Pneumonia in children: symptoms, forms, treatment. Doctors' advice. Drug treatment of pneumonia in children according to official recommendations and standards

The disease is most common during the off-season, when the frequency of acute respiratory infections increases. Pneumonia, as a rule, occurs secondarily. This is due to a local decrease in immunity.

What is pneumonia in a child, how to understand? This term refers to a group of diseases that have 3 characteristic features:

1. Inflammatory damage to the lungs with primary involvement in the pathological process of the respiratory sections (alveoli), in which exudate accumulates.
2. Availability clinical syndrome respiratory disorders(shortness of breath, increased frequency of chest excursions, etc.);
3. The presence of infiltrative signs on an x-ray (this criterion is considered the most important by the World Health Organization).

However, the causes and mechanisms of development of pneumonia can be very different. They are not decisive in making a diagnosis. The presence of clinical and radiological inflammatory syndrome is important.

The causes of pneumonia are always associated with the presence of a microbial factor. More than 80-90% are bacteria, the remaining cases are viruses and fungi. Among viral particles, the most dangerous are influenza, adenovirus and parainfluenza.

Against the background of severe pneumonia, it can develop lung abscess. What is it and how is it treated:

The nature of the pathogen leaves an imprint on the choice of etiological (affecting the cause) treatment. Therefore, with clinical point There are 3 main forms of pneumonia:

1). Out-of-hospital - develops at home and has no connection with a medical institution.

2). In-hospital or hospital- develops within 72 hours (3 days) of hospital stay or during the same time period after discharge.

This form poses the greatest danger because... associated with microorganisms that have developed resistance factors to pharmacological drugs. Therefore in medical institution Microbiological monitoring is carried out regularly.

3). Intrauterine– a child becomes infected from the mother during pregnancy. Clinically, it debuts within 72 hours after birth.

Each of these groups is characterized by the most likely pathogens. These data were obtained from a series of epidemiological studies. They need regular updating, because... The microbial landscape can change significantly over the course of several years.

At the moment they look like this. Community-acquired pneumonia most often associated with microorganisms such as:

• up to six months is coli and viruses;
• up to 6 years – pneumococci (less often Haemophilus influenzae);
• up to 15 years – pneumococci.

At any age, the pathogens can be pneumocystis, chlamydia, mycoplasma and others (an atypical type of disease).

The infection caused by them occurs with slightly pronounced clinical manifestations, but rapid development respiratory failure. Atypical pneumonia in a 3-year-old child is most often associated with mycoplasmas.

Microbial spectrum nosocomial pneumonia different from home. Causal agents may be:

• resistant Staphylococcus aureus;
• pseudomonas (their role is especially important in various medical procedures);
• serrations;
• Klebsiella;
• opportunistic microflora in patients on artificial ventilation.

There is a group of children whose risk of developing pneumonia is increased. They have predisposing factors:

• tobacco smoke if parents or other people around smoke;
• ingestion of milk into the respiratory tract (in babies);
• chronic lesions in the body (tonsillitis, laryngitis, etc.);
• hypothermia;
• hypoxia suffered during childbirth (in infants);
• immunodeficiency states.

The first signs of pneumonia in a child

Signs of pneumonia in a child are characterized by an increase in body temperature. This is a nonspecific reaction to the presence of an infectious agent in the body. Usually it rises to high values, but sometimes it is low-grade fever.

The inflammatory reaction of the pleura leads to painful breathing. It is often accompanied by a grunting sound that appears at the beginning of exhalation. It can be mistakenly taken for a sign of bronchial obstruction (for example, as in bronchial asthma).

Accessory muscles are often involved in breathing. But this sign is nonspecific, because may be observed in other diseases.

Lower right-sided pneumonia may simulate liver disease in a child. This is due to the appearance. However, with pneumonia there are no symptoms observed with the lesion digestive system– (may occur with severe intoxication), diarrhea, rumbling in the stomach, etc.

Severe intoxication during pneumonia causes the appearance of general symptoms:

• complete lack of appetite or its significant decrease;
• child's agitation or indifference;
• poor sleep;
• increased tearfulness;
• pale skin;
• convulsions that appear against the background of a rise in temperature.

