Today we offer you to talk about what pneumonia is. The wording of the diagnosis, etiology, the mechanism of the development of the disease, treatment, diagnosis and many other questions will be necessarily addressed in the article. It will be about acute inflammatory damage to the lungs (mainly of infectious origin). This disease affects both the alveoli and interstitial tissue. We also note that the disease is quite common, especially in older people (after 55 years).
Etiology
Before we move on to examples of formulating a diagnosis of pneumonia, we need to deal with the causes of the disease. We’ll talk about this now. Pathogens include:
- gram-positive microbes (pneumococci, staphylococci, streptococci and others);
- gram-negative pathogens (klepsiella, Pseudomonas aeruginosa, Pfeyffer rods, Legionella, rod-shaped intestinal bacteria);
- microplasma;
- viruses (adeno- and picornaviruses, herpes and flu);
- mushrooms (Candida, dimorphic yeast fungi and so on).
Non-infectious nature of the disease:
- poisoning by harmful substances and their vapors;
- chest trauma;
- allergens
- burn of the airways;
- radiation therapy.
Development
In total, there are 3 ways in which the pathogen enters the lungs. We’ll talk about them:
- Bronchogenic. The most common way is to get the virus with a breath. The greatest likelihood of the disease is observed in people with an inflammatory process in the nose. It is also possible infection as a result of certain medical procedures (intubation or bronchoscopy).
- Hematogenous. It is less common. The cause may be sepsis, intrauterine infection, intravenous drug administration.
- Lymphogenic It is extremely rare. The infection spreads with lymphatic flow, that is, harmful microorganisms need to get into the vascular system.
Classification
According to clinical and morphological characteristics, it is customary to divide the disease into the following groups:
- croupous;
- parenchymal;
- partial;
- focal;
- interstitial.
According to the method of infection, it is distinguished:
- community-acquired pneumonia (the formulation of the diagnosis may look as follows: non-hospital form, the lower lobe of the left lung is affected, the course is not severe, and so on);
- hospital;
- aspiration;
- pneumonia in immunocompromised individuals.
A fairly common ailment is precisely the hospital form (that is, the infection occurred outside the medical facility). There are 4 categories of this form of the disease.
| Category | Brief explanation (conditions) |
| 1 | - age - up to 60 years;
- no associated pathologies.
|
| 2 | - concomitant pathology is available or the patient's age exceeds 60 years;
- there is the possibility of outpatient treatment.
|
| 3 | - severe form;
- hospitalization required;
- no intensive care needed.
|
| 4 | - severe form;
- hospitalization required;
- intensive care is needed.
|
The diagnosis of community-acquired pneumonia is widespread not only in adults, but also in children. An interesting fact is that 90% of deaths after 60 years occur precisely for this reason.
3 groups of nosocomial pneumonia are also distinguished.
| Group | Brief explanation (conditions) |
| 1 (A) | - no risk factors;
- severity - mild or moderate;
- development occurred during hospitalization.
|
| 2 (B) | - the presence of specific risk factors;
- severity - mild or moderate;
- development occurred at the time of hospitalization.
|
| 3 (B) | - the presence of risk factors;
- the course is severe.
|
An example of the formulation of the diagnosis of pneumonia in a hospital form: the lower lobe of the right lung is affected, the course is severe, the etiology is a staphylococcal infection; the presence of complications - pleurisy.
Symptoms
We examined various forms of pneumonia; you could also see examples of the diagnosis in the previous section. Now I want to say that each specific form of the disease has its own characteristics (this also applies to symptoms). In this section, we discuss the manifestations of the disease that are inherent in all types.
There are 4 types of symptoms:
- general inflammatory reaction (it can be chills, fever, pain in muscles and joints, leukocytosis (left shift), an increase in ESR in the blood);
- inflammation of lung tissue (cough, expectoration of blood and sputum, vomiting, altered respiratory rate, shortness of breath, bronchophony, wheezing, changes in an x-ray, and so on);
- intoxication (weakness, headaches, palpitations, lack of appetite, severe thirst);
- changes regarding the functioning of other organs.
Complications and consequences
We talked about the wording of the diagnosis of "pneumonia" and about the symptoms, we proceed to the complications. Immediately, we note that the course of the disease directly depends on the consequences, which can be a great many. There are 2 forms:
- extrapulmonary (hepatitis, otitis media, anemia, sepsis, encephalitis, psychosis and so on);
- pulmonary (bronchitis, pleurisy, abscess, gangrene, pneumosclerosis and so on).
Particular attention should be paid to severe forms of the disease, which lead to the subsequent exposure to toxins:
- heart failure;
- respiratory failure;
- liver failure;
- renal failure;
- infectious toxic shock and so on.
Diagnostics
Regardless of the formulation of the diagnosis of pneumonia (we examined examples above), the diagnosis and treatment of the disease is necessary.
The necessary studies include:
- blood test (according to the results, the doctor can draw conclusions about the presence of an inflammatory process in the patient's body);
- X-ray of the lungs (done according to the patient’s request for diagnosis, on the 10th day of treatment to determine its effectiveness, on the 30th day in order to verify the absence of the inflammatory process and prevent complications);
- sputum culture;
- blood gas composition;
- pulse oximetry;
- Gram stained sputum microscopy.
If necessary, the doctor may prescribe other additional studies.
Treatment
Since pneumonia most often has a viral etiology, the first thing a doctor pays attention to is the selection of antibacterial drugs. For treatment, several groups of antibiotics are used:
- semi-synthetic penicillin;
- macrolides;
- lincosamides;
- cephalosporins and many others.
The duration of treatment is from 1 to 2 weeks (during this time, a change in drugs is possible).
Symptomatic therapy:
- antipyretic;
- mucolytic;
- expectorant;
- antihistamines;
- bronchodilator;
- immunomodulator;
- detoxification agents;
- corticosteroids.
If necessary, the doctor may prescribe some physiotherapeutic procedures. Also, the patient is recommended:
- bed rest;
- heavy drinking;
- sparing diet;
- regular airing and quartzing of the patient's premises (ward, room).
Prevention
Immediately draw your attention to the fact that there are no specific measures for the prevention of this disease. General strengthening of the body is necessary. That is, we are talking about hardening, strengthening immunity, timely treatment of diseases. It is important to avoid hypothermia, monitor the cleanliness of the house (avoid contact with dust and allergens), abandon bad habits. If work is associated with harmful production, then it is necessary to change it if possible.