Pneumonia - Causes, Symptoms and Treatment .MF .
pneumonia in children and adults
Despite the advances in modern medicine and the emergence of new effective antimicrobial drugs, pneumonia is a very common and life-threatening disease.According to the frequency of deaths Pneumonia is on the first place among all infectious diseases.Reduce the incidence does not work for the past many years.For example, in Russia, according to official statistics, each year at least 400 thousand new cases.However, many experts believe this figure too low.In their view, pneumonia more than one million people suffer each year in Russia.
Pneumonia - an acute infectious inflammation of the lower airways with obligatory involvement of the lung tissue (alveoli, bronchi, bronchioles).
Currently identify several types of pneumonia:
1) community-acquired pneumonia - the most common form of the disease.
2) Nosocomial pneumonia or hospital .For this form of the disease include, evolved in finding the patient in the hospital more than 72 hours.At the sam
3) Aspiration pneumonia - is the result of inhalation of food, water and foreign objects.
4) SARS .Variety of diseases caused by atypical microflora (Chlamydia, Mycoplasma, Legionella, etc.).
pneumonia Pneumonia is primarily a bacterial disease. main causative agents of pneumonia : pneumococcus (Streptococcus pneumoniae), staphylococci (Staphylococcus aureus), Haemophilus influenzae (Haemophilus influenzae) as well as "atypical" infections (Chlamydya pneumoniae, Mycoplasma pneumoniae, Legionella pneumoniae).Less
cause severe pneumonia can be (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter, etc.).They are more common in patients with severe concomitant diseases, in patients with weakened immune systems.
triggering factor for pneumonia may be different viral infections.They cause inflammation of the upper respiratory tract and provide "comfort" for the development of bacterial pathogens.
Risk factors that increase the likelihood of developing pneumonia:
1) Diseases of the internal organs, primarily the kidneys, heart, lungs, in the stage of decompensation.
2) Immune deficiency.
4) Carrying out of mechanical ventilation.
5) central nervous system disorders, including epilepsy.
6) Age older than 60 years.
7) Conducting general anesthesia.
Symptoms of pneumonia
main symptoms of pneumonia - fever with a temperature rise to 38-39.5 C, cough, often with profuse discharge of phlegm, shortness of breath on exertion and at rest.Sometimes patients may feel discomfort or pain in the chest.
All patients with pneumonia noted general weakness, decreased performance, fatigue, sweating, insomnia, decreased appetite.In elderly patients symptoms of intoxication can dominate.
Auscultation of a patient with pneumonia inflammation of the hearth are heard wheezing different character (usually finely).At a percussion of the chest there is a sound dullness over the inflamed area.But in some patients (about one in five) local symptoms of pneumonia may not be.
What tests need to take if you suspect pneumonia
for suspected pneumonia, and the appearance of the relevant symptoms will necessarily have to do a blood test clinical.The sharp increase in white blood cells, increasing the number of band neutrophils, and erythrocyte sedimentation rate - may indicate an acute bacterial inflammation.Thus, increase of leukocytes greater than 10 * 109 with high probability indicates the development of pneumonia.Reduced white blood cells less than 3 * 109 or an increase of more than 25 109 * are unfavorable prognostic factors, indicating the severity of the disease and a high risk of developing complications.
indispensable for accurate diagnosis of pneumonia is a chest X-ray.It is held in a straight line, if necessary, in side view and allows not only the diagnosis of acute pneumonia and identify possible complications, but also to evaluate the effectiveness of treatment.
Unfortunately, in some cases, radiography is not informative.In such situations, resorting to a more accurate method of study - CT scan of the lungs.When it makes sense to resort to this option of diagnostics?
1) if the patient has all symptoms of acute pneumonia, but the x-ray does not reveal inflammation.
2) with recurrent pneumonia (more than 3 episodes), with the proviso that the inflammatory focus is located in the same lung lobe.
