Features of the course of pneumonia segmental
Pneumonia segmental is a serious enough problem that needs immediate treatment. Otherwise, it can cause dangerous complications, which will not be easy to cure.
Segmental pneumonia - what is it
This disease is nothing more than a very serious damage to the airways of a person, which never spreads beyond the limits of a particular pulmonary segment.This form of pneumonia is in second place in the frequency of occurrence in humans. On the first place there was an inflammation of lungs of focal type.
Most often you can find pneumonia, which occurs in the lower lobe of the right lung, develops in most cases, it is in adults. It is interesting that in children there is an inflammatory process in the opposite side - left-sided pneumonia. This difference is caused by a certain difference in the structure of the chest.
In addition, subsegmental inflammation and the usual segmental inflammation are distinguished. The difference lies in the fact that in the usual inflammatory process, much less alveoli are affected, and the inflammatory process takes place in a smaller part of the lung. It should be noted that using X-ray to determine which type of disease in an adult or a child is very difficult. For this, it is necessary to do additional tests and examinations.
What is the pulmonary segment in man?
In order to understand the causes of this complex disease, it is worth considering a little the anatomy of a person and find out what exactly are the segments of the lungs.
The lung segment is a small cluster of alveoli. In this case, this cluster has a common blood supply to the body, as well as innervation. From other segments it is separated by thin layers, which are formed from connective tissue.
If we consider each segment of the human lungs in the x-ray image, then they are characterized by special localization both in the direct image and on the side. Therefore, in order to determine quite accurately the place in which the focus of inflammation is located, it is necessary to take pictures of the chest in two projections.
In addition, during the diagnosis it is very important to determine in advance which lung segmental pneumonia is observed. It can be done by a therapist or pulmonologist after carefully examining and studying X-rays.
Causes of the disease
This type of inflammation of the lungs arises because the local defense of the organism is sharply reduced. Such a change can result from the development of a cold or after a severe hypothermia. In addition, the cause of the development of the disease may well become pathogens of pneumonia, which begin to actively breed only in a particular area of the lungs.
So, right-sided segmental pneumonia in adults develops due to the following reasons:
- significant deformation of the bronchial system;
- rather often the wall of the lower respiratory tract becomes inflamed, which results in defects, for example, the amount of connective tissue increases;
- immunity in this part of the body is very much reduced due to the fact that blood flow is disturbed;
- under the influence of nicotine there is a sufficiently strong spasm of the vessels of the lungs, which causes the further development of the disease.
If we talk about the occurrence of pneumonia in children and in the elderly, the reasons for this are somewhat different. First of all it can be too weak immunity. To provoke the disease can the pathogen, which falls directly into the respiratory system. Even if it is the most common streptococcus, it can become the impetus to the fact that the inflammatory process in the lower part of the lungs will begin to develop.
Types of segmental pneumoniaTo date, experts distinguish several types of segmental pneumonia and, depending on this, assign the patient treatment:
- typical view;
Symptoms of the onset of the disease
Approximately two days after the inflammatory process began to develop in the human lungs, the first signs of the disease begin to appear. Symptoms of segmental pneumonia include the following:
- if the cause is a bacterial infection, then there is a sharp increase in temperature to 39 and above degrees;
- as a result of intoxication the person feels constant and strong fatigue, there is a headache, in especially severe cases, there may be delusions or even hallucinations;
- under the ribs one can feel the soreness that arises from the damage not only to the lungs, but also to the stomach;
- begins to develop tachycardia: this indicates that in the blood are in large quantities of toxins or even products of the decay of cells and tissues;
- if there is an adynamia in the patient, then this indicates a very serious course of the disease (in this case, specialists are guided by temperature: the higher it is, the faster the inflammatory process begins to progress);
- about the general intoxication of the whole organism can be understood by the fact that a very large amount of sweat begins to be released at each change in the position of the body by a person;
- a few days later there is a strong enough cough, a lot of sputum is released;
- there is shortness of breath.
Each specialist, in order to assign the right treatment to the patient, will pay attention to the patient's sweating. Thanks to sweating, you can understand how well the metabolic processes are going on in the human body. In addition, the degree of sweating warns about the possible occurrence of fever in humans. For example, if a person sharply began to stand out in a lot of sweat, it means that in a few minutes the body temperature will rise quite strongly. In this regard, it is necessary to take a medicine as quickly as possible against the heat.
