Pneumonia can have both bacterial and viral etiology. There are a lot of causative agents. But the main pests that cause pneumonia with complications are staphylococci, streptococci and pneumococci.
Untreated pneumonia at 2-3 weeks after the onset of the acute period often develops into pneumopleuritis - pleural pneumonia. Pleurisy is not an independent disease, but a symptom indicating an aggravation of inflammation.
Pleural pneumonia. Features
When inflammation affects both the pleural membranes of the lungs, severe inflammation begins, which can easily go into pleurisy. The pleural membranes are invented by nature so that after exhalation the lungs do not connect. The area of negative pressure formed between the parietal and visceral pleura leaves allows the lungs to expand freely during inspiration.
Pleura is a smooth serous membrane consisting of two layers that separates the lungs from the diaphragm. At the root of the lung, two pleura leaves are combined.
When a patient who has caught a virus or a bacterium has not consulted a doctor with pneumonia for a long time, the inflammation passes to the lung membranes. Such inflammation is called pleural pneumonia.
Complications
Nasal cilia, tonsils are natural barriers that must protect the respiratory tract from bacteria. But if the protective barrier is weak, immunity is suppressed, the likelihood of developing pneumopleuritis is high.
Among the complications of pleural pneumonia, there are:
- lung abscess
- dry pleurisy;
- purulent pleurisy;
- pneumothorax rupture of the lung and air entering the pleural cavity.
There are no less dangerous non-pulmonary complications:
- impaired renal or hepatic function;
- endocarditis or pericarditis - inflammation of the membranes of the heart;
- sepsis is a common blood poisoning.
Pneumothorax and sepsis are the most dangerous complications, often fatal. In order to prevent death, it is necessary to call an ambulance at the first symptoms of pneumonia. It is necessary to determine the pathogen of inflammation and the form of the disease.
Types of pneumonia
There are several classifications of pneumonia. According to the degree, severity, the prevalence of the focus of infection, clinical and morphological signs.
According to the prevalence of the outbreak:
- left-sided;
- right-sided;
- bilateral;
- segmental;
- subsegmented.
According to clinical and morphological characteristics:
- bronchopneumonia;
- croupous, or pneumopleuritis.
By severity:
- mild inflammation;
- moderate severity;
- heavy.
According to the shape of the flow:
The type of pneumonia is established after many tests. Mandatory after the doctor receives the results of bacteriological and histological studies.
Signs of pleurisy
It is difficult to determine the complication of common pneumonia for a person without a medical education. And if pneumonia is treated at home, then when symptoms of pleurisy appear, you must immediately call an ambulance.
The obvious symptoms of pleural pneumonia are:
- temperature 39 ° and above;
- chest pain, aggravated by coughing;
- shortness of breath, weakness;
- pale skin and a characteristic cyanotic triangle in the corners of the mouth;
- chest tightness;
- impotence;
- shallow breathing.
Pleurisy with purulent exudate is manifested by even more severe symptoms.
- Difficulty breathing.
- A person cannot move, pain is unbearable. He lies or sits in a position in which it is convenient for him to breathe air.
- The temperature is 40 ° C, and it is impossible to bring down the usual antipyretic drugs - antibiotics are needed.
- Strong aching muscles and joints.
- Cold and blue skin.
- The pressure is low.
It is believed that if the usual inflammation did not go away after 3 weeks, then the pleural effusion has already started to accumulate, which means that drainage is needed. But in each case, the development of pleural pneumonia is different. It is not possible to predict the result of complications.
Danger of complications
If a complication of pneumonia has begun, effusion often begins to accumulate in the pleural cavity. Pleural effusion in pneumonia - accumulation of fluid in the lung cavity with a volume of more than 4 mm. Exudate - fluid in the lung cavity depends on the nature of the inflammatory process and the cellular composition of the pleural effusion.
Pleural effusion is complicated by pneumonia caused not only by pneumococci and streptococci. There are a number of other factors:
- esophageal rupture;
- osteomyelitis;
- chest injuries;
- diverticulosis;
- fungal pneumonia;
- pneumonia with tuberculous etiology.
However, as a result of infection with streptococci, the likelihood of developing pneumopleuritis is most - about 60%.
