What happens during pneumonia. Features of the course and diagnosis of lobar pneumonia. Symptoms and signs of lobar pneumonia

Despite modern scientific advances in the field of medicine, pneumonia remains one of the most dangerous diseases. High mortality from this disease is observed in young children - up to two years old and in elderly people - over 65-70 years old. But it is necessary for every person to be able to raise the alarm in time, to know how to identify pneumonia, because the situation from moderate to severe can at any moment go into a critical stage, when the clock counts, and choosing an effective medicine will not be so easy.

Pneumonia, or pneumonia, is an inflammation of the lung tissue as a result of the penetration of pathogenic bacteria and strains of viruses into the cells of the organ. Less common are forms caused by protozoal infections - protozoa, mold spores.

The reaction to the penetration of pathogens becomes a symptom complex characteristic of pneumonia. To a man without medical education It may be difficult to distinguish the disease from pleurisy, bronchitis, so the final diagnosis should be made by an experienced specialist.

Causes of pneumonia development

Every child and adult encounters common upper respiratory tract infections, almost every year. However, in the course of common colds lies the risk of developing complications. Pneumonia can develop for the following reasons.

1. Complication of acute respiratory viral infections. For some reason, the human immune system is unable to defeat the virus, and it “descends” further down the respiratory tract. Often the “chain” begins with a sore throat or rhinitis, then progresses to pharyngitis, then comes bronchitis, and only after that the lung tissue becomes inflamed.
2. Infection with characteristic pathogens - most often these are bacteria from the genus Streptococcus pneumoniae. The disease can be transmitted by airborne droplets or household transmission.
3. The addition of a bacterial infection to a viral one. In this case, pneumonia develops a few days after suffering from acute respiratory viral infection or tonsillitis. Secondary infection is especially dangerous for people with initially weakened immune systems.
4. Congestive pneumonia. Typical for bedridden patients. A specific risk group is old people who have suffered a hip fracture and other people who are forced to remain in one position for a long time. Lack of proper ventilation in the lungs contributes to the development pathogenic microflora.
5. Defeat by hospital infections. This type of pneumonia is recognized as the most dangerous, since the pathogens, as a rule, are superinfections and are difficult to treat with antibiotics.

It must be remembered that, regardless of the type, the disease is severe. The first signs may begin to appear just a few days after infection, and sometimes the disease develops over a longer period of time. To avoid serious consequences, you need to take measures and know the symptoms of pneumonia.

The classification of types of disease is used by doctors to determine the source of infection, the pathogen, the method of development and the degree of damage to lung tissue. Important data are the nature of the course and associated complications. The severity of the disease affects the choice of treatment methods and the prognosis for a particular patient.

All together allows doctors to most effectively approach the treatment of each specific case of pneumonia.

Based on epidemiological data

This classification is necessary to determine the source of infection. These data are important from the point of view of possible drug resistance of the pathogen. Classification based on epidemiological data indicates the following types of pneumonia.

1. Community-acquired infections occur outside the hospital. Doctors are usually recognized for relatively “easy” cases.
2. Nosocomial infections. They are dangerous because the pathogen is almost always a superinfection. Such bacteria are insensitive to conventional antibiotics, since the strains develop protection against the main active substances. Modern directions medical science suggest the use of bacteriophages.
3. Triggered by immunodeficiency conditions. Risk groups for the development of pneumonia in adults include bedridden patients, HIV-infected people, and patients with cancer diagnoses. Pneumonia in an immunodeficient state always implies a cautious prognosis.
4. Atypical pneumonia. They occur with an altered clinical picture and are provoked by insufficiently studied pathogens.

By pathogen

Identifying the type of pathogen influences the choice of medications. The following types of infections are distinguished:

• bacterial - the most common type;
• viral;
• fungal;
• protozoan;
• mixed.

According to the development mechanism

The source of the disease allows you to determine the treatment strategy. The following forms of development are identified:

• primary - an independent disease;
• secondary - appear against the background of other diseases;
• post-traumatic - caused by mechanical damage to the lung tissue and secondary infection;
• postoperative;
• pneumonia after a heart attack - develops due to partial obstruction of the pulmonary veins.

According to the degree of lung tissue involvement

The level of tissue damage influences the intervention strategy and prognosis. There are such degrees:

• unilateral inflammation;
• bilateral;
• total lesion - includes basal forms, lobar, segmental.

According to the nature of the course

Taking into account complications

According to severity

Symptoms of the disease

Pneumonia shows different symptoms, but together they form a certain clinical picture. Some of them are general, others depend on the specific course of the disease. The patient or his relative should pay attention to the following manifestations.

1. High temperature, which does not respond well to antipyretics.
2. Sweating, shortness of breath even at rest. Weakness, sometimes confusion, this symptom indicates severe bilateral or lobar lung disease.
3. Cough - can be dry or with sputum. With focal pneumonia, the sputum is greenish in color and smells like pus. Lobar pneumonia is characterized by the release of blood-colored mucus; this is one of the important symptoms of a dangerous condition. The cough does not bring relief.
4. Pain in the sternum when breathing, especially during physical activity.
5. Croupous pneumonia is accompanied by severe intoxication, so rashes are observed in the area of ​​the nasolabial triangle.

Without special competent treatment, the patient's condition will worsen. Traditional methods are not effective for this serious disease, so you need to seek the help of a doctor. In severe conditions, it is recommended to call an ambulance.

Diagnostic methods

Correct diagnosis includes not only identifying the pathological process occurring in the lungs, but also clarifying additional details. The pathogen, severity and other data are taken into account, which help determine the prescription of drugs and additional procedures.

Diagnostic methods include the following:

• visual initial examination, assessment of the patient’s condition;
• taking sputum for analysis - identifies the causative agent of infection;
• general blood test - determines the degree of intoxication;
• radiography;
• Ultrasound of the pleural cavity.

Full set recommended diagnostic procedures to establish the most accurate diagnosis possible. Ultrasound is recommended to be performed several times to determine the effectiveness of the treatment and timely detection of complications.

Treatment of pneumonia

Treatment of pneumonia involves right choice drug therapy, aimed at destroying pathogenic microflora, in combination with drugs that help restore lung tissue and maintain the patient’s condition.

Home treatment of pneumonia is unacceptable; the patient is advised to be hospitalized in the pulmonology department for complex procedures.

The standard treatment regimen involves the following measures.

1. Prescribing antibiotic therapy. Doctors recommend starting it as early as possible, using new generation drugs, without wasting time identifying a specific pathogen. If necessary, drugs are adjusted and combined during the treatment process. The course of treatment lasts up to 14 days.
2. Providing the patient with bed rest in a warm, well-ventilated room. A special diet is recommended - light, but high in calories, with plenty of vitamins.
3. Prescription of antipyretics, expectorants, and antihistamines. These medications help relieve intoxication, improve the patient’s general condition, and reduce the load on the kidneys and heart.
4. For extensive lung damage and difficulty breathing, it is recommended to use oxygen masks.
5. After the acute phase of pneumonia is removed, physiotherapy (electrophoresis with potassium iodide), inhalations, and physical therapy are added to restore the damaged lung area.

At the right approach to treatment, the symptoms of pneumonia decrease after three to four days, and full recovery occurs in 15-21 days.

Prevention and prognosis

Pneumonia in adults occurs when methods of preventing this disease are neglected. To prevent the disease, it is recommended to avoid smoking and drinking alcoholic beverages.

Hardening and strengthening the immune system with proper nutrition, rich in vitamins and useful microelements, is also a great way to “prevent” bacterial or viral infections from reaching the lower respiratory tract.

The prognosis for healthy adults is good. In 80% of cases, with proper treatment, absolute restoration of lung tissue is observed within two to three months. Sometimes partial degeneration of the affected area - carnification - may occur, in which case additional measures will be required to recover from the disease.

A questionable and unfavorable prognosis in severe cases in people with HIV infection and suffering from cancer.

Conclusion

Pneumonia is a disease that should not be underestimated. Remember that before the invention of antibiotics, every third person who fell ill died from it. Achievements modern medicine made pneumonia not so dangerous, but qualified treatment is only possible with the help of professionals, in a hospital setting. Non-traditional and folk methods can be an addition to the main therapy, but not the basis of treatment.

The ability to breathe unimpeded is an important component good quality life. Due to unfavorable ecology, radiation and other negative factors lungs and other organs respiratory system people are at risk. In our article we will talk about one of the most common respiratory diseases in adults – community-acquired pneumonia.

Prevalence

According to official statistics, the incidence of pneumonia in adults averages 0.3-0.4%, but according to estimates it is much higher. It is believed that on average in Russia 14-15 out of 1000 people suffer from pneumonia every year. The incidence is higher in older people, as well as among conscripts. In Russia every year the number of patients is more than 1.5 million people, in the USA - more than 5 million, in European countries - 3 million.

The mortality rate from this disease is also quite high: in Russia it is approximately 27 cases per 100 thousand population per year. Thus, in a small city with a population of 300 thousand people, 81 people die from pneumonia per year from pneumonia. The risk of death from pneumonia is especially high in people over 60 years of age who have serious concomitant diseases (having suffered from kidney disease or), as well as in severe cases of pneumonia itself and in.

Late seeking of medical help plays a significant role in mortality from pneumonia.

What is pneumonia

Pneumonia is an acute infectious disease with focal damage to the lungs, accompanied by exudation (sweating) of fluid into the respiratory vesicles and alveoli. The diagnosis of “chronic pneumonia” is considered obsolete and is not used.

The International Classification of Diseases, X Revision, proposes to classify bacterial pneumonia depending on its causative agent, which can be:

• Pneumococcus;
• hemophilus influenzae;
• Klebsiella;
• pseudomonas;
• staphylococcus;
• streptococcus;
• coli;
• mycoplasma;
• chlamydia;
• other bacteria.

