Inflammation of the lungs is a disease of the respiratory system that occurs with intra-alveolar exudation and is accompanied by typical clinical and radiological properties.
Among the mortality factors of residents, pneumonia is in fourth place after diseases of the heart and blood vessels, malignant neoplasms, injuries and intestinal infections. Depending on the severity of pneumonia, the disease can progress in debilitated patients, with heart failure, with oncological diseases, pathologies of cerebral circulation, and complicates the outcome of past diseases. In AIDS patients, pneumonia is considered the leading cause of death.
Symptoms
Complaints with pneumonia are diverse. The following signs of pneumonia are distinguished:
- rapid increase in temperature, up to 39-40 degrees;
- intense cough with sputum discharge;
- chest pain when coughing.
Signs
The causative agent of traditional pneumonia described is pneumococcus. The atypical form can have other signs of the disease:
- dry cough;
- muscle pain;
- a sore throat;
- general weakness.
A similar course is more characteristic of mycoplasma and chlamydial pneumonia.
Diagnosis
Diagnosis is based on patient complaints. The characteristic diagnostic aspect of pneumonia is the presence of infiltration in the lung tissue. For this reason, an electro-radiography of the lungs is considered an important diagnostic method, while infiltration is detected as a blackout in the lung tissue.
But with atypical pneumonia in some cases, the sources of infiltration can only be detected with the support of computed tomography. Of laboratory research methods, a general blood test is of particular importance.
For normal bacterial pneumonia, the acceleration of erythrocyte sedimentation rate (ESR), neutrophilic leukocytosis with a shift to the left (an increase in the number of stab forms - young forms of neutrophils), an increase in the number of monocytes and a decrease in lymphocytes are characteristic.
Accelerated ESR, the usual total number of leukocytes, a decrease in the number of neutrophils with an increase in the number of monocytes and lymphocytes are characteristic of viral pneumonia.
In order to make a diagnosis of chlamydial or mycoplasma pneumonia, the detection of an increase in the titer of peculiar antibodies in the initial 2 weeks of the disease is essential. When sowing, an irritant is detected and its susceptibility to antibiotics is determined. It must not be forgotten that seeding should be done before antibiotic therapy begins.
Classification of pneumonia
The criteria for the severity of pneumonia depend on the type of disease.
The basis of epidemiological information is distinguished:
- community-acquired (out-of-hospital);
- nosocomial (hospital).
According to the etiological condition with the specification of the pathogen:
- infectious;
- fungal;
- combined.
According to the adaptation of the formation, there are pneumonia:
- primary, forming as an independent pathology;
- secondary, forming as an aggravation of concomitant diseases, for example, congestive disease;
- aspiration, formed when foreign bodies get into the bronchi (food elements, vomit, etc.);
- post-traumatic postoperative heart attack pneumonia, which is formed due to thromboembolism of small vein branches of the pulmonary artery.
By localization in the lungs, there are:
- unilateral with damage to the right or left lung;
- bilateral total, lobular, segmental, sublobular, basal (main).
By the nature of the direction of pneumonia can be:
- sharp
- sharp lingering;
- chronic.
Given the formation of multifunctional pathologies of pneumonia are:
- with the presence of multifunctional pathologies (with the prescription of their features and severity);
- with the absence of multifunctional pathologies.
Given the formation of pneumonia complications, there may be:
- uncomplicated course;
- complicated direction (with pleurisy, abscess, enterobacterial toxic shock, myocarditis, endocarditis, etc.).
Based on clinical and morphological properties, pneumonia is distinguished:
- parenchymal (croupous or lobular);
- focal (bronchopneumonia, lobular pneumonia);
- interstitial (present with mycoplasma lesion).
Severity
Classification of pneumonia by severity:
- Mild - characterized by mild intoxication (clear understanding, increased body temperature up to 38 ° C, blood pressure is normal, heart rate is not more than 90 beats per minute), dyspnea at rest is absent, with an X-ray examination, there is an insignificant source of inflammation.
- Medium - symptoms of moderate intoxication (clear understanding, hyperhidrosis, manifested weakness, increased body temperature up to 39 ° C, blood pressure is evenly reduced, heart rate is approximately 100 beats per minute.), Respiratory rate - up to 30 per minute at rest, X-ray examination shows manifested infiltration.
- Severe pneumonia severity is characterized by intoxication (fever, temperature rises to 39-40 ° C, blurred consciousness, impotence, delirium, tachycardia - over 100 beats per minute, collapse), shortness of breath - up to 40 per minute at rest, cyanosis , radiological causes a wide infiltration, the formation of complications of pneumonia.