3) if the X-ray pattern does not match the clinical manifestations of the disease.For example, the patient signs of acute pneumonia and atelectasis pattern on radiographs, etc.
biochemical blood analysis does not help in the diagnosis of pneumonia, but reveals the accompanying violations of the internal organs.Usually determine the following parameters: glucose, AST, ALT, total bilirubin, direct bilirubin, creatinine, urea, CRP.
development of respiratory failure is a direct indication for the definition of blood oxygen saturation and carbon dioxide.More accessible is the pulse oximetry.To do this, the patient put his finger on a sensor, evaluating the blood oxygen saturation in the small capillaries.
is mandatory sputum.Spend its microscopic and bacteriological examination.
If you suspect the presence of a patient with pneumonia atypical infections pass a blood test for antibodies (IgM and IgG) to the agents Chlamydya pneumoniae, Mycoplasma pneumoniae, Legionella pneumonia.
If there is evidence of a patient for tuberculosis is necessary to consult with a TB sputum binding, advanced radiological survey conducted intradermal tests.
Warning Signs of tuberculosis:
1) the presence of more than 3 weeks of cough with sputum or without it,
2) the emergence of hemoptysis,
3) the occurrence of pain in the chest,
4) long-term temperature ranging from 37.1 to 3790 C,
5) excessive sweating, especially at night,
6) progressive loss of body weight.
Treatment of pneumonia
treatment of uncomplicated forms of pneumonia can engage general practitioners: internists, pediatricians, family doctors and general practitioners.Severe condition of the patient requires hospitalization, it is desirable to specialized hospitals (Department of Pulmonology).
Indications for hospitalization for pneumonia:
1) The data of objective inspection: impaired consciousness, respiratory rate 30 per minute, the reduction in diastolic blood pressure less than 60 mmHg, and systolic blood pressure less than 90 mmHg,increase in heart rate over 125 per minute.
2) Body temperature less than 35.5 C or more than 40.0 C.
3) Reduced blood oxygen saturation less than 92% of normal.
4) changes in laboratory parameters: leukocyte concentration of less than 4 or more than 25 109 per liter, a decrease in hemoglobin of less than 90 grams per liter, increased creatinine more than 177 micromoles per liter.
5) Changes in the X-ray: changes in more than one share, the presence of cavities, pleural effusion.
6) Presence of foci of infection in other organs and systems (bacterial arthritis, meningitis, sepsis, etc.).
7) Decompensation accompanying heart disease, liver, kidneys, etc.
8) Failure to conduct adequate therapy at home for social reasons.
Drugs for treatment of pneumonia
basis of the treatment of pneumonia is the use of antibacterial drugs.Selection of the drug, its dosage and duration of application determined by the physician, depending on the patient's age, clinical features of pneumonia and associated diseases.Most often, for the treatment of pneumonia requires a combination of two antibacterial drugs.
Currently, the following pharmacological group of antibiotics used to treat pneumonia macrolides (eg, clarithromycin, macrofoams, fromilid, azithromycin, sumamed, Hemomitsin, vilprafen), penicillin and its derivatives (eg, amoxiclav, flemoklav, flemoksin, augmentin, ampioks andetc.), cephalosporins (medications: cefazolin, supraks, Rocephin, Zinnat, Fortum, cefixime, cephalexin, tsefataksim, ceftazidime, klaforan, cefepime, ceftriaxone), respiratory fluoroquinolones (levofloxacin, sparfloxacin).The average duration of antibiotic therapy is at least 7-10 days.
If you have a cough with expectoration prescribe expectorants and mucus-thinning drugs.The drugs of choice ACC, Fluimucil, Lasolvan bromhexine.A common mistake is to assign this group of drugs in patients without cough or dry, non-productive cough.
With the development of dyspnea prescribed bronchodilators.Most preferably, the use of inhaled medications such as Flomax, berotek salbutamol.The best delivery method - inhalation using a nebulizer.If unable to use inhaled medications administered aminophylline or its derivatives (teopek, teotard).According to the testimony
spend infusion therapy.For this purpose, make a dropper with saline (saline Disol, Ringer's solution, etc.) or glucose solution.
In severe pneumonias may conduct therapies.For this purpose, they can be assigned immunoglobulin for intravenous administration, eg, Octagam, pentaglobin, Intraglobin.Well-proven drug polyoxidonium, providing a immunoukreplyayuschee and expressed detoxification effect.