Symptoms of pneumonia in children

Symptoms of pneumonia in children may vary depending on the causative microorganism. This forms the basis of clinical and epidemiological diagnostics, which allows you to select the most rational antibiotic without laboratory examination.

Distinctive features pneumococcal lesions lungs are:

• high temperature increase (up to 40°C);
• chills;
• cough with rust-colored sputum;
• chest pain;
• frequent loss of consciousness;
• can develop in children starting from 6 months of age.

Streptococcal pneumonia:

• children aged 2 to 7 years are more susceptible;
• purulent complications ( purulent pleurisy, lung abscess);
• violations of the blockade of impulses from the atrium to the ventricles.

Haemophilus influenzae infection:

• most often observed before 5 years of age;
• acute onset;
• severe toxicosis;
• slight increase in leukocytes in the blood;
• extensive process in the lungs with the development of hemorrhagic edema;
• ineffectiveness of prescribed penicillin.

Mycoplasma pneumonia:

• more common among schoolchildren;
• long-lasting cough;
• non-severe general condition causing late referral to a pediatrician;
• redness of the conjunctival membrane of the eyes (“red eyes”);
• normal level of leukocytes in the blood;
• asymmetrical infiltration of pulmonary fields.

Diagnostics and tests

Diagnosis of pneumonia in childhood is based on the results of clinical, radiological and laboratory examinations. If there are symptoms suspicious for the disease, pulmonary radiography is performed.

It allows you to determine the massiveness of organ damage respiratory system and identify possible complications. With a characteristic x-ray picture, an accurate diagnosis of pneumonia is established.

Indications for prescribing and norms of biochemical blood tests in children:

At the second stage the causative agent is identified. For this purpose, various studies can be carried out:

1. Sputum culture as part of bacteriological analysis.
2. Blood cultures to rule out sepsis.
3. Determination of immunoglobulins (antibodies) to atypical pathogens in the blood (serological analysis).
4. Detection of pathogen DNA or RNA. The material for research is scraping from back wall pharynx, conjunctiva or sputum.

All children with fever are given general clinical and biochemical analysis blood. With pneumonia, it will have the following changes:

• increase in leukocyte levels. However, in viral and mycoplasma infections, leukocytosis rarely exceeds 15,000/μl. It is maximum with chlamydial infection (30,000/μl or more);
• shift of the formula to the left with the appearance of juvenile forms and toxic granularity of leukocytes (the most typical sign for bacterial pneumonia);
• increased ESR (20 mm/h or more);
• decrease in hemoglobin due to its redistribution between organs and the microcirculation system;
• increased fibrinogen levels;
• acidosis.

Basic principles of treatment of pneumonia in children

Treatment of pneumonia begins with correct mode and diets. Bed rest is recommended for all sick children. Its expansion becomes possible after the temperature decreases and stabilizes within normal values.

The room in which the child is located must be ventilated, because... fresh air deepens and shortens breathing. This has a positive effect on the course of the disease.

Learn more about the causes, signs and treatment methods of pneumonia in adults:

Dietary nutrition includes:

• easily digestible foods predominate in the diet;
• products must have a low allergenic index;
• the amount of protein foods (meat, eggs, cottage cheese) increases in the diet;
• drink plenty of fluids (purified water, teas).

Antibiotics for pneumonia in children are the main treatment, because are aimed at eliminating the causative agent that caused the disease. The sooner they are prescribed, the faster they will begin to act, and the child’s condition will return to normal.

The choice of antibacterial drug depends on the form of pneumonia. It is carried out only by a doctor - self-medication is unacceptable.

The main antibiotics approved for use in childhood are:

• Amoxicillin, incl. protected form (Amoxiclav);
• Ampicillin;
• Oxacillin.

Alternative antibiotics (prescribed in the absence of the main ones or intolerance) are cephalosporins:

• Cefuroxime;
• Ceftriaxone;
• Cefazolin.

