Any modern parent should know about pneumonia in children. What such a disease is, how it manifests, what is dangerous - all this information can become vital if one's own child gets sick. By identifying pulmonary inflammation in time and contacting a specialist for help, you can eliminate the likelihood of complications, and the healing process will not take much time. Without paying due attention to the disease, one can face serious consequences and risks to the health and even life of the child.
What is it about?
To find out all the important information about this disease, it is better to contact qualified doctors who know exactly what pneumonia in children is. This word is used to denote an acute inflammatory infectious disease. It is of various etiologies. The process of the development of the disease is caused by damage to the respiratory tract of the respiratory system. Respiratory pulmonary zones are parts of the human body localized above the terminal bronchi. These include the alveoli, alveolar passages, respiratory passages.
On average, from their experience they learn what pneumonia is in a child, up to twenty parents out of a thousand raising a baby younger than one year old. For children older than a year, but younger than three years of age, the prevalence of the disease reaches six cases per thousand. The main factors that speak of increased risk are: perinatal diseases, strangulation, hypertrophic processes, congenital heart defects, weak blood flow and a weakened immune system. For children older, the risk of pulmonary inflammation is higher if the body has a chronic infectious focus, if the body is too cold. More risks if loved ones smoke, and for children of an even older age group, active smoking becomes a hazard factor.
Types and Forms
Doctors have long and well known about pneumonia in children: what such a disease represents, how it manifests itself, as explained. Etiologically, all cases are divided into categories: viral invasion, bacterial infection, as well as provoked by mycoplasma, fungi, and helminths. Possible etiologies include: rickettsial cases, allergic, due to chemical aggressive factors and physical effects on the children's body. It is customary to distinguish varieties of the course: with the development of colonies of hemophilic, intestinal, Pseudomonas aeruginosa, strepto-, staphilo-, pneumococcus, protea. Finally, the last form is Friedlander.
Among the viral forms of the disease, the most typical for our area are influenza, parainfluenza, respiratory syncytial cases and provoked by adenovirus.
It is customary to divide all cases into primary, secondary. Secondary are observed if there is a chronic bronchial or pulmonary disease that goes into the relapse phase. Sometimes pulmonary inflammation is caused by other somatic pathologies of the child's body.
The nuances of the formation of the disease
Only when exposed to dangerous pathological microflora, physical, chemical factors, acute pneumonia does not appear in children: a complex of phenomena is needed that weaken the body, making it especially vulnerable. So, the risks of inflammatory processes are higher if mucous secretions penetrate into the lungs from the upper parts of the respiratory system by aerogenous route. In order for pulmonary inflammation to develop, the microorganism must pass into the bronchi (with simple contact with an external source, this does not normally occur). Additional important factors contributing to the development of the disease are damage to the respiratory tract, a violation of the normal protective mechanisms of this part of the body. The infection can spread to the lungs with blood flow, lymph.
Symptoms of pneumonia in children (without coughing and with this phenomenon) are due to impaired pulmonary ventilation. With this pathology, gas exchange deteriorates, the myocardium of the heart ventricles receives less oxygen necessary for its functionality. The lesions caused by pneumonia can form segments, lobules. There is a possibility of total damage and observed from one or two sides. The mechanism of disease progression is due to a lack of oxygen, hypercapnia. Such phenomena are explained by a malfunction of respiratory processes at the tissue level, as well as external pulmonary respiration.
How to notice?
Doctors who are well aware of the treatment features and symptoms of pneumonia in children urge parents to be careful: sometimes the pathology develops almost imperceptibly or disguises itself as other diseases that are less dangerous. The clinical course is determined by the type of disease, the prevalence of lesions, dimensions. Perhaps a focal course in which the inflammation is acute, subacute. Bronchopneumonia is usually fixed by the end of the first week of some acute respiratory illness. Pulmonary inflammation in this case is the "second wave".
Typical manifestations of the disease are fever, general weakness of the patient, cough and severe symptoms of general poisoning of the body. Pneumonia is indicated by chest, subscapular, headaches. A percussion sound is reduced above the lesion site. Auscultation shows bronchophony. There is a chance of crepitus. The patient's breathing is weak. Suspecting the need against the background of symptoms of treatment of pneumonia in children, the first needy are sent for an X-ray examination. The image should reflect the active pattern of the lungs between the inflammatory areas, pulmonary roots. A blood test shows an increase in ESR. The study of shaped elements gives a picture of neutrophilic leukocytosis.
Segmental flow
Sometimes the symptoms of pneumonia in children with fever suggest a case of segmental development of pathology. The disease spreads with blood flow, therefore several pulmonary segments are affected - this is what gave the name the form. More often, violations are localized in areas on the right. Diseases are characterized by an acute onset: temperature rises sharply, manifestations of general poisoning of the body are observed. The patient complains of pain in the sternum, abdomen. With this course of pneumonia, a rare cough is characteristic. Over time, pathological weakness of the respiratory system increases.
Secondary pulmonary inflammation of this type is usually preceded by respiratory infection. Manifestations of intoxication are rather weak. With an X-ray examination of the patient's respiratory system, you can see the damage zones merging together, the process spreading to segments.