However, the widespread use of this classification is difficult due to difficulties in isolating the pathogen, its identification, as well as due to frequent self-medication with antibiotics before seeing a doctor.

Therefore, in practical work, doctors use the division of pneumonia into community-acquired and hospital-acquired (nosocomial). These two groups differ in the conditions of occurrence and the presumed causative agents.

Community-acquired pneumonia, which will be discussed later, occurs outside the hospital, or later than 4 weeks after discharge from it, or earlier than 48 hours after admission for another reason.

How does the disease arise and develop?

The main ways microbes enter the lungs are:

• aspiration of the contents of the oral cavity and pharynx;
• inhalation of air containing germs.

Less commonly, the infection spreads through the blood vessels from other foci of infection (for example, with) or enters directly into the lung tissue when the chest is injured or abscesses of neighboring organs.

The most common route of entry for pathogens is from the mouth and pharynx during sleep. In healthy people, microorganisms are immediately eliminated by the cilia lining the bronchi, coughing, and are also killed by immune cells. If these defense mechanisms are violated, conditions are created for the “fixation” of pathogens in the lungs. There they multiply and cause an inflammatory reaction, manifested by general and local symptoms. Thus, in order to get pneumonia, it is not necessary to come into contact with a sick person. The pathogens live on the skin and in the nasopharynx of the sick person and are activated when the body’s defenses are reduced.

Inhalation of microbial aerosol is observed less frequently. It is described, for example, in the classic outbreak of which developed due to the entry of a microorganism into a hotel air conditioning system.

The most common causative agent of community-acquired pneumonia is pneumococcus; a little less often it is caused by chlamydia, mycoplasma and legionella, as well as Haemophilus influenzae. A mixed infection is often determined.

Viruses, as a rule, are only a “conductor” for the bacterial flora, inhibiting those protective mechanisms that we discussed above. Therefore, the term “viral-bacterial pneumonia” is considered incorrect. Viruses, including the virus, do not infect the alveoli, but the interstitial (intermediate) tissue of the lungs, and it is not recommended to call this process pneumonia.

Clinical signs

In most cases, based on complaints and examination data, it is impossible to accurately determine which microorganism caused the disease.

Typical signs of pneumonia in young patients:

• fever;
• cough: initially dry, after 3-4 days it softens;
• the appearance of sputum - from mucous to purulent, sometimes streaked with blood;
• chest pain;
• severe weakness;
• night sweats;
• cardiopalmus.

Classic signs such as sudden fever and severe chest pain are absent in some patients. This is especially true for elderly and weakened patients. Pneumonia should be suspected if they experience an unexplained increase in weakness, loss of strength, nausea, or refusal to eat. Pneumonia in such people may be accompanied by abdominal pain or impaired consciousness. Moreover, without apparent reason decompensation of concomitant diseases occurs: shortness of breath increases, blood sugar increases or decreases, and occurs.

Upon examination, the doctor can detect a dull percussion sound over the affected area, an area of ​​bronchial breathing with wheezing or crepitus, and increased vocal tremors. These classic signs do not occur in all patients. Therefore, if pneumonia is suspected, additional tests must be carried out.

Although the clinical division into typical ones is not recognized now, there are still features of the course of pneumonia caused by various pathogens, especially at the height of the disease.

Mycoplasma pneumonia can be complicated by erythema (foci of redness of the skin), otitis, encephalitis, myelitis (lesion spinal cord with the development of paralysis). The disease caused by Legionella is accompanied by impaired consciousness, renal and. Chlamydia manifests itself as hoarseness and sore throat.

Main diagnostic tests

Usually performed plain radiography chest organs in direct and lateral projections (“full face” and “profile”). It can be successfully replaced by large-frame or digital fluorography. The examination is carried out if pneumonia is suspected and 2 weeks after the start of antibacterial therapy.

Most informative for identifying pneumonia CT scan. It is carried out in the following situations:

1. In a patient with obvious symptoms of pneumonia, changes on the radiograph do not confirm the disease.
2. In a patient with typical symptoms, changes on the radiograph indicate another disease.
3. Recurrence of pneumonia in the same place as before.
4. Protracted course of the disease, longer than one month.

In the last two cases, it is necessary to exclude cancer of the large bronchus or other pulmonary diseases.

To diagnose the most common complications of pneumonia - pleurisy and abscess (abscess) of the lung - computed tomography and ultrasound examination are used in dynamics.

The reverse development of pneumonia takes 1-1.5 months. If treatment is successful, a control photograph is taken no earlier than 2 weeks after the start of the course of antibiotics. The purpose of such a study is to diagnose tuberculosis, “hidden under the guise” of pneumonia.

Additional diagnostic tests

A general blood test determines an increase in the number of leukocytes to 10-12 x 10 12 / l. A decrease in the number of these cells less than 3 x 10 12 / l or a significant increase - more than 25 x 10 12 / l - is a sign of an unfavorable prognosis.

The biochemical blood test changes little. It is used to determine liver and kidney function, which is important when choosing antibiotics.

If the patient has shortness of breath at rest, concomitant, massive pleurisy or blood oxygen saturation is less than 90%, then an analysis of the gas composition of arterial blood is necessary. Significant hypoxemia (decreased oxygen concentration in the blood) is an indication for transferring the patient to the intensive care unit and oxygen therapy.

A microbiological examination of sputum is carried out, but its results largely depend on external factors, for example, the correct technique for taking the analysis. In the hospital, microscopy of a Gram-stained sputum smear is required.

In case of severe pneumonia, blood should be taken for culture testing (“blood for sterility”) before starting antibiotic treatment. However, the inability to quickly take such an analysis should not prevent the early start of treatment.

Research is being conducted on the feasibility of determining pathogen antigens in urine, a pneumococcal rapid test, and a polymerase chain reaction.

Fiberoptic bronchoscopy is performed if pulmonary tuberculosis is suspected, as well as to diagnose a foreign body or bronchial tumor.

If it is impossible to perform any research, you need to start treating the patient with antibiotics as soon as possible.

Where to treat the patient

In many ways, the solution to this issue depends on the doctor and the characteristics of the patient. Often, mild pneumonia is treated at home. However, there are signs, the presence of at least one of which is an indication for hospitalization:

• shortness of breath with a respiratory rate of more than 30 per minute;
• blood pressure level is below 90/60 mmHg. Art.;
• increase in heart rate to 125 per minute or more;
• a decrease in body temperature of less than 35.5˚ or an increase of more than 39.9˚;
• disturbance of consciousness;
• the number of leukocytes in the blood test is less than 4 x 10 9 / L or more than 20 x 10 9 / L;
• decrease in oxygen content in the blood according to pulse oximetry to a level of 92% or less;
• an increase in the level of creatinine in the blood serum in a biochemical analysis over 176.7 µmol/l (this is a sign of beginning);
• damage to more than one lobe of the lung according to radiography;
• lung abscess;
• the presence of fluid in the pleural cavity;
• rapid increase in changes in the lungs;
• hemoglobin level in the blood is below 90 g/l;
• foci of infection in other organs, sepsis, multiple organ failure;
• inability to carry out all medical prescriptions at home.

In severe cases of the disease, treatment begins in the intensive care unit.

It is preferable to carry out treatment in a hospital in the following situations:

• patient over 60 years old;
• presence of chronic lung diseases, malignant tumors, severe heart disease or renal failure, low body weight, alcoholism or drug addiction;
• failure of initial antibiotic therapy;
• pregnancy;
• the desire of the patient or his relatives.

Antibiotics for pneumonia

The drugs of choice are inhibitor-protected penicillins that are not destroyed by microbial enzymes: amoxicillin/clavulanate and amoxicillin/sulbactam. They effectively kill pneumococcus, have low toxicity, and the experience of their effective use is calculated over years and decades. These drugs are usually used for oral administration in outpatient settings, with mild severity of the disease.

In the hospital, the primacy often belongs to 3rd generation cephalosporins: cefotaxime and ceftriaxone. They are administered intramuscularly once a day.

The disadvantage of beta-lactams (penicillins and cephalosporins) is their low effectiveness against mycoplasma, klebsiella and legionella. Therefore, macrolides, which also act on these microbes, are widely used to treat pneumonia. Erythromycin, clarithromycin, and azithromycin are used both orally and by injection. The combination of macrolides and beta-lactams is especially effective.

An excellent treatment for pneumonia are the so-called respiratory fluoroquinolones: levofloxacin, moxifloxacin, gemifloxacin. They effectively act on almost all known pathogens of pneumonia. These drugs are prescribed once a day; they accumulate in the lung tissue, which improves the outcome of treatment.

The duration of treatment is determined by the doctor and is individual for each patient. Typically, treatment with antibacterial drugs is stopped if the patient has all of the following symptoms:

• body temperature below 37.8˚C for 2-3 days;
• heart rate less than 100 per minute;
• respiratory rate less than 24 per minute;
• systolic blood pressure more than 90 mm Hg. Art.;
• blood oxygen saturation according to pulse oximetry is more than 92%.

In most cases of uncomplicated pneumonia, the duration of antibiotic treatment is 7-10 days.

Pathogenetic and symptomatic therapy

If pneumonia is severe or has caused complications, the following drugs are used in addition to antibiotics:

• fresh frozen plasma and human immunoglobulin to restore immunity;
• heparin in combination with dextran to correct microcirculation disorders;
• albumin in case of a violation of the protein composition of the blood;
• saline sodium chloride solution, if necessary, potassium and magnesium salts for detoxification;
• oxygen using a nasal catheter, a mask, or even transfer to artificial ventilation;
• glucocorticoids in shock;
• vitamin C as an antioxidant that reduces cell damage;
• bronchodilators for proven bronchial obstruction: ipratropium bromide, salbutamol through;
• mucolytics (ambroxol, acetylcysteine) orally or through.