If all the symptoms of the disease have disappeared and there is nothing to be seen in the X-ray images, sweating and general malaise, this indicates that the disease was not completely cured.
In such situations, doctors can prescribe an additional intake of antibacterial and vitamin preparations to support the patient's body.
Treatment of allergy due to segmental pneumonia in an adultRarely, but in the presence of segmental pneumonia, an allergic reaction may occur. In this regard, a person may experience suffocation and even anaphylactic shock. If this happens, you need to inject the adrenaline dose as soon as possible to the sick person and immediately take him to the pulmonology department.
Shortness of breath in people who suffer from segmental pneumonia, arises because a small area of the lungs does not participate in breathing. Other segments thus become larger due to the fact that the usual amount of air is placed in a smaller number of alveoli. This is due to the fact that the body is trying to eliminate all the possible ways of shortage of oxygen. If there is a similar problem with the disease, the patient should be taken to the hospital and at the same time to make artificial ventilation of the lungs. Thus, it will be possible to restore very quickly the amount of oxygen necessary for the body.
Inflammatory processes in the lungs are a very serious problem that needs immediate treatment. The recovery process can take a very long time, and even if the X-ray images do not show affected areas, the disease can still not leave the sick person for a long time.
With children, the situation is even more severe than with adults. The fact is that the child's immunity is of a reactive type. This means that just a few days after all the symptoms of segmental pneumonia have disappeared, they can appear again and again in a heavier and more dangerous form for the child.
As practice shows, treatment in most cases ends without complications and quite successfully. The main thing is to take all the necessary measures in time and not to start the disease.
Causes of the appearance of polysegmental pneumonia
Polysegmentary pneumonia (especially bilateral) is one of the most difficult illnesses and requires prompt treatment. The fact is that bilateral polysergmental pneumonia always develops rapidly, leading to a complication of breathing and even death.
With this type of disease of any type (bilateral, right-sided or left-sided), inflammatory effects on the lung epithelium occur. This inflammation disrupts work in several functional segments (they are called lung areas containing alveoli in large numbers). There is a rapid progress of the disease, which eventually becomes the cause of respiratory failure.
Polysegmentary pneumonia: causes of appearance
The conclusion of roentgenography about polisegmental pneumonia is established by experts in the case of a patient in the pulmonary tissues of foci of inflammation that can be located in different segments from either side or from 2 sides simultaneously.When this disease occurs, children experience painful sensations, because in their lungs during the whole illness irritates the pleura (it acts as a protective shell), which is located over the pulmonary fields.Contains a pleura of a lot of nerve endings, which causes irritation and pain.The lungs themselves do not have receptors sensitive to pain, so serious bilateral inflammation is not always immediately appears until the patient performs the radiographic procedure or notices the first signs.
The causes of polysegmental ailment can be different, the main ones are:
- the emergence of bacterial infections, such as staphylococcus, pneumococcus, chlamydia or mycoplasma;
- lung damage by viruses;
- affliction with ailments of a number of parasitic and fungal.
Most often, immediate type hypersensitivity occurs with pneumococcal infection, since its antigens most similar to the proteins of the body, in view of which immunity is unstable, not recognizing antigens of GNT. In this case, the immune system perceives its proteins as bacterial antigens and subsequently begins to destroy them. In adults, such a reaction occurs when there is a right-sided lower-lobe polysegmental pneumonia in the body. Hypersensitivity immediate type contributes to the deterioration of the patient due to increased inflammatory effects on the body.
Signs of the emerging polysegmental inflammation
Polysegmental type of inflammation in patients of any age includes symptoms of intoxication or bronchopulmonary category. The first aggravate the course of the disease in the patient and are revealed by muscle weakness, dizziness, headaches, chills, feverish condition and painful sensations in the joints.
Signs of intoxication syndrome:
- Polysegmentary inflammation with an intoxication syndrome is always accompanied by an elevated temperature reaching 39-40 ° C. Development of the disease is lightning fast and is most often provoked by pneumococcal pneumonia. The pneumonia itself is characterized by constantly high fever (it almost does not fall off even for several days), gradual decrease in temperature is promoted by adequate treatment.