Reserve antibiotics are used when the above are ineffective. Their use is limited in pediatrics due to increased risk side effects . But in situations of pharmacological resistance of microorganisms, this is the only way etiotropic treatment.

Representatives of these drugs are:

• Vancomycin;
• Carbopenem;
• Ertapenem;
• Linezolid;
• Doxycycline (in children over 18 years of age).

At the same time, symptomatic therapy is carried out.

It depends on the complications that have developed and the general condition of the child:

1. Fever - antipyretics (non-steroids and Paracetamol).
2. Respiratory failure - oxygen therapy and artificial pulmonary ventilation (in severe cases).
3. Pulmonary edema - careful consideration of the administered fluid to avoid overhydration and artificial ventilation.
4. Disseminated blood coagulation in blood vessels - prednisolone and heparin (in the phase of increased blood coagulation).
5. Septic shock - adrenaline and prednisolone to increase blood pressure, assessment of the effectiveness of the antibiotics used, sufficient infusion therapy, artificial methods blood purification (in severe cases).
6. Anemia - iron-containing drugs (but in acute period diseases they are contraindicated).

Forecast and consequences

The prognosis for pneumonia in children depends on the timeliness of treatment and the state of the premorbid background (the presence of aggravating factors). If therapy is started within 1-2 days from the onset of the disease, then full recovery no residual changes.

If the first signs of the disease are missed, complications may develop.

The consequences of pneumonia can be different. Their severity depends on the causative agent. Most often the most severe consequences cause Haemophilus influenzae, pneumococci, staphylococci, streptococci, Klebsiella and Serratia. They contribute to the development of lung destruction.

The severity of the infectious process may be associated with an unfavorable premorbid background:

• prematurity of the child;
• nutritional deficiency;
• foreign body in the respiratory tract;
• habitual entry of food into the respiratory system.

Classified into 3 types (depending on topography):

1. Pulmonary:

• inflammation of the pleura;
• lung abscess;
• pulmonary edema;
• - air entering pleural cavity when lung tissue ruptures with subsequent compression.

2. Cardiological:

• heart failure;
• endocarditis;
• myocarditis.

3. System:

• bleeding disorder (DIC syndrome);
• septic shock, manifested by a critical drop in pressure and impaired microcirculation in organs;
• sepsis – the presence of microorganisms in the blood and their spread throughout various bodies(extremely serious condition).

A child who has had pneumonia may long time cough in the morning. This is due to the restoration of the mucous membrane not yet completely completed. The cough is usually dry. To eliminate it, it is recommended to inhale salty sea ​​air and general hardening of the body. Physical exercise are allowed only 1.5 months after recovery for mild pneumonia, and 3 months after severe pneumonia (with complications).

Prevention

Specific prevention (vaccination) of pneumonia in childhood is carried out against the most dangerous and common pathogens. This is how a vaccine against Hib infection (Haemophilus influenzae) was developed and put into practice.

Nonspecific prevention implies the following rules:

• avoiding hypothermia;
• rational and balanced diet child, not leading to underweight or obesity;
• parental cessation of smoking;
• general hardening;
• timely treatment colds(not self-medication, but therapy prescribed by a doctor).

Nowadays in pediatrics the question of how to structure and consistently should be undertaken is quite acute. therapeutic measures if the child is sick with pneumonia. It is very important to start treating childhood pneumonia in time, and also to treat it quickly and effectively to prevent a complicated course of the disease. There are several groups of drugs that are appropriate in the treatment of sick children. Within each of these groups there are drugs that are more preferable for the treatment of childhood pneumonia than others. When treating a disease, it is important to take into account not only the specific pathogenic microorganism and use it against it. antibacterial drugs, but also to alleviate the baby’s general condition by using other medications.

Pneumonia or pneumonia in children is called acute infectious process, the target of which is the child’s lung tissue. The microorganism that causes childhood pneumonia is usually bacterial cell, such as pneumococcus or Haemophilus influenzae. When pneumonia occurs, the respiratory parts of the lungs are affected - the alveolar sacs and passages, in which exudation can develop. Exudation is sweating through the walls of the respiratory sacs in their cavity and the surrounding lung tissue rich in protein fluids along with some cellular elements of the blood.