When the temperature rises over 38,0-38,50 With appoint antipyretics.
Assign a multivitamin.
Treatment of pneumonia folk remedies Treatment of pneumonia
"folk remedies" can only complement the "traditional" drug treatment, but not to be his replacement.
often recommend use of bee products (honey, propolis, etc.).For example eat 1-2 tablespoons of honey 2-3 times a day with warm by drinking.It is also advised to use the inside of large doses of garlic and / or onions.
Because herbs often recommended leaves mother and stepmother, rose hips, elderberry fruit, flowers, lime, raspberry.
Met advice, recommends wrapping with fresh leaves of plantain and burdock.
All these folk remedies treatment of pneumonia can be used in the absence of you have allergies to these funds.
Features of diet and lifestyle for the treatment and prevention of pneumonia
bed rest in the recovery stage - polupostelny.It is strictly no smoking.It should be sufficient fluid intake.Recommended standards - at least 2.5-3 liters per day.In the daily diet should be sufficient amount of protein and carbohydrates, and vitamins, especially A, B and C.
Most patients will benefit breathing exercises.For example, according to the method of Strelnikova and Buteyko.Old hands on Pulmonology guidelines recommended patients to inflate the balls in their spare time.
Before you do breathing exercises, consult your doctor whether you can do it.In some states, such as lung abscess, some diseases of the heart breathing exercises are contraindicated.
Pneumonia in Children
Symptoms of pneumonia in a child are similar to those in adults.Particular attention is paid to the frequency of respiratory movements and the appearance of shortness of breath.Pathology, life-threatening respiratory rate is considered to be more than 40 per minute in children older than 1 year.The appearance of shortness of breath on the background of ARI - a poor prognostic sign.
wants to highlight the broader prevalence of "atypical" agents of pneumonia in children.In this regard, it is desirable to use antibiotics of macrolide in the acute treatment regimens pneumonia in children.
Given the high probability of developing complications from respiratory and cardiovascular systems, preferred hospital treatment of such patients.
Pneumonia during pregnancy
Acute pneumonia in pregnant women, even a benign course, is very dangerous, both for the woman and the fetus.This is due to the direct influence of intoxication, and the negative influence of prescribed drugs.
Even when a minimum of cold symptoms should consult a doctor that is associated with a high prevalence of latent forms of the disease, easily flowing initially, but can cause serious complications.Diagnosis on General Principles.Radiography is possible and relatively safe for the fetus after 10 weeks of pregnancy.
Antibiotic therapy is only performed when the diagnosis confirmed.Treatment only in a hospital.
Usually, pneumonia is not a cause for termination of pregnancy.
Possible complications of pneumonia and forecast
Pneumonia can lead to the development of a number of complications in the lung: lung abscess, pneumothorax, pleural empyema, etc.The most serious complication - the development of respiratory failure.Its development is more likely in older patients, patients with underlying chronic lung diseases (bronchiectasis, chronic obstructive pulmonary disease, chronic obstructive bronchitis, etc.) and of the heart.Respiratory failure in such patients may result in death.Also in death can lead the development of cardiovascular disease.
proved an effective measure of prevention of lung diseases, including pneumonia, is not smoking.Often pneumonia develops after a viral infection, so annual vaccination against influenza is also considered a preventive measure.
also for pneumonia prophylaxis is recommended to vaccinate preparation pneumatic 23 once every five years.The most common infectious agent that causes development of pneumonia is Streptococcus pneumoniae. vaccine Pneumo 23 creates immunity to this pathogen pneumonia.
Answers to frequently asked questions about pneumonia:
Do not use antibiotics for pneumonia is dangerous?
If they are not used, the pneumonia progresses, the focus of inflammation increases.As a result, it can lead to respiratory failure and death.
During the year the child (7 years) underwent 3 pneumonia.What are some ways to prevent this disease?
you need a mandatory consultation of two specialists: a pulmonologist and immunologist.The first will help identify related lung diseases that can provoke such frequent pneumonia, the second appoint immunoukreplyayuschuyu therapy.
beneficial effects also provides hardening.It is better to start in the summer and on a background of full health.
When you can be vaccinated after pneumonia?
must be at least 1.5 months after recovery.
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