- A significant chill in some cases is a precursor of feverish sensations lasting for several hours, the patient is sweating at this time. When the epithelium of the lung is damaged, the concentration of pathogens increases, which contributes to the deterioration of the blood supply to the brain due to the increase in the viscosity of the blood. At the same time there are dizziness and headaches.
- Violation of pulmonary epithelium in children occurs due to staphylococcal or streptococcal ailment and contributes to a stable elevated temperature to 40 ° C. The medical workers gave this fever the name febris continua, the translation of which means "constant fever". Pneumococcal pneumonia in children is capable of causing fulminant fever, accompanied by a visual intoxication syndrome. This type of fever may not occur for several days.
- Croupous child pneumonia is accompanied by an intoxication syndrome. This type of pneumonia is very rare. Clinical signs of polysegmental are similar to those of segmental pneumonia. It manifests in children in the form of dyspnea, wheezing and weakened breathing, and the localization of foci occurs mainly in the upper parts of the lungs. To clarify the defeat of the segments, the x-ray is done in 2 projections. In this case, the shadow of infiltration is homogeneous and intense.
- Polysegmentary pneumonia promotes the formation of muscle weakness in patients. The reason for this is a low fluidity of the blood, which in the future disrupts the saturation of the body with oxygen.
- A similar pathogenesis arises in the joints, accompanied by painful sensations in them. This is due to the deterioration of microcirculation in the periosteum.
Symptoms of bronchopulmonary syndromeWith the accumulation of infiltrates in the body and reproduction of pathogens in the respiratory tract, bronchopulmonary syndrome occurs.
There are the following main symptoms:
- the appearance of hoarseness during breathing and talking, which appear due to edema of the walls of the bronchi;
- cough with sputum;
- When inflammation occurs in the pleural sheets painful sensations occur in the chest.
A normal organism uses the cilia of the epithelium of the upper respiratory tract to remove pathogens. If the cilia are not working properly, or if infectious bacteria enter the lower parts, bacteria are eliminated by means of bronchial cuts in the form of a cough.
Polysegmentary pneumonia promotes large accumulation of fluid, the body removes it through a protracted cough. With pneumonia, the cough lasts until the respiratory system is completely cleansed.Pain sensations in the areas of the lungs' lesions occur due to inflammation of the pleura, which has irritations in lesions in any form of the pleural leaf. With pleurisy, polysergmental pneumonia exacerbates pain or causes severe pain in the chest during sharp movements.
All of the above symptoms are factors of pneumonia. To confirm them, you need to take a radiograph. All these signs are the reason for an early visit to the pulmonologist, in order to avoid serious complications.
How is polysegmental pneumonia treated?
Treatment of one- or two-sided pneumonia is possible by using antibacterial drugs and medications.
The etiology of pathogens in children and adults is different, so the therapy involves the use of different antibiotics.
The best will be timely treatment, when medical specialists will be able to sow bacterial cultures in a short time, which are the consequence of an ailment in a special environment, and determine the sensitivity of the disease to antibiotics. Within 2 weeks of therapy, the physician prescribes broad-spectrum antibacterial drugs. Also, treatment includes the elimination of existing complications or their prevention.
Two-sided, right-sided or left-sided polysergmental pneumonia is a disease that can not be triggered in any case. Its development can lead to respiratory insufficiency and death.
Treatment of pneumonia in an adult
Diseases of the respiratory system have a high risk for humans. One such common pathology is pneumonia, which causes inflammation of the lung tissue and irreversible changes in it. To avoid oxygen starvation of tissues, the disease must necessarily start on time to treat.
How to treat pneumonia at home in adults
Pneumonia often has a viral nature, but even in other cases, it is joined by bacterial infections, so adults are obliged to perform antibiotic therapy, appointing 1-2 drugs at a time. The treatment standards take into account several factors:
- type of pneumonia;
- volume of damage to lung tissue;
- state of health and age of the patient;
- concomitant diseases of the heart, kidneys or lungs.