The patient needs bed rest and then gentle rest, a sufficiently high-calorie diet that is easy to digest, and plenty of fluids. Breathing exercises should be started 2-3 days after body temperature normalizes. It may include both special exercises, as well as basic ones, for example, inflating balloons 1-2 times a day.

During the period of resorption of the inflammatory focus, physiotherapy is prescribed:

• inductothermy;
• microwave therapy;
• electrophoresis of lidase, heparin, calcium chloride;
• thermal procedures (paraffin compresses).

Complications

Community-acquired pneumonia can be complicated by the following conditions:

• pleural effusion;
• pleural empyema;
• destruction of lung tissue (abscess formation);
• acute respiratory distress syndrome and acute respiratory failure;
• sepsis, septic shock, bacterial foci in other organs (heart, kidneys, etc.).

Of particular importance are purulent complications: lung abscess and pleural empyema. For their treatment, long-term antibiotic therapy is used, and for empyema (accumulation of pus in the pleural cavity), drainage is used.

Slowly resolving pneumonia

It happens that even after intensive antibiotic treatment, the symptoms of the disease disappear, but radiological signs remain. If they persist for more than 4 weeks, they speak of slowly resolving pneumonia. Risk factors for protracted course:

• age over 55 years;
• alcoholism;
• severe diseases of the lungs, heart, kidneys, diabetes;
• severe pneumonia;
• smoking;
• sepsis;
• resistance of microorganisms to drugs.

If these factors are present, the patient continues rehabilitation treatment, which we will talk about below, an x-ray control is prescribed after a month. If changes persist, additional research methods are prescribed. These methods are prescribed immediately if the patient does not have risk factors for prolonged pneumonia.

What diseases can occur under the guise of prolonged pneumonia:

• malignant tumors (lung and bronchus cancer, metastases, lymphoma);
• pulmonary embolism, pulmonary infarction;
• immunopathological diseases (vasculitis, aspergillosis, idiopathic pulmonary fibrosis and others);
• other diseases (heart failure, drug-induced lung damage, bronchial foreign body, sarcoidosis, pulmonary atelectasis).

To diagnose these conditions, bronchoscopy with biopsy, computed tomography and magnetic resonance imaging are used.

Residual effects of pneumonia

After the destruction of microorganisms in the lungs of a recovering patient, residual effects associated with subsiding inflammation, tissue regeneration, and a temporary weakening of the body’s defenses may be disturbing.

A persistent increase in body temperature to 37-37.5˚ may indicate non-infectious inflammation, post-infectious asthenia, and drug fever.

Changes on a chest x-ray may persist for 1-2 months after recovery. During the same time, the patient may complain of a dry cough, especially if he smokes or suffers from chronic bronchitis.

As a manifestation of post-infectious asthenia (weakness of the body), night sweats may persist, fast fatiguability. Typically, complete recovery takes 2-3 months.

The natural process is to maintain dry wheezing in the lungs for a month. An increased erythrocyte sedimentation rate may also be noted, which is a nonspecific process and does not provide any additional information.

Prevention

Prevention of pneumonia includes nonspecific and specific methods.

A specific method of preventing the disease is vaccination with pneumococcal vaccine and. It is suggested that these vaccinations be given to the following categories of the population who are at high risk of pneumonia and its complications:

• all people over 50 years of age;
• persons living in nursing homes;
• patients who have chronic diseases heart or lungs, diabetes mellitus, kidney disease, immunodeficiency conditions, including HIV-infected;
• women in the 2nd and 3rd trimesters of pregnancy;
• family members of the listed persons;
• medical workers.

Vaccination is carried out in October-November annually.

Nonspecific prevention of pneumonia:

• labor protection and compliance with hygiene standards at work;
• public health education;
• and giving up bad habits;

Despite the achievements of world medicine and the development of fundamentally new antibacterial drugs, pneumonia remains a life-threatening disease to this day. Among all infectious diseases, pneumonia occupies a leading position in the number of deaths of patients. Pneumonia is especially severe in categories of people with reduced immune potential, which include children and elderly citizens.

Symptoms and signs of lobar pneumonia

Lobar pneumonia is considered one of the most dangerous forms inflammatory process in the lungs. This pathology is characterized by large-scale tissue damage and serious complications. Lobar pneumonia is an acute disease with lobar lesions of the lungs, most often on both sides. It occurs with pronounced intoxication, accompanying toxic damage to other organs. A common causative agent of this pathology is Frindler's bacillus, which is particularly toxic and highly destructive. IN in rare cases pneumonia is provoked by opportunistic microorganisms, such as staphylococci and streptococci, when the body's immune activity decreases.

Inflammatory changes develop in the lobes of one or both lungs. The inflammatory infiltrate compresses the alveoli with small-caliber bronchi and pulmonary edema develops. Pathogenesis reflects the specific symptoms of pneumonia and is the proliferation of pathogenic bacteria in the lower tract of the respiratory system and the activation of protective immune processes, including a delayed-type hypersensitivity reaction.

What are the main symptoms of lobar pneumonia?

1. Symptom of "Rusty sputum".
2. Weakness due to intoxication.
3. Chest pain.
4. Painful cough.

Pulmonary inflammation shows symptoms very quickly. The body temperature rises to 39ºC, shortness of breath appears with a dry cough, but two days later, the cough intensifies and sputum appears with a characteristic orange color, containing hemolyzed red blood cells. The patient's general condition deteriorates sharply and severe pain appears in the area of ​​​​the projection of the lung tissue.

Symptoms and signs of focal pneumonia

Focal pneumonia is another type of inflammatory process in the respiratory tract. A characteristic feature of this type of disease is the limited localization of the pathological focus, in the lobule. With its symptoms, focal pneumonia often resembles bronchitis, and therefore the diagnosis of the disease is complicated and is already detected in the later stages, when the infectious process has managed to cause significant harm to the body.

There are several types of focal pneumonia:

1. Infectious.
2. Aspiration.
3. Hypostatic.
4. Traumatic.
5. Postoperative.

Penetration of the pathogen often occurs through the bronchogenic pathway, when bacteria enter the alveolar space from the bronchial system. Usually one lung is affected, with inflammation occurring within one or several lobules.

What are the symptoms of focal pneumonia?

1. Low-grade fever.
2. Cough with mucous discharge.
3. General weakness of the body.
4. Dyspnea.

The disease develops acutely with symptoms similar to acute respiratory viral infections. Fever begins with low-grade fever and can reach 40ºC; with adequate treatment, its duration is no more than five days. The cough in the initial period of the disease is often dry, and two days later it becomes mucopurulent in nature.

The specific action of toxins from pathogenic bacteria causes characteristic signs of pneumonia. Bacterial toxins act systemically and cause severe intoxication syndrome, which manifests itself in general weakness of the body, signs of inflammation of the lung tissue, due to the alterative action of microbial substances. Infiltrative foci, including alveolar sacs and bronchioles, complicate gas exchange within the lungs and provoke the development of shortness of breath with tachypnea.

Symptoms and signs of pneumonia in people with alcohol dependence

People who abuse alcohol and smoking are highly susceptible to pneumonia. Couples ethyl alcohol have a strong irritant effect on the mucous membrane of the bronchopulmonary system, thereby reducing its protective functions and creating favorable conditions for the penetration and development of infectious agents. The complicated course of pneumonia is also facilitated by: vitamin deficiency as a consequence of an unbalanced diet, hormonal disorders, immunodeficiency states and toxic damage to the liver with disruption of its normal functioning.

The lung tissue of alcoholics contains less glutathione, which is a powerful antioxidant and protects the lungs from the damaging effects of reactive oxygen species. In addition, ethanol destroys the protein claudin, which is part of the blood-air barrier. With the help of this barrier, gases are exchanged between the blood and the external environment, so if there is a deficiency of claudin, then liquid media begin to permeate the pulmonary parenchyma. Thus, ideal conditions are created for the development of the infectious process.

In patients with alcoholism, the signs of pneumonia do not have any special manifestations. One has only to take into account that the clinic, in the background alcohol intoxication, may be erased and not have clearly defined symptoms, however, this does not exclude the development of a pathological process in the respiratory organs.

What are the signs of pneumonia in alcoholism?

1. Body temperature is in the low subfebrile range.
2. Cough with expectoration.
3. Lagging of the affected side of the chest in the act of breathing.
4. The pain is mild.
5. Dyspnea.
6. Cyanosis.

Alcoholism makes it difficult to diagnose the pathology, so an accurate diagnosis can only be made after a complex of instrumental studies. The main and most important method is X-ray examination chest organs. Only on the basis radiological symptoms a definitive diagnosis can be made and treatment can be prescribed.

Symptoms and signs of pneumonia in children

Childhood pneumonia deserves Special attention. Already starting from the second half of the year, the child’s body is susceptible to the development of a generalized inflammatory process. A child’s body at different periods of its life has certain functioning features, and all this will certainly affect how pneumonia is expressed in children of a particular age group. In childhood, Haemophilus influenzae and pneumococci are common causative agents of infection. At a younger age, pneumonia can be caused by mycoplasma, in particular in the summer-autumn period of the year. In adolescence, chlamydia becomes a common causative agent of pneumonia.

Factors contributing to the activation of opportunistic microflora:

1. Post-mortem ARVI.
2. Hypothermia.
3. Entry of foreign bodies and substances into the respiratory tract.
4. Vitamin deficiency.
5. Immunodeficiency states.
6. Congenital malformations.
7. Rickets.

With frequent regurgitation, vomit certainly enters the airways, introducing microflora from digestive tract: Staphylococcus aureus and Escherichia coli, the activity of which causes the development of characteristic signs of pneumonia.