All childhood pneumonia is usually divided into community-acquired and hospital-acquired. The latter infection of children occurs directly in a medical institution, 72 hours after the child’s admission to the hospital.

Based on the volume of affected lung tissue and the corresponding picture on x-rays In children, the following types of pneumonia are usually distinguished:

• Focal;
• Focal-confluent;
• Lobar or lobar;
• Segmental;
• Interstitial, which also seriously affects the connective tissue between the alveolar sacs or interstitium.

Along the flow, in turn, it is customary to distinguish special group prolonged pneumonia. A protracted disease is a disease in which the child shows virtually no positive dynamics for 1.5-6 months.

How does the disease progress?

Typically, pneumonia in children manifests itself with the following characteristic symptoms:

1. The respiratory rate in children under 3 months of age can exceed 60 per minute.
2. The respiratory rate in children under 12 months of age may exceed 50 per minute.
3. The respiratory rate in children under 5 years of age can exceed 40 per minute.

What complications can there be?

If pneumonia in children takes severe form, complications may develop, even life-threatening ones. Most frequent complications The following should be considered childhood pneumonia:

In order not to have to treat severe complications of childhood pneumonia, the child must be hospitalized in time - placed in a specialized hospital, where, as a next step, it will be necessary to choose the right treatment and effectively fight the disease.

Principles of the healing process

From not medicinal methods treatment regimen matters. For children suffering from pneumonia, the regime should be strictly bed rest.

The basic treatment for childhood pneumonia is drug therapy.

The latter is distributed in the following areas:

1. Etiotropic therapy. The word “etiotropic” means that the drugs used in this treatment section are aimed directly at the causative microorganism. These drugs are called antibacterial. Antibacterial drugs can destroy the causative bacterium itself, and can also prevent the latter from reproducing. It is customary to begin treating the baby with antibacterial therapy.
2. Syndromic and symptomatic treatment. The drugs used in this treatment section are intended to alleviate the child’s condition at the time of their use. That is, each of the drugs used is aimed at reducing the manifestations of any pathological syndrome or symptom, for example, a syndrome of microcirculation disorders or a symptom of pain.
3. Surgery. The latter includes pleural puncture, indications for which usually arise during a complicated course of the disease.
   Let us consider the antibacterial and symptomatic treatment of childhood pneumonia in more detail.

Antibacterial therapy

Antibacterial drugs are usually prescribed for pneumonia in children. wide range actions penicillin series: ampicillin and amoxicillin in combination with clavulanic acid, which protects chemical structure drug - beta-lactam ring - from destruction by penicillin-resistant microorganisms.

The combination of clavulanate and amoxicillin is called amoxiclav.

Second-generation cephalosporins are also often prescribed: cefazolin and cefuroxime. Often, children with pneumonia are also prescribed antibacterial drugs from the macrolide group: roxithromycin and azithromycin.

If a child’s pneumonia is quite severe or the disease is associated with severe concomitant diseases, then the baby is treated with such combinations antibacterial agents, such as amoxicillin with aminoglycosides, or cephalosporins of the third and fourth generation are prescribed, such as cefotaxime, ceftriaxone or cefepime.

Alternative drugs prescribed in cases where a child experiences destructive process in lung tissue, linezolid, vancomycin and carbapenems such as meropenem can serve.

After conducting a clinical analysis of sputum and isolating from the latter the microorganism that causes the disease in a particular patient, it is possible to culture a Petri dish and diagnose which antibacterial drugs this particular pathogen is sensitive to. To do this, special round plates - disks containing various antibacterial drugs - are placed in a Petri dish along with the pathogen. When colonies of the microorganism grow, after two to three days, the “empty” zones around the antibiotics to which the microorganism is sensitive can be clearly seen and measured.

The method allows you to prescribe a known effective antibacterial treatment. However, its use takes time, and the prescription of an antibiotic by a doctor must be done immediately. More often, the method with such antibacterial discs is used to confirm the correctness of the prescribed therapy, or helps to replace the drug with a more effective one in case of low effectiveness of an already prescribed antibacterial drug.