Croupous case
Sometimes the symptoms of pneumonia in children with fever suggest a croupous course of the disease. Such a pathology is characterized by coverage of the pulmonary lobe, part of the lung, pleura. In practice, it is diagnosed relatively rarely. The form of the disease is explained by pneumococcal invasion, characterized by acute onset. The patient complains of dizziness, his head hurts sharply, his health suddenly becomes worse. The heat rises to 41 degrees. Many are worried about chills. In the first three days of the course, the patient rarely coughs dryly, with time a sputum of a rusty color is observed.
The course of the case is characterized by shortness of breath, cyanosis. Children are characterized by abdominal syndrome. Pain covers the umbilical zone, accompanied by vomiting and increased gas formation. Croupous pneumonia is usually divided into stages. There are four stages of the pathological process.
Step by step
If pneumonia in a child at home begins with weakness of breathing and crepitus in the chest, the first stage of the large-flow course can be assumed. In medicine, it is called the tide step. The examination shows a short percussion sound that has a tympanic tone. As the patient progresses, the patient's face turns red, and the phenomenon is more pronounced on the damaged side. The patient's condition is serious. The percussion sound is even shorter. The doctor, examining the child, reveals bronchial breathing, bronchophony, it is not possible to hear wheezing.
The third stage of the disease develops by the fourth day, sometimes a little later, but usually no more than the seventh. At this stage, the cough becomes very strong, the fever subsides, a critical decrease in body temperature is possible. Percussion sound has a tympanic character, examination shows crepitus. The final stage is the fourth, in medicine, called the resolution step. The heat subsides, the patient often coughs, rales are possible.
Status Features
To clarify the case, an X-ray examination is indicated. For the diagnosis of pneumonia in children, the clinical recommendations are as follows: take an X-ray, study the quality of blood and the composition of the elements. The x-ray in the first step will show an active vascular pattern and limited diaphragm mobility. The second stage is accompanied by dense shadows, showing which lobes are involved in the disease, whether the pleura, pulmonary roots are affected. The following two stages are accompanied by a gradual disappearance of infiltration.
A croupous case is usually accompanied by severe neutrophilic leukocytosis. ESR is increasing. In young children, pneumonia without coughing with fever can be croupous: it is noted that an atypical course is characteristic of an early age. In babies, the symptoms are lubricated, determining the exact diagnosis is not easy. If antibacterial treatment is prescribed, the stages are shortened in duration. With an unsuccessfully selected therapy, the disease develops according to a protracted scenario.
Interstitial form
Developed against the background of invasion of mycoplasma, pneumocysts, fungus, staphylococcus, as well as viral pneumonia in children - all of these options can proceed according to the interstitial scenario. More often, such a diagnosis is given to infants and children who were born prematurely. Predisposing factors consider lack of immunity, dystrophy. The disease can manifest itself with severe intoxication, a decrease in blood pressure in the arteries. Many recorded the response of the central nervous system to infection, the disease can affect the work of the digestive tract.
Among the key manifestations is a debilitating cough, accompanied by scanty secretions. Sputum foams. Many have a swollen sternum. Percussion examination reveals tympanitis. Single crepitation, dry rales are possible. The patient's breathing is weak. The x-ray image shows emphysema, the pattern of blood vessels is cellular, peribronchial infiltration is observed. A blood test shows an increase in ESR, leukocytosis.
Status Update
To understand whether pneumonia occurs without a cough in a child, an atypical form of the course, a classic version, you need to send the patient to the clinic. The case is clarified by collecting facts about the clinical picture and studying the lungs through an x-ray. A typical clinical picture involves fever, weakness of breath, cyanosis and shortness of breath, involvement of auxiliary muscles for the act of breathing. Pulmonary abnormalities are diagnosed, infiltration shadows are visible on the x-ray in the foci, the blood picture changes. Another signal indicating pulmonary inflammation is an adequate response of the body to etiological treatment.
The course is determined by the etiology of the disease, the patient's age group, concomitant health problems. If the child has pneumonia without symptoms or symptoms due to invasion of Staphylococcus aureus, the strain belongs to the number of hospital, if the disease is due to gram-negative life forms, treatment is given especially hard. Such diseases are characterized by abscess formation. The focus of inflammation quickly erupts into the pleura, pyopneumothorax is formed. More often the current is stormy.
Age and Allergy
All the above forms of the course, atypical, community-acquired pneumonia in children have a particularly unfavorable prognosis. If the disease has formed in a baby, pulmonary inflammation in this age group is divided into that obtained during the period of intrauterine development and which appeared after birth. The first option is due to infection during pregnancy. The reason may be the strangulation of amniotic fluid infected with dangerous microflora. Aspiration is intrauterine, intrapartum. Observations show that infant pneumonia is more often accompanied by atelectasis, destructive processes in the tissues of the lungs.
If the diagnosis in the child shows pneumonia (without fever or fever), it is necessary to analyze the tendency to sensitization reaction. Studies show that a predisposition to allergies plays an important role in the formation of the disease - more often catarrhal pulmonary inflammation is formed, localized in the mucous membranes of the respiratory system. With pneumonia of this format, a complication of asthmatic syndrome is observed.