Pathogens penetrate the airways through airborne droplets. In this case, the disease develops as a primary pathological process, but often pneumonia is secondary, as a complication of the inflammatory process in the upper parts of the pulmonary system. Secondary pneumonia is more often recorded in children.

With the penetration of the pathogen, edema develops on the bronchial mucosa as a result of which the air supply to the alveoli becomes difficult, they begin to collapse, gas exchange is disrupted, oxygen deficiency and acidotic conditions develop.

Nosocomial pneumonia is very dangerous.

They develop in a hospital setting, when the child is being treated for another disease. The causative agents of hospital-acquired pneumonia are distinguished by their resistance to many antibiotics, which seriously impedes treatment and often threatens the life of a sick child. Chemotherapy given to the child may contribute to the development of hospital-acquired pneumonia. Antibacterial therapy has a detrimental effect on the child’s normal flora, which is replaced by new resistant strains. Such antibiotic-resistant bacteria cause hospital-acquired pneumonia symptoms, which appear two days after discharge from the hospital. Often this disease affects newborns already on the third day of their life.

As in adults, lobar pneumonia is possible in children. Inflammation caused by pneumococcus covers several segments at once, and more often the entire lobe of the lung, involving the pleura in the pathological process. It is more often found in children of preschool and school age. Lobar pneumonia almost always affects the lower lobe of the left lung, which is valuable information for diagnosis.

Interstitial pneumonia is characterized by the localization of an inflammatory focus in the connective tissue structures of the lung. This type of pneumonia occurs in children in the first two years of life. The pathology is particularly severe in infants.

Frequent pathogens interstitial pneumonia:

1. Viruses.
2. Pneumocystis.
3. Mycoplasmas.
4. Chlamydia.

Other causes of childhood pneumonia:

1. Allergens.
2. Worm infestation.
3. Action of chemical and physical irritating factors.

The younger the child is, the higher the risk of developing and the severity of pneumonia. The frequent occurrence of the above pathology is facilitated by anatomical and physiological factors in young children:

1. Immaturity of lung tissue.
2. The upper airways are wider and shorter, while the lower ones are narrow.
3. The mucous membrane is loose with a large abundance of blood vessels.
4. Immaturity of the ciliated epithelium.
5. Abdominal type of breathing.
6. Immaturity of the immune system organs.
7. Artificial feeding.
8. Toxic effects tobacco smoke due to family members smoking.
9. Rachitic factors.

The clinical picture of the disease depends not only on the infectious pathogen, but also on the age of the patient. The older age group of children has clearer symptoms, which cannot be said about young children, who, with a minimally developed pathological process, may experience severe respiratory failure due to oxygen starvation. As a result, it is quite difficult to assume the development of a pathological process.

What signs of pneumonia can occur in childhood?

1. Difficulty in nasal breathing.
2. Tearfulness.
3. Signs of laryngospasm.
4. Temperature above 38°C.
5. Increased breathing.
6. Increased heart rate.
7. Paleness of the skin.
8. Blueness of the nasolabial triangle.
9. Sweating.
10. Participation of auxiliary muscles in breathing.
11. Retraction of intercostal spaces.
12. Movement of the wings of the nose.
13. Cough (superficial, deep, paroxysmal, dry, wet).

In school-age children, it is almost always preceded by minor manifestations of acute respiratory viral infections. Three days after the condition normalizes, chest pain and a sharp rise in temperature occur.

Pneumonia caused by chlamydia occurs catarrhal phenomena in the pharynx and the cervical groups of lymph nodes increase in size. For mycoplasma inflammation distinctive feature are a dry cough and hoarseness of voice, against the background of a relatively low body temperature.

Symptoms and signs of pneumonia in older people

In old age there are characteristics how pneumonia manifests and progresses. In older people, pneumonia occurs due to weakening of the immune system's defense mechanisms, accumulation of toxins and tissue damage. All these negative manifestations are the result of physiological aging of the body.

Many older people suffer strokes and heart attacks, which makes them inactive. In people with reduced physical activity congestion often occurs in lower parts lungs, which provokes the development of inflammatory processes. In patients who are on bed rest for a long time, pneumonia often leads to a significant deterioration of the condition, as well as death.

Symptoms of pneumonia in older people differ significantly from clinical manifestations In young age. In old age, pneumonia occurs latently for a long time (without pronounced symptoms), which is a serious obstacle to diagnosis and it becomes impossible to start treatment in advance. Often the onset of inflammation occurs against the background of neurotoxic disorders, accompanied by a disorder of consciousness, the occurrence of irritability, hyperesthesia and emotional lability. An interesting fact is the absence of increased body temperature and leukocytosis at an early stage of the development of pathology.

What are the possible symptoms of pneumonia in older people?

1. Dyspnea.
2. Nonproductive cough.
3. Chest pain.
4. By participating in the act of breathing the auxiliary muscles.
5. Fine bubbling rales.
6. Increased body temperature.
7. Impaired consciousness.
8. Appetite disorders.
9. Losing weight.
10. Cyanosis of the skin.

Often, patients with pneumonia experience acrocyanosis, which manifests itself as blue discoloration of the fingertips and lips. Symptoms of respiratory failure often occur, especially in patients with chronic pathology respiratory system. It is impossible to describe specific symptoms for pneumonia in the elderly, since they will vary depending on pre-existing concomitant diseases of the respiratory system and other systems.

Early diagnosis of pneumonia is of great importance, since advanced pathology can lead to many complications from the respiratory system.

One of the most dangerous complications is respiratory failure. The likelihood of its development is very high in the elderly and young children, as well as in patients of all age categories with concomitant pathology of the lungs and heart. Often, respiratory failure leads to fatalities. That is why you should pay special attention to the general symptoms of lung pathologies, so that in case of an unpleasant diagnosis, you can start treatment in time and save the body from chronic inflammatory processes and the development of complications.

Pneumonia is usually called a whole group of diseases that are usually of an infectious nature (the process is caused by the penetration and proliferation of microorganisms in the lungs). Pneumonia is characterized by damage mainly to the alveoli - the sacs in which gas exchange occurs (oxygen enters the body through a special membrane, and carbon dioxide leaves the body). In this case, inflammatory exudation occurs in the alveoli: against the background of their inflammation, fluid is released from microvessels that are located in the walls of the alveoli (exudate). The symptoms of pneumonia are entirely determined by the introduction of the pathogen and how the lung tissue reacts to it.

In addition to the properties of the microorganism that was the causative agent of the disease in a given patient, the course of the disease in adults and its overall prognosis are also influenced by the patient’s concomitant diseases and the risk factors to which he is permanently exposed.

The simplest and, at the same time, most convenient working classification of pneumonia in adults. All pneumonia in adults is usually divided into the following groups:

1. Community-acquired pneumonia (if the infection occurred outside the walls of a medical institution)
2. Nosocomial pneumonia (nosocomial)
3. Pneumonia in persons with immunodeficiency conditions
4. “Atypical” pneumonia (usually caused by intracellular pathogens that are not typical for most cases of the development of the disease)

The most common form of the disease in adults in Russia at the moment is community-acquired pneumonia. In initially healthy adults, the infection is most often single (one pathogen). But in the elderly and people with underlying serious diseases, the infection can be associated (several pathogens together). This somewhat complicates the competent selection of medications (antibacterial) and treatment.

Pneumococcus as the most common cause of the disease

Typically, the causative agent of pneumonia in adults is the bacterium pneumococcus. This microorganism has a special capsule that does not allow blood cells (neutrophils, monocytes) to capture it and destroy it. However, in many adults, pneumococcus is normally present in the lungs, but does not cause illness.

Pneumococcus (lat. Streptococcus pneumoniae) - a type of bacteria of the genus Streptococcus, a nonmotile lanceolate diplococcus 0.5-1.25 µm long

The pathogen spreads by airborne droplets (the potential patient simply inhales it along with various particles from the air), when the patient or carrier of the microorganism sneezes or coughs.

So-called outbreaks of the disease are characteristic of winter. They are especially noticeable where many people are concentrated in one place (schools, boarding schools, prisons, barracks, etc.)

Less commonly, community-acquired pneumonia can be caused by other microorganisms:

Main signs of the disease

The formation of the clinical picture in adults involves symptoms of local inflammation of the lung tissue (wheezing, for example), extrapulmonary signs (temperature and other symptoms) and complications of the disease, as well as the results of laboratory and instrumental studies. The most common types of pneumonia should be considered lobar (if the entire lobe of the right or left lung is affected) pneumonia and bronchopneumonia (lung tissue is involved in a small area).

Features of the course and diagnosis of lobar pneumonia

Lobar pneumonia in adults typically affects the entire lobe of the right or left lung. In this case, the pleura (the membrane of the lung that tightly covers it, like a bag) also participates in the process of inflammation.

The disruption of the vascular wall in the microvessels of the alveoli in lobar pneumonia is very significant. Exudate, liquid released into tissue from small blood vessels during inflammation, is fibrinous in nature (fibrin protein is released from the vessels into the alveoli). The large bronchi are free and their patency is not impaired.

The way pneumonia manifests depends on the stage of the disease, of which there are three:

It should be noted that nowadays a clearly defined staged process of pneumonia in lobar pneumonia can not be seen very often. This is due to the use of various drugs to treat the disease, as well as changes in the properties of the pathogens themselves.

During diagnosis, signs of pneumonia characteristic of this form of the disease are usually revealed. The first signs of pneumonia are fever (temperature over 37 degrees: 39-40),

chest pain arising from involvement of the pleural layers in the process of inflammation, pain in the back, head and muscles, weakness, sweating and lethargy. In this case, the patient usually clearly remembers the day and hour of the onset of the disease, since its onset is acute. And a rising temperature (temperature significantly above 37 degrees) is usually preceded by severe shaking chills, which can last from 1 to 3 hours. The fever itself can persist for a week, however, against the background of adequate drug treatment(treatment with antibacterial drugs), it is now usually possible to reduce this period to 3-4 days.