A special approach to antibacterial treatment should be practiced if a child has hospital-acquired pneumonia or pneumonia occurs against the background of congenital immunodeficiency.

Symptomatic and syndromic therapy of childhood pneumonia

From medicines used to treat and eliminate pathological symptoms and syndromes in a child suffering from pneumonia, the following drugs are often used:

It is important to understand that despite the existing various sources information on ready-made treatment regimens for childhood pneumonia, it is under no circumstances possible to treat a child at home. It is important to contact a medical facility in a timely manner to confirm the diagnosis and select adequate therapy for a particular patient. You can treat your baby at home only with the permission of a doctor.

Video: How to diagnose pneumonia? — Dr. Komarovsky

– an acute infectious process in the pulmonary parenchyma involving all structural and functional units of the respiratory part of the lungs in inflammation. Pneumonia in children occurs with signs of intoxication, cough, and respiratory failure. The diagnosis of pneumonia in children is made on the basis of characteristic auscultatory, clinical, laboratory and x-ray patterns. Treatment of pneumonia in children requires antibiotic therapy, bronchodilators, antipyretics, expectorants, and antihistamines; in the stage of resolution - physiotherapy, exercise therapy, massage.

General information

Pneumonia in children - acute infectious lesions lungs, accompanied by the presence of infiltrative changes on radiographs and symptoms of damage to the lower respiratory tract. The prevalence of pneumonia is 5-20 cases per 1000 children early age and 5–6 cases per 1000 children over 3 years of age. The incidence of pneumonia among children increases annually during the seasonal influenza epidemic. Among various lesions respiratory tract in children, the proportion of pneumonia is 1-1.5%. Despite advances in diagnostics and pharmacotherapy, rates of morbidity, complications and mortality from pneumonia among children remain consistently high. Studying pneumonia in children does all this topical issue pediatrics and pediatric pulmonology.

Causes

The etiology of pneumonia in children depends on the age and conditions of infection of the child. Pneumonia of newborns is usually associated with intrauterine or nosocomial infection. Congenital pneumonia in children is often caused by herpes simplex virus types 1 and 2, chickenpox, cytomegalovirus, and chlamydia. Among nosocomial pathogens, the leading role belongs to group B streptococci, Staphylococcus aureus, Escherichia coli, and Klebsiella. In premature and full-term newborns, the etiological role of viruses is great - influenza, RSV, parainfluenza, measles, etc.

In children of the first year of life, the predominant causative agent of community-acquired pneumonia is pneumococcus (up to 70-80% of cases), less often - Haemophilus influenzae, Moraxella, etc. Traditional pathogens for children up to school age include Haemophilus influenzae, Escherichia coli, Proteus, Klebsiella, Enterobacter, Pseudomonas aeruginosa, Staphylococcus aureus. In school-age children, along with typical pneumonia, the number of atypical pneumonias caused by mycoplasma and chlamydial infections is increasing. Factors predisposing to the development of pneumonia in children are prematurity, malnutrition, immunodeficiency, stress, cold, chronic foci of infection (dental caries, sinusitis, tonsillitis).

The infection penetrates into the lungs mainly through the aerogenic route. Intrauterine infection combined with aspiration of amniotic fluid leads to intrauterine pneumonia. The development of aspiration pneumonia in young children can occur due to microaspiration of nasopharyngeal secretions, habitual aspiration of food during regurgitation, gastroesophageal reflux, vomiting, and dysphagia. Hematogenous spread of pathogens from extrapulmonary foci of infection is possible. Infection with hospital flora often occurs when a child undergoes tracheal aspiration and bronchoalveolar lavage, inhalation, bronchoscopy, and mechanical ventilation.

"Conductor" bacterial infection Usually there are viruses that infect the mucous membrane of the respiratory tract, disrupting barrier function epithelium and mucociliary clearance, increasing mucus production, reducing local immunological defense and facilitating the penetration of pathogens into terminal bronchioles. There, intensive proliferation of microorganisms occurs and inflammation develops, which involves adjacent areas of the pulmonary parenchyma. When you cough, infected sputum is thrown into the large bronchi, from where it goes to others respiratory bronchioles, causing the formation of new inflammatory foci.

