Pneumonia is a disease that provokes the development of the inflammatory process in the lung tissue with a significant damage to the respiratory departments. It can manifest itself or develop as a complication of other ailments. The patient is not contagious to others, the disease is not transmitted from person to person, but with all this, an infectious breed is present in it.
Definition
Lobar pneumonia is a severe infectious-allergic lesion that captures one or more sides of the lung. Often manifested by chills, pleural and headache, fever, sweating, general weakness, wet cough and shortness of breath.
The incidence of patients is quite high, among all infected pneumonia accounts for 29.3% of cases. For this pathology, characteristic is the defeat of half of the lung and also the involvement of the pleura. The disease often affects adults, rarely children.
Etiology
The causative agent is pneumococcus, or rather, its various strains, but the influence of other pathogenic bacteria is not excluded: chlamydia, staphylococcus, mycoplasma, streptococcus and hemophilic bacillus. If it is not possible to identify the cause of the disease, the diagnosis is set as "unspecified lobar pneumonia." It should be noted that the virus can be in the nasopharynx for a long time without manifestation. It is also noteworthy that the disease often affects a completely healthy person, but under the influence of certain secondary factors.
The main methods of penetration:
- through the bronchi;
- lymphogenous course;
- hematogenous pathway.
The pathogenetic picture of lobar pneumonia is described by immediate hypersensitivity. Acute inflammatory changes in the parenchyma appear in the respiratory tract, and the disease forms in one or many foci through Cohn's alveolar pores, and then significantly spreads to the lung tissue. Damage to the lymphatic and small blood vessels leads to severe violations of vascular permeability, as well as the formation of fibrinous exudate.
Classification
At the place of deployment is divided:
- upper lobar;
- lower lobar pneumonia;
- medium share;
- interlobar
- bilateral;
- left-sided;
- right-handed.
By the nature of the course:
- protracted - lasts more than four weeks, often with mucus symptoms;
- acute - forms quickly and actively develops.
Symptoms
- An ailment very rarely begins with a strong rise in temperature or a fever.
- Patients experience excruciating headaches, sweating, and mild malaise, accompanied by weakness.
- Initially, shortness of breath occurs, which after provokes the appearance of discomfort in the affected area, depending on the pleural state in the chest and on breathing. The pain is pronounced, has a clear localization, especially with active inspiration. If you try to bend the body into the focus of the problem, then the breath will become superficial and weak.
- Lobar lobar pneumonia is accompanied by a strong cough and increased sputum, but in the initial stages, inherent dryness can cause painful breaths.
- Fever is often absent in the elderly and in patients with a weak body.
- Sputum is purulent-mucous, with rusty color and blood.
- There is a clear feeling of lack of air, which can lead to problems with the cardiovascular system and a bluish nasolabial triangle.
- High intoxication with lobar pneumonia leads to problems with sleep, neuralgic disorders, inability to move, arousal, as well as delirium and hallucinations, therefore, such patients require constant care and control.
- Jaundice manifestations on the skin, eye proteins and mucous membranes.
- Isolation of fluid in the pleural cavity, the appearance of pleurisy.
- Aching pain in joints and muscles.
- Lowering blood pressure.
- Bowel problems.
Stages
Doctors say that all the morphological changes that occur in the lungs can be divided into 4 stages.
- The stage of the tide, in which microbial edema appears. It can develop due to the occurrence of right-sided and left-sided lobar pneumonia or its focal form. This period lasts only 1 day.
- It is characterized by red hepatitis, in which damage to the entire lobe of the lung begins to appear. It significantly increases in size and takes on an airless and loose form. On the pleura there are spot hemorrhages and a grayish-whitish coating.
- From the 4th to the 6th day of the disease, changes in the red shade of the lung to gray occur. Tissues of the respiratory organs begin to become even harder and at the same time looser. This phase of lobar pneumonia is called "gray guardianship." Alveoli are completely filled with exudate. It is formed from neutrophilic white blood cells and filamentous fibrin particles.
- Only on day 9, the disease passes to the resolution stage.
Causes
In most cases, pathogens are various strains of pneumococcus, less commonly other microorganisms that enter the body in a variety of ways.
The development of focal and lobar pneumonia is closely associated with the persistence of pneumococcus in the nasopharynx in a strong, healthy person and preliminary sensitization of the sick body to its antigens.
The rapid onset of the disease can occur against the background of complete health and lack of contact with patients.
Often, lobar lobar pneumonia appears along with diseases such as:
- tuberculosis;
- diabetes;
- SARS (acute respiratory viral infection) or influenza;
- COPD (chronic obstructive pulmonary disease) ;
- malignant neoplasms in the respiratory system.
The main factors are:
- prolonged exposure to cold temperatures on the body;
- severe injuries, most often chest;
- bad habits, smoking comes first;
- decreased resistance of the immune system;
- strong physical activity;
- emotional instability and the impact of stressful situations;
- poor microclimate;
- production hazards.