If the temperature does not remain approximately at the same level (above 37 degrees), but constantly changes by 1-2 degrees, then one should look for destruction of the lung tissue (destruction can also occur with tuberculosis; then it is necessary to accurately distinguish the signs of pneumonia, since treatment for tuberculosis other). This course of events may be accompanied dangerous complications. Pneumonia pain in the chest and back,

which the patient usually associates with breathing (due to the movement of the inflamed pleura), usually end after 2-3 days from the onset of the disease. A cough does not occur until sputum begins to enter the large parts of the respiratory tract (large bronchi and trachea).

At first, the cough is dry, especially strong or occurring during inhalation (accompanied by chest and back pain). Two days after the onset of the disease (due to the release of exudate and its entry into the large bronchi), the signs of the disease change somewhat. With a cough, sputum begins to come out. At first it may be brownish in color (with few blood cells) due to the release of red blood cells (red blood cells) in the exudate. Later, the sputum takes on a mucous (transparent) or mucopurulent (transparent yellowish) appearance. The temperature may drop slightly.

In addition to the symptoms described above, lobar pneumonia is always accompanied by shortness of breath. How severe the shortness of breath is depends on the area affected in the lung (its size). This phenomenon is due to three main factors:

1. Part of the lung cannot take part in breathing
2. The elasticity of the organ is reduced due to the inflammatory process in it
3. The ratio of blood gases may shift slightly from the norm due to the involvement of the membrane through which gases are exchanged in inflammation

Examination of the patient at different periods will demonstrate different signs pneumonia.

During the hot flash stage, the patient may take a forced position (lying on the painful side or partially on the back with emphasis on the painful side) due to severe pleural pain (trying to limit the movement of the affected person). lung department). He is febrile (temperature well above 37 degrees). The skin is somewhat damp. When listening to the lungs in the affected area, breathing is weakened; on inspiration, you can hear crepitus (a gentle crackling sound, reminiscent of the crunch of snow underfoot in frosty weather).

The mechanism of crepitation during the flushing stage of lobar pneumonia

It is due to the fact that the walls of the respiratory sacs are lined with exudate and when inhaling, they undergo a kind of “explosion” (this is crepitus). There are no wheezes. If you perform percussion (tapping), then in the projection of the area that is affected, the sound will be shorter (dull) than over other areas of the organ.

During the hepatization stage, the patient's temperature usually remains above 37 degrees. A cough with rust-colored sputum appears (due to blood cells in it). The position on the affected side may be maintained (this depends on how much the pleura is involved in the process). If gas exchange is significantly impaired, there may be cyanosis (bluish-gray skin color due to insufficient oxygen in the blood). The patient breathes frequently (takes up to 30 breaths per minute). The percussion (when tapping) sound over the affected area is almost completely dull (to hear a real dull sound, you need to percussion the thigh). When listening to the lungs above the affected area, you can hear the so-called bronchial breathing (you can imitate this sound if you start saying “hee” and breathe a little with your mouth at the position of the lips for the letter “i”).

Percussion and auscultation data during the resolution stage coincide with those during the tide stage. Outwardly, a clear improvement in the patient’s condition is visible, and he himself admits that he feels much better. The pain when breathing goes away. Shortness of breath decreases. The cough stops tormenting the patient. Less sputum is produced (and it is usually already transparent). The temperature is normalizing. Of course, all this happens quickly if the treatment was chosen correctly.

In addition to the diagnostic methods described above, which do not have a “hardware” basis, voice tremors can provide reliable information. Voice tremors are sound wave, which passes through the lung tissue when speaking.

If you put your hands on your chest, you can feel (“feel”) the vocal tremor with your fingertips. Vocal tremors are best felt when patients make “growling” sounds. So he is asked to say “thirty-three.” With lobar pneumonia, vocal tremors over the affected area are intensified, since the lung tissue is, as it were, “compressed” (compacted, airless): sound transmission is facilitated.

Features of the course and diagnosis of focal pneumonia

If, with pneumonia, a small area in the lung is affected - a focus, then it usually has a connection with the bronchus, which supplies this area with air (first the bronchus becomes inflamed, and then inflammation begins in the lung area). Therefore, focal pneumonia is also called bronchopneumonia. It differs somewhat from lobar pneumonia in its course and diagnostic data obtained by the doctor during examination.

The phenomena of exudation in bronchopneumonia are weakly expressed. Usually the exudate is immediately mucous or mucopurulent in nature and quickly ends up in the bronchi. The patient's cough is almost immediately accompanied by sputum production. There are no stages in the course of bronchopneumonia, since different small areas of the organ are simultaneously at different stages of the inflammatory process.

The onset of bronchopneumonia is usually noted by the patient as gradual. The temperature slightly exceeds 37 degrees (usually no higher than 37 and a half or 38). The patient's skin is moist and may be paler than usual, and the lips may have a bluish tint. Since the affected area is small in area, vocal tremor and percussion are not of decisive importance. More important is the data from listening to the lungs: breathing over the affected area is weakened (muffled) and may be harsh. The most important sign of pneumonia will be wheezing.

These wheezes are called “fine-bubble wheezing” (wet wheezing, sonorous wheezing). Usually, wheezing is better heard when listening to the lungs on the back (not with the patient in the supine position, but with the phonendoscope - the listening device - on the back). Wheezing can be heard during the entire inhalation. Sometimes, if the inflammation affects a small area of ​​the pleura, rales may be accompanied by a pleural friction rub (similar to crepitus, but not associated with just one breath).

Diagnosis confirmation

Diagnosis of pneumonia can be carried out not only physically (objective examination during direct contact with the patient: examination, percussion or auscultation, etc.) It is important to distinguish pneumonia from other lesions of the lung tissue (with tuberculosis, for example). For this purpose, diagnostic methods such as radiography are used. In this case, the image usually shows clearly visible areas of shading (the affected lesion or lobe).

The patient's sputum and blood are also examined. Leukocytosis is detected in the blood (an increase in blood cells - white blood cells, responsible for inflammation), as well as an increase in various biochemical substances involved in inflammation (C-reactive protein, for example). However, signs of pneumonia in the blood are nonspecific (detected in any inflammatory process).

In addition, bacterial culture of sputum is performed to understand which microorganism caused the disease and to select antibacterial drugs to which this particular pathogen is sensitive.

This is especially important for tuberculosis. It is not always possible to easily distinguish the manifestations of pneumonia from the signs that occur in a patient with tuberculosis. And the treatment of these diseases is radically different. It is important that for tuberculosis and pneumonia, microorganisms (the causative agent for tuberculosis is Mycobacterium tuberculosis) will behave differently after sowing. In addition, the sputum itself in tuberculosis has its own characteristics (often contains streaks of blood).

Therapeutic measures

Treatment of pneumonia usually comes down to eliminating the cause of the disease (treatment with antibacterial drugs) and alleviating the symptoms of the disease. In order for antibiotic treatment to be effective, when culturing a culture of the causative microorganism, its sensitivity (susceptibility) to specific antibacterial drugs is checked in order to prescribe those antibiotics that can destroy the bacterium.

Symptomatic treatment involves antipyretics and expectorants (to facilitate and accelerate sputum production).

It is important to remember that treatment with antibacterial drugs is of paramount importance. If there are no symptomatic components of therapy, then this is not as scary as if there are no antibacterial components.

The incidence of pneumonia in children of the first year of life is 15-20 per 1000 children, over 3 years old 5-6 per 1000, in adults 10-13 per 1000 adults. The high incidence of pneumonia in young children is associated with the anatomical and physiological characteristics of the respiratory system.

Anatomy and physiology of the lungs

The lungs are located in the chest cavity. Each lung is divided into parts (segments), the right lung consists of three segments, the left lung of two, since it is adjacent to the heart, therefore the volume of the left lung is less than that of the right by about 10%.

The lung consists of the bronchial tree and alveoli. The bronchial tree in turn consists of bronchi. Bronchi come in different sizes (caliber). The branching of bronchi from large caliber to smaller bronchi, up to the terminal bronchioles, is the so-called bronchial tree. It serves to conduct air during inhalation and exhalation.

The bronchioles, decreasing in diameter, pass into the respiratory bronchioles and ultimately end in the alveolar sacs. The walls of the alveoli are very well supplied with blood, which allows gas exchange.

The inside of the alveoli is covered with a special substance (surfactant). It serves to protect against microbes, prevents the collapse of the lung, and is involved in the removal of germs and microscopic dust.

Features of the respiratory system in young children

2. In newborns horizontal position ribs and underdeveloped intercostal muscles. Children at this age are in a horizontal position for a long time, which leads to stagnation of blood circulation.

3. Imperfect neural regulation respiratory muscles, which leads to respiratory failure.

Main forms of pneumonia

Causes of pneumonia

According to many scientists, in 50% of all patients with pneumonia the cause remains unknown.

The causative agents of pneumonia in early childhood are most often staphylococcus, mycoplasma, microviruses, and adenoviruses.

The most dangerous is a mixed viral-microbial infection. Viruses infect the mucous membrane of the respiratory tract and provide access to microbial flora, which aggravates the manifestations of pneumonia.
I would like to note other causes of pneumonia

Pneumonia symptoms (manifestations)

The onset of the disease can be either gradual or sudden.

Signs of intoxication.
1. Increase in body temperature from 37.5 to 39.5 degrees Celsius.
2. Headache of varying intensity.
3. Deterioration of well-being in the form of lethargy or anxiety, decreased interest in the environment, sleep disturbances, night sweats.

From " pulmonary symptoms» Cough may be noted. Its character is dry at the beginning, and after some time (3-4 days) it becomes moist with the production of copious sputum. Usually the sputum is rusty in color due to the presence of red blood cells.