The organization of the focus of inflammation is facilitated by bronchial obstruction and the formation of areas of hypoventilation of the lung tissue. Due to impaired microcirculation, inflammatory infiltration and interstitial edema, gas perfusion is disrupted, hypoxemia, respiratory acidosis and hypercapnia develop, which is clinically expressed by signs of respiratory failure.

Classification

In used in clinical practice classification takes into account the conditions of infection, x-ray morphological signs various forms pneumonia in children, severity, duration, etiology of the disease, etc.

According to the conditions in which the child was infected, community-acquired (home), hospital-acquired (hospital) and congenital (intrauterine) pneumonia in children are distinguished. Community-acquired pneumonia develops at home, outside medical institution, mainly as a complication of ARVI. Nosocomial pneumonia is considered to be pneumonia that occurs 72 hours after the child’s hospitalization and within 72 hours after his discharge. Hospital pneumonia in children they have the most severe course and outcome, since nosocomial flora often develops resistance to most antibiotics. A separate group consists congenital pneumonia, developing in children with immunodeficiency in the first 72 hours after birth and neonatal pneumonia in children in the first month of life.

Taking into account X-ray morphological signs, pneumonia in children can be:

• Focal(focal-confluent) - with foci of infiltration with a diameter of 0.5-1 cm, located in one or several segments of the lung, sometimes bilaterally. Inflammation of the lung tissue is catarrhal in nature with the formation of serous exudate in the lumen of the alveoli. In the focal-confluent form, individual areas of infiltration merge to form a large focus, often occupying an entire lobe.
• Segmental– with the involvement of an entire segment of the lung in inflammation and its atelectasis. Segmental damage often occurs in the form of prolonged pneumonia in children, resulting in pulmonary fibrosis or deforming bronchitis.
• Krupoznaya– with hyperergic inflammation, passing through the stages of flushing, red hepatization, gray hepatization and resolution. Inflammatory process has lobar or sublobar localization with involvement of the pleura (pleuropneumonia).
• Interstitial– with infiltration and proliferation of interstitial (connective) lung tissue of a focal or diffuse nature. Interstitial pneumonia in children it is usually caused by pneumocystis, viruses, and fungi.

Based on the severity of the course, uncomplicated and complicated forms of pneumonia in children are distinguished. IN the latter case possible development of respiratory failure, pulmonary edema, pleurisy, destruction of the pulmonary parenchyma (abscess, lung gangrene), extrapulmonary septic foci, cardiovascular disorders etc.

Among the complications of pneumonia that occur in children are infectious-toxic shock, abscesses of lung tissue, pleurisy, pleural empyema, pneumothorax, cardiovascular failure, respiratory distress syndrome, multiple organ failure, disseminated intravascular coagulation syndrome.

Diagnostics

The basis clinical diagnostics pneumonia in children is general symptoms, auscultatory changes in the lungs and radiological data. A physical examination of the child reveals a shortening of the percussion sound, weakening of breathing, fine bubbling or crepitating rales. The “gold standard” for detecting pneumonia in children remains chest x-ray, which makes it possible to detect infiltrative or interstitial inflammatory changes.

Etiological diagnosis includes virological and bacteriological studies of mucus from the nose and throat, sputum culture; ELISA and PCR methods for detecting intracellular pathogens.

The hemogram reflects inflammatory changes (neutrophilic leukocytosis, increased ESR). Children with severe pneumonia need to conduct a study of biochemical blood parameters (liver enzymes, electrolytes, creatinine and urea, BUN), pulse oximetry.

November 2013

Key Facts

• Pneumonia is main reason child mortality worldwide.
• Every year, pneumonia kills approximately 1.1 million children under five years of age. This is more than AIDS, malaria and measles combined.
• Pneumonia can be caused by viruses, bacteria and fungi.
• Pneumonia can be prevented through immunization, adequate nutrition, and environmental factors.
• Pneumonia caused by bacteria can be treated with antibiotics, but only about 30% of children with pneumonia receive the antibiotics they need.