Pneumonia in children
The body of the child is much weaker than that of an adult, so the course of the disease occurs even sharper and more sudden. Throughout all time, an extremely large unbreakable temperature is traced. In the nasolabial triangle, in addition to blue, a herpetic rash can also form. Toddlers are exposed to severe muscle weakness and headache.
The main signs of the course of the disease are the same as in adults, although complications can leave their mark on the nervous system, cause acute psychosis in the child during and after the disease, as well as serious disturbances in brain activity. This can further affect the development of the child.
Diagnostics
The difficulties of early detection of the disease in modern conditions are associated with a rather diverse clinical picture and attrition of symptoms.
To confirm left-sided or right-sided lobar pneumonia, the doctor arranges a questioning of the patient (the presence of complaints, concomitant diseases, risk factors) and his physical examination. Suspicion of the disease includes signs such as severe fever, symptoms of intoxication, cough, shortness of breath, pleural pain, cyanosis of the tip of the nose and lips.
The main factors for the presence of an ailment during the examination are:
- lag of the chest at the time of breathing on the side of the lesion;
- increased bronchophony and voice trembling;
- the presence of tachycardia, as well as more frequent shallow breathing;
- limited chest pain;
- cross stupidity.
During auscultation at the time of community-acquired lobar pneumonia, characteristic inspiratory crepitus is heard, as well as noise from grazing pleura. Further, pathological bronchial breathing, sonorous small-bubbly or moist deaf rales can be revealed.
The results after radiography, which is done in 2 projections, are important for confirming the diagnosis. It shows an increase in pulmonary pattern, and at the beginning of the disease, the root is not structural in the affected area. And there are also homogeneous segmented foci of infiltration in the pulmonary fields after 4-6 days of lesion.
Laboratory studies of the patient's blood indicate the presence of leukocytosis with a shift in the formula to the left, and in very difficult situations - leukopenia, hyperfibrinogenemia and an increase in ESR (erythrocyte sedimentation rate). To detect the causative agent, doctors diagnose sputum culture to determine the microflora with the detection of sensitivity to antibiotics.
Treatment
Therapy of the disease is carried out only in a hospital, especially if it concerns children, with severe and compulsory bed rest. The use of antibiotics should take place immediately after setting the conclusion, without waiting for the results of the analysis for sowing on sensitivity to drugs. Antipyretic and antiallergic drugs, immunostimulants and drugs that help improve sputum discharge are also additionally prescribed.
Treatment of lobar pneumonia should not take place without physiotherapeutic procedures, since thanks to them, the patient's recovery is accelerated. Sometimes patients are connected to an artificial lung ventilation apparatus, blood pressure is stabilized, bronchoscopy, oxygenobarotherapy and other useful procedures are performed.
Rehabilitation after an illness is rather complicated, since most of the complications that can be obtained end up with amputation of a part of the lung. To a greater extent, it is based on folk methods and hardware procedures.
Physiotherapy
In order to defeat the disease, it is necessary to use the following methods of treatment:
- UHF (ultra high frequency therapy);
- drug electrophoresis;
- Exercise therapy (medical physical culture);
- chest massage;
- drug inhalation.
ethnoscience
As an auxiliary technique, unconventional methods are used for treatment. The most effective herbs for therapy are:
- young birch leaves;
- chamomile and oregano;
- coltsfoot;
- knotweed;
- aloe leaves;
- raisins and blueberries;
- buckwheat honey;
- thyme and thyme.
Complications
Lobar pneumonia is described by a huge number of serious problems, which in the future often lead to disability or death.
- Acute respiratory failure can be associated both with the disease itself and remain after irreversible changes that have occurred in pulmonary matters.
- The development of abscesses, namely purulent formations with the death of tissues that are removed only surgically.
- Lung gangrene - purulent-putrefactive necrosis spreads very quickly.
- Pleural empyema - inflammation of the pleural sheets with fluid exudate between the lining of the lung, which contains pus.
- Pleurisy - damage to the serous cover of internal organs.
- A variety of purulent complications at the time of infection in the blood: purulent pericarditis, meningitis, brain abscesses and other similar complications.
- Cardiological disorders, damage to the development of heart failure and the appearance of the aortic valve.
Forecast
Lobar pneumonia is considered a dangerous and serious disease with a huge number of serious consequences and complications. Although with a timely visit to the attending physician, you can avoid a lot of problems. This ailment refers to diseases that are characterized by a bright and strong, but relatively fleeting course, so if you follow all the necessary measures, then it proceeds quite quickly. The prognosis for the risk group is not very encouraging, patients with immunodeficiency, elderly people and children under 5 years old do not tolerate this disease well, and the consequences are also serious.