In children, cough with rusty sputum occurs mainly at an older age. Cough occurs as a result of inflammation of the bronchial and tracheal mucosa under the influence of inflammatory mediators, or mechanical (sputum) irritation.
Swelling interferes normal operation lung and therefore, with the help of coughing, the body tries to cleanse it. When a cough lasts 3-4 days, there is a persistent increase in pressure in all structures of the lung, so red blood cells move from the vessels into the lumen of the bronchi, forming rust-colored sputum along with mucus.

In addition to coughing, chest pain appears on the side of the damaged lung. The pain usually gets worse when you inhale.

Signs of pulmonary failure include symptoms such as: shortness of breath, cyanosis (blue discoloration) of the skin, especially the nasolabial triangle.
Shortness of breath appears more often with extensive pneumonia (bilateral); inhalation is especially difficult. This symptom appears due to the shutdown of the affected part of the lung from function, which leads to insufficient oxygen saturation of the tissues. The larger the focus of inflammation, the stronger the shortness of breath.

Rapid breathing, for example, in children over one year old (more than 40 breaths per minute) is one of the main signs of pneumonia. Blue discoloration of the nasolabial triangle is especially noticeable in young children (during breastfeeding), but adults are no exception. The cause of cyanosis is again a lack of oxygen.

Course of pneumonia: The duration of the disease depends on the effectiveness of the prescribed treatment and the reactivity of the body. Before the advent of antibiotics, the high temperature dropped on days 7-9.

When treated with antibiotics, the temperature may drop early. Gradually the patient's condition improves, the cough becomes more wet.
If the infection is mixed (viral-microbial), the disease is accompanied by damage to the cardiovascular system, liver, and kidneys.

Diagnosis of pneumonia

What awaits you at the doctor?

In children, radiographic changes characteristic of pneumonia may develop before the appearance of symptoms of pneumonia (wheezing, decreased breathing). In children, when the lower lobe of the lung is affected, it is necessary to differentiate pneumonia even from appendicitis (children complain of pain in the abdominal area).

Pneumonia in the picture

Effective treatmentpneumonia

Hygiene, regimen and nutrition for pneumonia

2. Balanced diet : increase fluid intake 1.5-2.0 liters per day, preferably warm. You can use fruit drinks, juices, tea with lemon. Do not eat fatty foods (pork, goose, duck), confectionery products (cakes, pastries). Sweets enhance inflammatory and allergic processes.

3. Clearing the respiratory tract of mucus, by expectoration.
In children under one year of age, the respiratory tract is cleansed of mucus and sputum at home by the mother (the oral cavity is cleaned with a napkin). In the department, mucus and sputum are sucked out with an electric suction from the oral cavity and nasopharynx.

4. Regular ventilation and wet cleaning of the room, when there is no patient in the room.
When the air temperature outside is more than 20 degrees, the window in the room should always be open. At lower temperatures outside, the room is ventilated at least 4 times a day, so that in 20-30 minutes the temperature in the room drops by 2 degrees.
In winter, to avoid rapid cooling of the room, close the window with gauze.

What medications are used for pneumonia?

Broad-spectrum antibiotics are most often used. The choice of group of antibiotics and the route of their administration (orally, intramuscularly, intravenously) depends on the severity of pneumonia.

For mild forms of pneumonia, antibiotics are usually used in tablet form and in the form of intramuscular injections. The following drugs are used: Amoxicillin 1.0-3.0 grams per day in 3 doses (orally), cefotaxime 1-2 grams every 6 hours intramuscularly.

Treatment of mild pneumonia is possible at home, but under the supervision of a doctor.

Severe forms of pneumonia are treated in the hospital in the pulmonology department. Antibiotics in the hospital are administered either intramuscularly or intravenously.

The duration of antibiotic use should be at least 7 days (at the discretion of the attending physician)
The frequency of administration and dosage are also selected individually. As an example, we give standard drug regimens.

Cefazolin 0.5-1.0 grams intravenously 3-4 times a day.

Cefepime 0.5-1.0 grams intravenously 2 times a day.

On the 3-4th day of taking antibiotics (or simultaneously with the start of taking antibacterial drugs), an antifungal drug (fluconazole 150 milligrams, 1 tablet) is prescribed to prevent fungal infection.

An antibiotic destroys not only the pathogenic (disease-causing) flora, but also the natural (protective) flora of the body. Therefore there may be fungal infection, or intestinal dysbiosis. Therefore, the manifestation of intestinal dysbiosis can manifest itself loose stools, bloating. This condition is treated with drugs such as bifiform, subtil after completing a course of antibiotics.

When using antibiotics, it is also necessary to take vitamins C and group B in therapeutic doses. Expectorants and sputum thinners are also prescribed.

When the temperature normalizes, physiotherapy (UHF) is prescribed to improve the resorption of the source of inflammation. After the end of the UHF, 10-15 sessions of electrophoresis with potassium iodide, platiphylline, lidase are carried out.

Herbal medicine for pneumonia

These plants are mixed in equal parts, ground and 1 tablespoon of the collection is poured with 1 glass of boiling water, simmered for 10-20 minutes (boiling bath), infused for 1 hour, drunk 1 tablespoon 4-5 times a day.

Physiotherapy an obligatory part of the treatment of patients with acute pneumonia. After normalization of body temperature, short-wave diathermy and UHF electric field can be prescribed. After completing the UHF course, 10-15 sessions of electrophoresis with potassium iodine and lidase are performed.

Adequate treatment of pneumonia is possible only under the supervision of the attending physician!

Therapeutic exercise for pneumonia

1. Strengthening the general condition of the patient
2. Improving lymph and blood circulation
3. Prevention of the formation of pleural adhesions
4. Strengthening the heart muscle

In the initial lying position, breathing exercises with simple movements of the limbs are performed 2-3 times a day. Then include slow turns of the body and bends of the body. The duration of classes is no more than 12-15 minutes.

For preschool children, gymnastics is used partly using a play method. For example, walking in various variations. Using the story “a walk in the forest” - a hunter, a bunny, a clubfooted bear. Breathing exercises (the porridge is boiling, the woodcutter, the ball burst). Drainage exercises - from a position, standing on all fours and lying on its side (the cat is angry and kind). Exercises for the chest muscles (mill, wings). Ends with walking with a gradual slowdown.

To finally convince you that treatment should be carried out under the supervision of a doctor, I will give several possible complications pneumonia.

An abscess (accumulation of pus in the lung), which, by the way, is treated with surgery.

Pulmonary edema - which, if not treated promptly, can lead to death.

Sepsis (the entry of microbes into the blood) and, accordingly, the spread of infection throughout the body.

Prevention of pneumonia

• Proper nutrition (fruits, vegetables, juices), walks in the fresh air, avoiding stress.
• In winter and spring, to avoid a decrease in immunity, you can take a multivitamin complex, for example, Vitrum.
• To give up smoking .
• Treatment of chronic diseases, moderate alcohol consumption.
• Exception is important for children passive smoking, consultation with an otolaryngologist if the child often suffers from colds, timely treatment of rickets, anemia.

Breathing exercises using yoga techniques for the prevention of diseases of the respiratory system

2. Stand up straight. Hands forward. Inhale: while holding the breath, wave your arms like a mill. Exhale vigorously with your mouth open.

3. Stand up straight. Grab yourself by the shoulders with your fingertips. While inhaling, connect your elbows to your chest and spread them wide several times. Exhale vigorously with your mouth wide open.

4. Stand up straight. Inhale in three vigorous, gradual breaths. In the first third, stretch your arms forward, in the second, to the sides, at shoulder level, in the third, up. Exhale forcefully, opening your mouth wide.

5. Stand up straight. Inhale, rising onto your toes. Hold your breath while standing on your toes. Exhale slowly through your nose, lowering onto your heels.

6. Stand up straight. As you inhale, rise onto your toes. Exhaling, sit down. Then stand up.

How does pneumonia manifest in children?

In most cases, pneumonia in children manifests itself in the form of three main syndromes.

The main syndromes of pneumonia in children are:

• general intoxication syndrome;
• syndrome of specific inflammation of lung tissue;
• respiratory distress syndrome.

Signs of general intoxication syndrome are:

• increased body temperature;
• increased heart rate ( more than 110 – 120 beats per minute for preschool children, more than 90 beats per minute for children over 7 years old);
• fatigue;
• fast fatiguability;
• drowsiness;
• pale skin;
• decreased appetite to the point of refusing to eat;
• rarely sweating;
• rarely vomiting.

Syndrome of specific inflammation of lung tissue
The most characteristic signs of pneumonia in children are signs indicating organic lesion lungs, infection and inflammation.

Signs of specific inflammation of the lung tissue during pneumonia are:

• cough;
• pain syndrome;
• auscultatory changes;
• radiological signs;
• deviations from the norm in the hemoleukogram ( general blood test).

Pneumonia in children usually goes away without pain. Painful sensations in the form of aching pain in the abdomen may appear when the lower segments of the lungs are affected.
When the inflammatory process from the lungs moves to the pleura ( the lining of the lungs), children complain of chest pain when breathing. The pain is especially worse when trying to take a deep breath and when coughing.

On radiographs of pneumonia in children, darker areas of lung tissue are noted, which correspond to the affected areas of the lungs. Areas can cover several segments or entire lobes. In a general blood test for pneumonia, an increased level of leukocytes due to neutrophils is observed ( leukocytes with granules) and increased ESR ( erythrocyte sedimentation rate).

Respiratory distress syndrome
As a result of damage to the lung tissue during pneumonia, the area of ​​the “breathing” surface of the lungs decreases. As a result, children develop respiratory failure syndrome. How smaller child, the faster he develops respiratory failure. The severity of this syndrome is also influenced by concomitant pathologies. So, if a child is weak and often gets sick, then the symptoms of respiratory failure will quickly increase.