Pneumonia is one of the forms of acute respiratory infection affecting the lungs. The lungs are made up of small sacs called alveoli, which when you breathe healthy person filled with air. In pneumonia, the alveoli fill with pus and fluid, making breathing painful and limiting oxygen supply.

Pneumonia is the leading single cause of death in children worldwide. It kills approximately 1.1 million children under the age of five every year. It accounts for 17.5% of all under-five deaths worldwide. Pneumonia is common everywhere, but children and families suffer from the disease in to the greatest extent in South Asia and African countries located south of the Sahara Desert. Pneumonia can be prevented with simple measures and can be treated with simple, inexpensive medications with proper care.

Causes

Pneumonia is caused by a variety of infectious agents, including viruses, bacteria and fungi. The most common ones include:

• streptococcus pneumoniae- the most common reason bacterial pneumonia in children;
• haemophilus influenzae type b (Hib)- the second most common cause of bacterial pneumonia;
• respiratory syncytial virus is a common cause of viral pneumonia;
• In HIV-infected children, one of the most common causes of pneumonia is pneumocystis jiroveci. These microorganisms are responsible for at least one quarter of all deaths from pneumonia in HIV-infected children.

Transmission of infection

There are several ways pneumonia can spread. Viruses and bacteria that are usually present in a child's nose or throat can infect the lungs when they are inhaled. They may also spread by airborne droplets when coughing or sneezing. In addition, pneumonia can be transmitted through blood, especially during or immediately after childbirth. It is necessary to carry out additional research for studying various pathogenic microorganisms, causing pneumonia, and ways of their transmission, since it has vital importance for treatment and prevention.

Symptoms

The symptoms of viral and bacterial pneumonia are similar. However, the symptoms of viral pneumonia can be more varied than those of bacterial pneumonia.

In children under five years of age with symptoms of cough and/or difficulty breathing, with or without high temperature, the diagnosis of pneumonia is made in the presence of rapid breathing or retraction of the lower chest, if the chest is drawn in or pulled back when inhaling (in a healthy person when inhaling chest expands). Wheezing is more common with viral infections.

Infants at very severe course sick people may be unable to eat or drink, and they may also experience loss of consciousness, hypothermia, and seizures.

Risk factors

Although most healthy children are able to fight off infection using their own body's defenses, children with compromised immune systems are at greater risk of developing pneumonia. The immune system the child may be weakened by insufficient or poor nutrition. This applies especially to children infancy who are not exclusively breastfed.

Pre-existing medical conditions, such as symptomatic HIV infections and measles, also increase the risk of pneumonia in children.

A child's susceptibility to pneumonia is also increased by the following environmental factors:

• indoor air pollution caused by cooking and the use of biofuels (such as wood or manure) for heating;
• living in overcrowded housing;
• parental smoking.

Treatment

Pneumonia caused by bacteria can be treated with antibiotics. They are usually prescribed in medical center or hospital, but in the vast majority of cases, pneumonia in children can be effectively treated at home at low cost oral antibiotics. Hospitalization is recommended for children under two months of age and in very severe cases.

Prevention

Preventing pneumonia in children is a key component of the strategy to reduce child mortality. Immunization against Hib, pneumococcus, measles and whooping cough is the most effective way prevention of pneumonia.

Adequate nutrition is important for increasing the child’s body’s defenses, starting with exclusively breastfeeding during the first six months of life. It is also effective in preventing pneumonia and shortening the duration of the disease.

Fight against such environmental factors, such as indoor air pollution (for example, through the use of affordable eco-friendly cookstoves) and promoting good hygiene in overcrowded homes also reduce the number of children suffering from pneumonia.

To reduce the risk of pneumonia, HIV-infected children are given the antibiotic cotrimoxazole daily.

Economic costs

The cost of antibiotic treatment for all children with pneumonia in the 66 countries monitoring maternal, newborn and child survival rates as part of the Countdown to 2015 initiative is approximately US$109 million per year. The price of treatment includes the cost of antibiotics and diagnostic tools for pneumonia.