Criteria
In accordance with the recommendations of the doctors, the conclusion “community-acquired pneumonia of moderate severity” is recommended to be given if the patient has manifestations in the lungs during an X-ray examination and at least 2 or even more of the following medical signs:
- fever (> 38.0 ° C) with a sharp onset;
- sputum cough;
- voice changes;
- leukocytosis is greater than 10.
Pneumonia therapy
The main drugs for the treatment of moderate pneumonia are, of course, considered antibiotics. Their selection, dose and duration of use is determined by the attending doctor. In addition, bronchodilating and sputum-thinning drugs, anti-allergic and general strengthening substances in combination with heavy drinking are prescribed.
With the correct treatment of moderate severity of community-acquired pneumonia, dangerous symptoms disappear within 3-4 weeks with an absolute resumption of lung transparency. However, the function of the respiratory system remains reduced for another 1-6 months, in connection with which, at this time, it is desirable to carry out therapeutic respiratory exercises and massaging the chest, physiotherapy exercises, and climatotherapy. If pneumonic infiltration does not disappear within the specified time, several examinations are carried out in order to clarify the provoking factors (reduced immunity, characteristic features of the pathogen, the presence of another lung disease).
Mode
To effectively treat pneumonia, you need the right regimen of the day: all manipulations and studies must be extremely gentle, personal supervision of the patient is important. Assign a bed rest, it is often necessary to change the position of the body. It is necessary to reduce physical activity during pneumonia, especially with severe severity, with a gradual increase in load after improvement. Physical overload after pneumonia is contraindicated for another 6-12 weeks.
Treatment for pneumonia complications
Along with antibiotic therapy, in order to effectively treat pneumonia, adjustment of treatment of complicating conditions and symptomatic treatment are required.
Respiratory failure is associated with disorders of microcirculation, the extent of damage to the lung or interstitial tissue, pathology of bronchial conduction, the formation of massive exudative pleurisy.
It is necessary to resume bronchial conduction (bronchodilators, mucolytic and coughing drugs), reduce restrictive changes (for example, prescribe an enema with flatulence and high standing of the diaphragm).
For cardiovascular pathologies, cardiotropic substances (Strofantin-K, Korglikon, Digoxin) and agents that resume microcirculation (parenteral administration of medium molecular colloidal solutions, drugs that improve the rheological quality of blood, and vasodilators) are used.
In case of toxic syndrome, infusion therapy should be carried out along with the corresponding forced diuresis. In severe stages, intravenous administration of glucocorticoids in a dose of 4-5 mg / kg / day is indicated. In infectious lesions, plasmapheresis will be quite effective. For changes in acid-base balance, proper adjustment is required.
Diet for pneumonia
Nutrition is required to meet age-related needs for energy, protein, fats and carbohydrates. But, taking into account the reduction in appetite in severe illness, the patient must be fed repeatedly, in small doses, to prepare his favorite dishes. After improving health, normalizing body temperature, appetite improves significantly.
Children under the age of 6 months are preferably given breast milk or special fermented milk products. It is necessary to reduce the amount of carbohydrates in the diet, as they increase fermentation movements in the intestinal tract, and bloating and high standing of the diaphragm complicate breathing, increase shortness of breath. The optimal drinking regime, taking into account the daily norm of water, is very significant. The volume of fluid obtained must be regulated in accordance with its losses from the patient's body (fever and shortness of breath).
Pneumonia Prevention
For prevention, apply:
- Quenching. Strengthening procedures strengthen the immune system and increase the body's resistance to various infections. Prevention of pneumonia typically includes contrasting water treatments and foot douche. We must not forget that the starting water temperature should not be lower than 35 degrees. Over time, this figure is reduced up to 25 degrees.
- Breathing exercises. A similar type of prophylaxis is used in bedridden patients. Respiratory gymnastics focuses on improving lung ventilation. In order to prevent suppuration, it is necessary to inflate balloons or constantly perform deep breaths and exhalations.
- Elimination of sources of infection. It has been established that banal tonsillitis or untreated carious tooth can cause severe pneumonia, since any such diseased organ is a source of pathogenic flora that can end up in the lungs.
- Strengthening immunity. For these purposes, immunomodulators of plant origin are often used: echinacea, chamomile, wild pepper and others. Accepted in the form of infusions or teas.
- Massaging. A way to prevent pneumonia is massaging. It is used in both adults and children, including those just born. At the same time, massaging uses a key technique - patting.