Signs of respiratory failure with pneumonia are:

• dyspnea;
• tachypnea ( increased breathing movements);
• difficulty breathing;
• mobility of the wings of the nose when breathing;
• cyanosis ( bluish coloration) nasolabial triangle.

With pneumonia, children experience difficult, irregular breathing. Attempts to take a deep breath are accompanied by great efforts involving all muscle groups of the chest. During breathing in children, you can see retraction of the skin in the subcostal or supraclavicular area, as well as in the spaces between the ribs.
During inhalation, mobility of the wings of the nose is observed. The child seems to be trying to inhale more air by inflating the wings of his nose. This is another distinctive sign that indicates respiratory failure.

What are the features of pneumonia in newborns?

Another feature of pneumonia in newborns is the predominance of symptoms of general intoxication. So, if in adults pneumonia is more manifested by pulmonary symptoms ( cough, shortness of breath), then intoxication syndrome predominates in newborns ( refusal to feed, convulsions, vomiting).

Pneumonia in newborns may have the following manifestations:

• refusal to breastfeed;
• frequent regurgitation and vomiting;
• shortness of breath or wheezing;
• convulsions;
• loss of consciousness.

The first thing the mother notices is that the child refuses to eat. He whines, is restless, throws up his chest. In this case, a high temperature may not be observed, which will complicate the diagnosis of the disease. A slight increase in temperature or a decrease in temperature is usually observed in premature infants. High temperature is typical for children born at normal terms.

Newborns immediately show signs of respiratory failure. In this condition, an insufficient amount of oxygen enters the child’s body, and body tissues begin to experience oxygen starvation. Therefore, the child’s skin acquires a bluish tint. The skin of the face begins to turn blue first. Breathing becomes shallow, intermittent and frequent. The frequency of respiratory excursions reaches 80–100 per minute, while the norm is 40–60 per minute. At the same time, the children seem to groan. The breathing rhythm is also interrupted, and children often develop foamy saliva on their lips. Against the background of fever, convulsions occur in more than half of the cases. So-called febrile convulsions occur at high temperatures and are clonic or tonic in nature. Children's consciousness is rarely preserved at such moments. It is often confused, and children are sleepy and lethargic.

Another difference between pneumonia in newborns is the presence of so-called intrauterine pneumonia. Intrauterine pneumonia is one that developed in a child while he was still in the womb. The reason for this may be various infections that a woman suffered during pregnancy. Also, intrauterine pneumonia is typical for premature babies. This pneumonia appears immediately after the birth of the child and is characterized by a number of symptoms.

Intrauterine pneumonia in a newborn baby may have the following features:

• the baby’s first cry is weak or absent altogether;
• the baby's skin has a bluish tint;
• breathing is noisy, with multiple moist rales;
• decrease in all reflexes, the child reacts poorly to stimuli;
• the baby does not latch on to the breast;
• swelling of the limbs is possible.

Intrauterine pneumonia in newborns is most often caused by bacterial flora. These can be peptostreptococci, bacteroides, E. coli, but most often they are group B streptococci. In children after six months, pneumonia develops against the background of a viral infection. So, it first develops viral infection (for example, flu), to which bacteria subsequently attach.

The most common pathogens of pneumonia in children of the first year of life

The following forms of pneumonia are typical for newborn children:

• microfocal pneumonia– on X-ray images there are small areas of darkening ( appears white on film);
• segmental pneumonia– the focus of inflammation occupies one or more lung segments;
• interstitial pneumonia– it is not the alveoli themselves that are affected, but the interstitial tissue between them.

What temperature can there be with pneumonia?

The nature of the temperature depends on the form of pneumonia, the degree of reactivity of the body and, of course, the age of the patient.

How does pneumonia caused by Klebsiella occur?

The main syndromes that dominate the clinical picture of pneumonia caused by Klebsiella are intoxication syndrome and lung tissue damage syndrome.

Intoxication syndrome
One of important features Klebsiella pneumonia is an acute, sudden onset due to the action of microbial toxins on the human body.

The main manifestations of intoxication syndrome are:

• temperature;
• chills;
• general weakness;
• increased sweating;
• dizziness;
• headache;
• delirium;
• prostration.

Lung tissue damage syndrome
Klebsiella are quite aggressive towards lung tissue, causing destruction ( destruction) lung parenchyma. For this reason, the course of Klebsiella pneumonia is particularly severe.

Symptoms of lung tissue damage due to pneumonia caused by Klebsiella are:

• cough;
• sputum;
• pain syndrome;
• dyspnea;
• cyanosis ( bluish coloration).

Sputum
Sputum from Klebsiella pneumonia contains particles of destroyed lung tissue, so it has a reddish color. It can be compared to currant jelly. Sometimes there are streaks of blood in the sputum. Also, sputum has a sharp, specific odor, reminiscent of burnt meat. On the 5th – 6th day from the onset of the disease, large quantities of bloody sputum are released.

Pain syndrome
Firstly, there is constant pain in the throat and chest area due to persistent cough. Secondly, pleural pain appears. The inflammatory process from the lungs quickly spreads to the pleural layers ( membranes of the lungs), which have a large number nerve endings. Any irritation of the pleura causes severe pain in the chest area, especially in the lower sections. The pain intensifies when coughing, walking, bending the body.

Dyspnea
Due to the destruction of lung tissue by Klebsiella, the area of ​​the alveoli involved in the breathing process decreases. For this reason, shortness of breath occurs. When several lobes of the lungs are affected, shortness of breath becomes severe even at rest.

Cyanosis
Severe respiratory failure leads to the appearance of a bluish coloration of the nasolabial triangle ( area covering the nose and lips). This is especially pronounced on the lips and tongue. The rest of the face becomes paler with a grayish tint. The bluish color of the skin under the nails also stands out.

In particularly severe cases of Klebsiella pneumonia with severe intoxication syndrome, other organs and systems are often affected. At untimely treatment in 30–35 percent of cases the disease ends in death.

What are the features of the course of lobar pneumonia?

Main features of the course of lobar pneumonia

What is the difference between viral pneumonia and bacterial pneumonia?

Differences between viral and bacterial pneumonia

What is nosocomial pneumonia?

The term "hospital-acquired" means that pneumonia is caused by bacteria living within the walls of hospitals. These bacteria are particularly resistant and have multidrug resistance ( resistant to several drugs at once). Also, nosocomial pneumonia in most cases is caused not by one microbe, but by a microbial association ( several pathogens). Conventionally, early and late hospital-acquired pneumonia are distinguished. Early pneumonia develops within the first 5 days from the moment of hospitalization. Late hospital pneumonia develops no earlier than the sixth day after the patient is admitted to the hospital.

Thus, the course of hospital-acquired pneumonia is complicated by both the polymorphism of bacteria and their special resistance to medications.

The most common pathogens of hospital-acquired pneumonia

Risk factors for the development of nosocomial pneumonia are:

• old age ( over 60 years);
• smoking;
• previous infections, including those of the respiratory system;
• chronic diseases (chronic obstructive pulmonary disease is of particular importance);
• unconsciousness with a high risk of aspiration;
• feeding through a tube;
• long horizontal position ( when the patient stays for a long time supine position );
• connecting the patient to the device artificial ventilation lungs.

Clinically, nosocomial pneumonia is very severe and has numerous consequences.

Symptoms of hospital-acquired pneumonia are:

• temperature more than 38.5 degrees;
• cough with phlegm;
• purulent sputum;
• frequent shallow breathing;
• interruptions in breathing;
• changes in the blood - may be observed as an increase in the number of leukocytes ( more than 9x 10 9), and their reduction ( less than 4x 10 9);
• decreased blood oxygen levels ( oxygenation) less than 97 percent;
• The x-ray shows new foci of inflammation.

What is SARS?

Symptoms of atypical pneumonia are:

• high fever - more than 38 degrees, and for pneumonia caused by Legionella - 40 degrees;
• symptoms of general intoxication predominate, such as painful headaches, muscle pain;
• erased pulmonary symptoms - moderate, non-productive ( no sputum) cough, and if sputum appears, then its amount is insignificant;
• the presence of extrapulmonary symptoms characteristic of the pathogen ( for example, rashes);
• mild changes in the blood - no leukocytosis, which is characteristic of pneumococcal pneumonia.
• The radiograph shows an atypical picture - there are no pronounced foci of darkening;
• there is no reaction to sulfonamide drugs.

A feature of this atypical pneumonia is also the erased pulmonary symptoms and severe intoxication syndrome. Also, with pneumonia caused by coronavirus, multiple changes in internal organs are noted. This happens because, upon entering the body, the virus spreads very quickly to the kidneys, lungs, and liver.

Features of atypical viral pneumonia or SARS are:

• The disease mainly affects adults from 25 to 65 years old; among children, isolated cases;
• the incubation period lasts from 2 to 10 days;
• the route of transmission of infection is airborne and fecal-oral;
• pulmonary symptoms appear on day 5, and before that, symptoms of viral intoxication appear - chills, muscle pain, nausea, vomiting, and sometimes diarrhea ( this course of the disease can imitate an intestinal infection);
• on the blood side, there is a decrease in the number of both lymphocytes and platelets ( which often provokes hemorrhagic syndrome);
• a biochemical blood test shows an increase in liver enzymes, which reflects liver damage by the virus.
• Complications such as distress syndrome, toxic shock, and acute respiratory failure quickly develop.

What are the stages of development of pneumonia?

The stages of development of pneumonia are:

• onset stage;
• high stage;
• resolution stage.

Stage of onset of pneumonia
The onset of the inflammatory process in the lungs is characterized by a sharp, sudden deterioration in the general condition of the patient against the background of complete health. Sudden changes in the body are explained by its hyperergic ( excessive) reaction to the causative agent of pneumonia and its toxins.