Health Issues: Everyone is Important
If a child has rickets, it is likely that pneumonia will last longer. In this category of children, the disease is more common. With hypotrophy, pulmonary inflammation is observed more often than in individuals who do not have such a problem. This is due to a weak immune system. For this category of patients, the course of pneumonia in a child without temperature and severe symptoms is more characteristic.
Atypical case: mycoplasma
Symptoms of pneumonia without fever are sometimes observed in children . The atypical course is recorded on average in 21% of patients, due to mycoplasma invasion. It is more common in children older than three years of age, but under 14 years of age. Distribution is airborne. Incubation lasts up to 11 days, the prodromal stage lasts no more than a day. The patient notes a mild headache, sore throat and dry, slightly sore. The general condition of the patient is weak, the temperature rises no higher than the subfebrile level. The examination shows hyperemia of the tissues of the pharynx, proliferation of follicles on the back wall. The cough gradually becomes stronger, comes in bouts, is not productive in the first couple of weeks. Damage to lung tissue is accompanied by deterioration and fever, chills. Symptoms of general poisoning of the body are observed.
A doctor, comparing physical indicators and x-rays, can assume that pneumonia occurs without temperature in children: the symptoms do not correspond to the general picture, and taking penicillins and cephalosporins does not give any effect. By the fifth day, auscultation allows you to hear weak breathing, small moistened wheezing. Atypical pneumonia can be assumed if the x-ray shows a heterogeneous infiltration, noticeable in combination with a strong change in the pattern of blood vessels.
Screening and treatment
If pulmonary inflammation and infection with mycoplasma are suspected, serodiagnosis is necessary. The study shows the binding of the components. Human body fluids are screened for specific antigens. Microbiological examination is required. A sputum is obtained from a patient for inoculation, a nasopharyngeal wash is taken. The research process involves the use of specific nutritional components.
Explaining how to treat pneumonia in children, the doctor will talk about the effectiveness of macrolides. Of this group of antibiotics, drugs containing erythromycin, azithromycin are more often prescribed. The pharmaceutical product Sumamed has a good reputation. Clindamycin is sometimes recommended. If the child is older than eight, you can resort to Doxycycline. If studies show bronchial obstructive syndrome, bronchodilators must be prescribed to the patient.
Chlamydia and pneumonia
If tests and examinations show left-sided, right-sided pneumonia in a child, the course is atypical, possibly due to chlamydia. This form is distributed by drip with air masses. A pathological agent enters the environment during a conversation, with a patient sneezing and coughing, the aspiration method leads to infection. The upper respiratory tract is the pathway for chlamydia to enter the body. Epithelial bronchial villi lose mobility approximately two days after the penetration of the pathological agent.
Usually, the onset of the disease is a temperature reaching 39 degrees, accompanied by pain in muscle and joint tissues. Headache, sore throat. A dry cough forms immediately, less often accompanied by small volumes of mucous secretions. Auscultation shows wheezing: dry, wet. .
Diagnosis and therapy
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Atypical course: Legionella
The invasion of this infectious agent leads to the formation of an acute form of pathology. The infection penetrates through the mucous membrane covering the organs of the respiratory system, at the time of the arrival of water aerosols in the pathway. This is possible with hygiene procedures or using a humidifier for pulmonary ventilation. Certain risks are associated with fountains and liquid sprays in the room. There is currently no information on the transmission of such a disease between representatives of humanity.
Pathological processes affect one pulmonary lobe or a larger area. Pneumonia is called drain. The incubation duration reaches 10 days, but sometimes it only takes a couple of days. The patient has a mild headache, the temperature rises to 40 degrees for a couple of days, and is very cold. Concerned about general weakness. The cough is dry, then accompanied by mucous secretions, purulent inclusions are possible. Cases of shortness of breath, muscle soreness, pleura are known. May vomit, vomit, may cause abdominal pain. Physical examination does not show manifestations of compaction of the lung parenchyma. X-ray images reflect a large volume of pathological processes. In the first steps, one-way infiltration can be diagnosed. Pictures show rounded shadows, which tend to merge. They affect one pulmonary lobe or a larger area.
Check and cure
About one in three with Legionella-related pneumonia suffers from hyperventilation and hypoxemia. It requires artificial ventilation of the lungs through hardware systems. Erythromycin is injected into a vein. If the pathology develops severely, additional use of rifampicin is necessary. As a means of secondary choice, Ciprolet, Ciprofloxacin are distinguished. Sometimes you can use drugs based on doxycycline, if the main medical course does not give the desired result.
Rehabilitation
Recovery after pulmonary inflammation is recommended in sanatoriums and resorts. The needy is prescribed a gymnastic course in the fresh air. Exercise therapy is planned so that the load increases gradually. It is important to have a balanced diet that meets age requirements. In some cases, drug rehabilitation is indicated. For stimulation, a course lasting several weeks is suitable. They use ginseng, vitamin preparations, medicines with eleutherococcus, aloe. Herbal medicine fees will benefit.