WHO activities

In 2013, WHO and UNICEF launched the Global Action Plan to Fight Pneumonia and Diarrhea. Its goal is to intensify the fight against pneumonia through combined measures to protect children from pneumonia, its prevention and treatment, including the following activities:

• protection children against pneumonia, including promoting exclusive breastfeeding and handwashing, and reducing indoor air pollution;
• prevention pneumonia through vaccination;
• treatment pneumonia: provision proper treatment for each child - either with the help of a community health worker, or, in the case of serious illness, in a medical facility, as well as providing the antibiotics and oxygen necessary for recovery.

Unfortunately, very often this leads to serious complications, namely, to pneumonia. Pneumonia has a dramatic effect on general condition body. The younger the baby, the more severely he suffers from the disease and the more dangerous it is for his life.

Why do children get pneumonia?

Pneumonia in the human body is caused by microbes: staphylococci, pneumococci and many others. fertile soil A variety of viruses are prepared for the life activity of these microbes. They settle on mucous membranes and differ from microbes in their particularly small size. They also have the ability to multiply very quickly, as a result of which the nasal mucosa is damaged and, thus, viruses pave the way for microbes.

Therefore, doctors most often talk about pneumonia as a complication after a viral infection. This complication occurs especially often after the flu. In addition, we must not forget that in our age of global emancipation, mothers are forced to go to work when the child is not yet 3 years old. And in children's team viral infections are very common.

How can we explain that children under 6 years of age get sick more often and suffer more severely from the disease? It all depends on the child’s insufficiently stable immunity and the structural features of the baby’s respiratory system. Even a slight runny nose in young children causes severe swelling of the nasal mucosa.

Also, every mother should know about the first signs and symptoms of pneumonia.

Development of the disease in children

Most often, pneumonia occurs on the third day after the onset of an acute viral infection. The inflammatory process descends from the upper respiratory tract to the trachea and bronchi, and if tracheitis and bronchitis are not recognized in time and appropriate measures are not taken, then to the lungs. The cough becomes more frequent and may be dry and painful. The child's temperature rises sharply.

A so-called “candle” occurs: a condition in which the circulatory system cannot cope with a sharp change in temperature and the blood vessels narrow. In this regard, convulsions, loss of consciousness, and cardiac dysfunction may occur. In such cases, you must immediately call ambulance. How younger child the more he needs urgent hospitalization. With adequate and timely treatment, after three days the baby is on the path to recovery.

How to protect your child from pneumonia?

The strength of the immune system plays a decisive role in the development of pneumonia and the severity of its course. The stronger your child, the greater the hope that the child will not get sick or will endure the illness more easily. Prevention of the disease is carried out in two ways. On the one hand, it is necessary to protect children from contact with sick people.

But this is not always possible. On the other hand, strengthen the body's defenses as much as possible. Children need to be actively taught to fresh air, temperature fluctuations. At the same time, the body will gradually harden and in the future will be resistant when “encountering” viruses and bacteria.

The basic principles of hardening can be formulated as follows:

• accounting individual characteristics nervous system every child;
• gradual hardening;
• systematic hardening.

Hardening procedures include:

• ventilation;
• walks;
• rubbing;
• dousing

During walks, the child must be dressed according to weather conditions, and not the fears and worries of the mother. Airing should take place in the presence of the baby. Of course, you shouldn’t plant it on the floor under an open window, especially in winter. In the children's room you can always find a place for the child during ventilation. But then you won’t worry about how he will endure this procedure in a children’s educational institution.

After bathing, it is useful to dry yourself with a wet towel, soaking it in more cool water. After a week, pour over the baby’s feet. After a few more days, the water temperature is reduced by 1-2 degrees, and when dousing, an increasingly larger area of ​​the child’s body is covered from the periphery to the center.

It is best to start hardening in the summer. This is especially good to do while relaxing at a seaside resort. But the most important thing is systematicity, because, unfortunately, it is impossible to do hardening for future use. All good things are achieved through patience and hard work. And if you add physical education to all this, then health, well-being and strong immunity for your fidget will be ensured for a long time. long years. Be healthy!