The first symptom of the disease is low-grade fever body ( 37 – 37.5 degrees). In the first 24 hours it quickly increases to levels of 38 - 39 degrees and more. High body temperature is accompanied by a number of symptoms caused by general intoxication of the body with pathogen toxins.

Symptoms of general intoxication of the body are:

• headaches and dizziness;
• general fatigue;
• fast fatiguability;
• accelerated heartbeat ( more than 90 – 95 beats per minute);
• a sharp decrease in performance;
• loss of appetite;
• the appearance of blush on the cheeks;
• blueness of the nose and lips;
• herpetic rashes on the mucous membranes of the lips and nose;
• increased sweating.

Stage of height of pneumonia
During the peak stage, symptoms of general intoxication of the body increase, and signs of inflammation of the lung tissue also appear. Body temperature remains high and is difficult to treat with antipyretic drugs.

Symptoms of pneumonia at its height are:

• severe chest pain;
• increased breathing;
• cough;
• sputum production;
• dyspnea.

During the peak phase, a persistent cough persists. Due to constant irritation of the pleural layers, the cough intensifies and becomes painful. At the height of the disease, thick mucopurulent sputum begins to be released with a cough. Initially, the color of sputum is gray-yellow or yellow-green. Gradually, streaks of blood and particles of destroyed lungs appear in the discharge. This gives the sputum a bloody rusty color. During the height of the disease, sputum is released in large quantities.

As a result of inflammation of the respiratory surface of the lungs, respiratory failure occurs, which is characterized by severe shortness of breath. In the first two days of the height of the disease, shortness of breath appears during movement and normal physical activity. Gradually, shortness of breath appears when performing minimal physical activity and even at rest. Sometimes it can be accompanied by dizziness and severe fatigue.

Disease resolution stage
At the stage of resolution of the disease, all symptoms of pneumonia subside.
Signs of general intoxication of the body disappear, and body temperature normalizes.
The cough gradually subsides, and the sputum becomes less viscous, as a result of which it is easily separated. Its volumes are decreasing. Chest pain appears only when sudden movements or severe cough. Breathing gradually normalizes, but shortness of breath persists during normal physical activity. Visually there is a slight lag of half of the chest.

What complications can pneumonia cause?

Pulmonary complications of pneumonia are:

• development of obstructive syndrome;

With pleurisy, symptoms of respiratory failure quickly increase. Skin at the same time, they quickly become cyanotic, and interruptions in the functioning of the heart are observed.

Empyema
Empyema, or purulent pleurisy, is also a serious complication of pneumonia. With empyema, it is not fluid that accumulates in the pleural cavity, but pus. Symptoms of empyema are similar to exudative pleurisy, but are much more intense. The main symptom is high temperature ( 39 – 40 degrees) hectic in nature. For fever of this type Typical daily temperature fluctuations are from 2 to 3 degrees. So, the temperature from 40 degrees can sharply drop to 36.6. Sharp rises and falls in temperature are accompanied by chills and cold sweat. With empyema, the cardiovascular system also suffers. The heart rate rises to 120 beats per minute or more.

Lung abscess
With an abscess, a cavity forms in the lung ( or several cavities) in which purulent contents accumulate. An abscess is a destructive process, so in its place the lung tissue is destroyed. The symptoms of this condition are characterized by severe intoxication. Until a certain time, the abscess remains closed. But later he breaks through. It can break into the bronchial cavity or into the pleural cavity. In the first case there is copious discharge purulent contents. Pus from lung cavity exits through the bronchus to the outside. The patient develops foul-smelling, profuse sputum. At the same time, the patient’s condition improves when the abscess ruptures, and the temperature drops.
If the abscess breaks into the pleural cavity, pleural empyema develops.

Development of obstructive syndrome
Symptoms of obstructive syndrome include shortness of breath and periodic attacks suffocation. This is due to the fact that the lung tissue at the site of the former pneumonia loses its functionality. In its place, connective tissue develops, which replaces not only the lung tissue, but also its vessels.

Pulmonary edema
Edema is the most serious complication of pneumonia, with a very high mortality rate. In this case, water from the vessels penetrates first into the interstitium of the lungs, and then into the alveoli themselves. Thus, the alveoli, which are normally filled with air, are filled with water.

In this state, a person quickly begins to choke and becomes agitated. A cough appears, which is accompanied by discharge frothy sputum. The pulse rises to 200 beats per minute, the skin becomes covered with cold, sticky sweat. This condition requires resuscitation measures.

Extrapulmonary complications of pneumonia are:

• toxic shock;
• toxic myocarditis;

Toxic shock
Toxic shock is a condition in which toxins from bacteria and viruses enter the patient's bloodstream. This is an emergency condition in which multiple organ failure occurs. Multiple organ failure means that more than 3 organs and systems are involved in the pathological process. Most often the cardiovascular, renal, digestive and nervous systems are affected. The main symptoms are fever, low blood pressure and a polymorphic rash on the body.

Toxic myocarditis
Myocarditis is called damage to the heart muscle, as a result of which its function is lost. The greatest cardiotropism ( selectivity for cardiac muscle) viruses have. Therefore, viral pneumonia is most often complicated by toxic myocarditis. Bacteria such as mycoplasma and chlamydia also specifically affect cardiac tissue.
The main symptoms are heart rhythm disturbances, cardiac weakness, and shortness of breath.

Pericarditis
Pericarditis is an inflammation of the serous membrane that covers the heart. Pericarditis may develop independently or precede myocarditis. In this case, inflammatory fluid accumulates in the pericardial cavity, which subsequently puts pressure on the heart and compresses it. As a result, the main symptom of pericarditis develops – shortness of breath. In addition to shortness of breath, a patient suffering from pericarditis complains of weakness, pain in the heart area, and a dry cough.

Meningitis
Meningitis ( inflammation of the meningeal membranes of the brain) develops due to the penetration of pathogenic microorganisms into the central nervous system. Meningitis can also be either bacterial or viral, depending on the etiology of the pneumonia.
The main symptoms of meningitis are nausea, vomiting, photophobia and a stiff neck.

Hepatitis
It is a very common complication of atypical pneumonia. With hepatitis, the liver tissue is affected, as a result of which the liver ceases to perform its functions. Since the liver plays the role of a filter in the body, when it is damaged, all metabolic products are not removed from the body, but remain in it. With hepatitis, a large amount of bilirubin enters the blood from destroyed liver cells, which leads to the development of jaundice. The patient also complains of nausea, vomiting, and dull pain in the right hypochondrium.

What antibiotics are used in the treatment of pneumonia?

Drugs used in the treatment of typical pneumonia

Also, having studied the patient’s medical history in detail, he can guess what the nature of the disease is. If the patient has recently been hospitalized, then most likely it is nosocomial ( hospital) pneumonia. If the clinical picture is dominated by symptoms of general intoxication, and the pneumonia is more like measles or mumps, then most likely it is atypical pneumonia. If this is intrauterine pneumonia of a newborn child, then perhaps it is caused by gram-negative bacilli or Staphylococcus aureus.

As soon as pneumonia has been diagnosed, antibacterial drugs are prescribed ( if it's bacterial pneumonia).

Drugs used in the treatment of atypical pneumonia

It is important to note that although antibiotic therapy is the basic treatment, other drugs are also used in the treatment of pneumonia. Antibiotic therapy is mandatory in parallel with the prescription of antifungal drugs ( for the prevention of candidiasis) and other drugs to eliminate the main symptoms of pneumonia ( for example, antipyretics to lower fever).

Is there a vaccine against pneumonia?

The Prevenar vaccine is one of the most modern and most expensive. The vaccine is prescribed in three doses with an interval of one month. It is believed that immunity after vaccination is developed after a month. The Synflorix vaccine is given on the same schedule as Prevenar. Pneumo-23 is the oldest vaccine currently in existence. It is installed once and is valid for about 5 years. A significant disadvantage of this vaccination is that it can only be given after reaching the age of two. It is known that newborn children are the most vulnerable category in terms of the development of pneumonia.

It should be noted right away that vaccination against pneumonia does not mean that a child or adult will not get sick again. Firstly, you can get pneumonia of another origin, for example, staphylococcal. And secondly, even from pneumococcal pneumonia, immunity does not develop for life. Vaccine manufacturers warn that it is possible to get sick again after vaccination, but the patient will survive the disease much easier.

Besides pneumococcal vaccine There is a vaccination against Haemophilus influenzae. Haemophilus influenzae, or influenza bacillus, is also a common cause of pneumonia. The following three vaccines are registered in Russia - Act-HIB, Hiberix and Pentaxim. They are given at the same time as the polio and hepatitis B vaccines.

As for vaccination against viral pneumonia, it is a little more complicated. It is known that viruses are capable of mutating, that is, changing. Therefore, it is very difficult to model a vaccine against a particular virus. As soon as science invents one vaccine against a known virus, it changes and the vaccine becomes ineffective.

How does aspiration pneumonia develop?

Aspiration pneumonia can develop under the following conditions:

• alcohol intoxication;
• drug intoxication;
• use of certain medications;
• unconscious state;
• severe, uncontrollable vomiting;
• early childhood.

In children, aspiration pneumonia can develop when food particles enter the bronchi. This happens when complementary foods are introduced into the baby’s diet. Porridges, such as buckwheat, are the most dangerous. Even one buckwheat grain, once in the lungs, causes local inflammation.

Another risk group is people taking psychotropic drugs medicines, for example, antidepressants or hypnotics ( sleeping pills). These drugs weaken all body reactions, including reflexes. People, especially those who take sleeping pills, are in a sleepy, somewhat slow state. Therefore, the obstruction in their airways is weakened, and food ( or drinks) easily penetrates the lungs.

Foreign bodies entering the lung tissue ( vomit, food) cause inflammation and the development of pneumonia.