Pneumonia with a high temperature of more than 7 days leads to a sharp loss of body weight and anemia - anemia. Therefore, therapy should be started as soon as the pathogen becomes known.
Phases of the formation of exudate in the lungs
Pleurisy develops in several stages. And the sooner measures are taken, the better the disease is treated.
The stages of accumulation in the pleural cavity of the fluid are as follows:
- pneumonia passes to the pleura;
- blood vessels expand and the excretion of biological fluids increases;
- fluid outflow is disturbed;
- commissures appear in the lungs;
- fluid, if it is in the pleural cavity for a long time, will thicken.
- purulent exudate is formed.
The result of an abnormal process in the lungs is the formation of pleural empyema. This is a very dangerous complication, the treatment of which does not always end well. Another danger of a large accumulation of fluid is the mediastinum bias. When a fluid, for example, in the right lung, presses on the mediastinum, it is strongly inclined to the left side, and vice versa.
Pneumonia in children
Children suffer pneumonia harder, if you suspect you need to call an ambulance so that the doctor makes an X-ray and tells the diagnosis exactly. Many parents, not knowing the diagnosis, begin to give the child advertised antibiotics. From this, the symptoms only blur and it is more difficult for the doctor to establish the cause of the ailments.
Pleural pneumonia in children is difficult. Their immunity is weak. And the body's defenses cannot resist the attack of pneumococci for a long time. If purulent pleurisy and acute respiratory failure begin in pneumonia in a young child, delaying qualified doctor help may cost the baby.
Is pneumonia contagious?
Some believe that pneumonia develops after hypothermia. Others argue that inflammation can be transmitted by airborne droplets. Is it worth protecting a child from other children if he has pleural pneumonia? Is it contagious? When the results of the study confirm that the disease is of a viral or bacterial nature, then yes - the child is contagious.
Diagnostics
A patient with pneumonia - regular or pleuropneumonia - needs a quality multilateral examination. What studies do you need to go through?
- X-ray of the lungs in two projections: frontal and lateral;
- general blood analysis;
- puncture of pleural fluid and its histological and biochemical analysis;
- when listening with a stethoscope, wheezing and characteristic sounds from the movement of an inflamed pleura are heard;
- videothoracoscopy;
- computed tomography, if the picture on the x-ray is not clear enough.
Left-sided pleural pneumonia often causes myocardial infarction. When diagnosing such a disease, the doctor will require an ECG of the heart.
How to remove fluid from the lung cavity?
To remove exudate from the pleural cavity, drainage is performed. Puncture is carried out in the II — III intercostal space, necessarily on the front surface of the chest. The fluid is pumped out through a puncture using a special drainage apparatus. During pumping, a negative pressure must be maintained in the pleural cavity, equal to 0.98-1.5 kPa.
Timely pumping fluid serves as a prevention of pneumothorax and pleural empyema. However, a thoracic doctor should do this.
If the exudate is not pumped out, the substance will turn into pus, and it will be more difficult to pump it out.
Drug treatment
In the case of pleurisy, treatment with folk methods should not be carried out in any case. The doctor, after determining the cause of inflammation, prescribes the necessary drugs.
If pleural pneumonia is diagnosed, the treatment is:
- The course of third-generation antibiotics, in the event that the cause of pneumonia pleurisy bacteria. Among antibiotics, macrolides and cephalosporins are most effective for various types of inflammation. For example, Ceftriaxone from cephalosporins. Of the macrolides of semi-synthetic origin - "Azithromycin".
- Puncture of the pleural cavity for pumping fluid.
- For some time, diuretics are also taken.
- Painkillers.
- Anti-inflammatory drugs.
- A course of vitamins to maintain immunity.
In the event that the reasons are for the multiplication of fungus in the lungs, antifungal drugs are prescribed.
At the end of treatment, when the inflammation is almost gone, there is only a little sputum, then breathing exercises are prescribed.
Prevention
During the period of autumn-winter decline in immunity, it is recommended to walk more often, not to stay in stuffy rooms. When there are patients with infectious diseases at home, separate them from the rest of the family. Pneumonia can indeed be contagious. Especially dangerous is pneumonia in the elderly, children and girls with low body weight who are on diets.
It is advisable to take vitamins in the winter, actively engage in sports and eat well. All this will strengthen the body's ability to fight bacteria and viruses.