough examination, during which attention is focused on the nature of the percussion sound and wheezing.

With this disease, signs of intoxication of the body and heart failure appear. Diagnosis of bronchopneumonia in childhood is carried out in several stages.

To confirm the diagnosis, a test is prescribed x-ray examination. When the lungs are affected, dark spots are present at the sites of infection. In addition, instrumental diagnostics is complemented by laboratory tests. Appointed general analysis blood, based on the results of which it is possible to determine the content of leukocytes and ESR.

Drug treatment

For bronchopneumonia, treatment is selected, which includes taking antibacterial drugs. Taking antibiotics continues for 14 days, and preference should be given to those drugs to which the microflora of the patient’s secretions is sensitive.

If a severe form of the disease is detected in a child, broad-spectrum antibiotics are prescribed:

• Zinnat
• Erythromycin

In the event that the ongoing antibacterial therapy does not bring positive result within 2 days, then a replacement is selected for her. Mostly in childhood, Levorin and Nystatin are prescribed, which have an antifungal effect.

Treatment of childhood bronchopneumonia involves taking restoratives and immunostimulating drugs.

In addition, the patient is prescribed compliance special diet, drinking plenty of fluids and taking vitamin and mineral complexes.

Typical forms of the disease are treated at home, and if more complex disorders are detected, the child is placed in a hospital. This is due to the fact that some forms of bronchopneumonia can be fatal and therefore require specialist supervision.

Traditional methods of treatment

In case of bronchopneumonia, it is necessary to provide the child with maximum care, be with him constantly and surround him with care.

It is also possible to improve the patient’s condition with the help of traditional medicine, before using which it is recommended to consult a specialist.

Effective traditional medicine recipes:

1. Bronchopneumonia in children can be treated with a honey compress, which should be applied 2 times a day. To do this, carefully lubricate the lung area with honey and place a cloth on top, well soaked in a solution of water and vodka in a 1:1 ratio. The child should be wrapped in cling film and well wrapped in a blanket.
2. To treat bronchopneumonia, you can use plantain leaves, which should first be washed and dried. After this, you need to spread a towel on the bed and put the leaves of the plant on it, and lay the child on them. The remaining plantain leaves should be spread on his stomach, wrapped well in a blanket and left overnight. This procedure should be carried out until the child feels relief.
3. At home, you can prepare a mixture of buckwheat honey and birch buds. To do this, you need to bring 750 ml of honey to a boil and pour 100 grams of birch buds into it. The resulting mass must be kept on fire for 7-8 minutes, then strain and cool. One teaspoon of this folk remedy should be diluted in 200 ml of water and given to the child to drink 30 minutes before bedtime.

Bronchopneumonia is considered complex and dangerous disease which is accompanied by the development of various complications. With absence effective therapy death is possible, so parents should be constantly on alert. When characteristic features illness, the child should be shown to a specialist as soon as possible, and not self-medicate.