Adults prescribe antibiotics for pneumonia, taking into account their age, and even with little effectiveness one drug is not changed for 3 days or until the patient's sputum analysis is deciphered. For the treatment of pneumonia use modern popular drugs under the names:
- Ceftriaxone. As a form of release, white powders are used for the preparation of injections. The course of treatment of pneumonia is determined by the doctor depending on the degree of severity. For an adult, the dose is 1-2 g daily. A solution for injections is prepared from 500 mg of the drug and 2 ml of a 1% solution of lidocaine, and for the droppers 5 ml of sterile water are used. The price is from 25 rubles, it is sold by prescription.
- Sephpotek. Antibiotic, also allowed a child with 12 years. Effective in the treatment of pneumonia and other respiratory tract infections. Adults need to take 200 mg - 1 tablet, with an interval of 12 hours. End the course of treatment is necessary in 2 weeks. Price from 120 rub.
- Sumamed. In addition to tablets, it is available as a powder or lyophilizate. It is indicated for infectious and inflammatory diseases, including respiratory tract. From pneumonia, you need to take 500 mg of the drug per day treatment course, equal to 3 days. The price from 520 r.
Folk treatment of pneumonia in adults is effective in combination with taking medications if therapy is done at home. To do this, you can use the following recipes:
- Decoction of raisins. Rinse with 0.5 tbsp. Dark raisins, pass it through the meat grinder. Gulf a glass of boiling water, soak under the lid for about 10 minutes. To treat inflammation of the lungs with such a decoction, you need to drink 1.5 tablespoons. daily.
- "Milk" milk. Prepare 3 dried white figs. Heat the milk, pour the fruit, cook over a small fire for about half an hour. To treat pneumonia, drink 2 glasses a day until symptoms improve.
- Nastoy on the nuts. Take 500 ml of dry red wine. Fill them with 50 g of peeled nuts. Strew the remedy on a low heat for about a quarter of an hour. Eat 1 tbsp each. before each meal.
To begin with, it is recommended that you change your position frequently in bed and do not lie on your side, which hurts. After 3-4 days, when the acute period of the disease is already behind, you can begin respiratory gymnastics, for which you lie on your back and put your hands on your stomach. You need to exhale after a deep breath, but do it slowly, straining your abdominal muscles. Approaches should be at least 5 per day, each of which includes 15 reps. It is recommended to use LFK and for the prevention of pneumonia.
Features of treatment of pneumonia
Treatment of pneumonia in an adult depends on many factors, the first of which is the type of this disease. Therapy for the elderly is mandatory in the hospital, otherwise the decision is made by the doctor. The algorithm of treatment consists of several stages. First pneumonia is diagnosed, then the focus of inflammation is eliminated with antibiotics. Next, additional medications are prescribed for the remaining signs of the disease.
In adults this form arises more often than others and is divided into right-sided and left-sided. A particular species is bilateral, when lesions are present in both lungs. Treatment of pneumonia in an adult is carried out permanently with the use of antibiotics, physiotherapy, inhalations and elimination of allergic reactions. With a one-sided or bilateral form, you need to ensure the correct position of the patient - semi-sitting to improve the performance of the lungs.
Viruses, bacteria or fungi and parasites lead to the viral form. The first two days for the treatment of pneumonia for an adult are prescribed to take antiviral drugs, such as Tamiflu or Ingavirin in influenza and Acyclovir with a causative agent that causes varicella. In addition to these medicines, the patient is prescribed antipyretic, analgesic and cough suppressants that help to sputum. Antibiotics are prescribed only with the addition of bacterial infection.
This type of pneumonia is also called focal. It develops against the background of bronchitis, therefore it is especially dangerous due to its consequences - pleuropneumonia, abscess and even gangrene, therefore the methods of treatment are chosen only by a doctor. Antibiotics become mandatory in therapy, and they are chosen according to the degree of influence on the intestinal microflora. Ecoantibiotics are often used. In addition, adults are treated with drugs that dilute, excrete phlegm and restore the immune system.
The most serious of all is the atypical form, because it is caused by atypical pathogens and often there is such pneumonia in an adult without temperature. The insidious disease is also due to the fact that it has a latent period when the symptoms are practically absent. Antibiotics are often unable to cope with the manifestations of this type of pneumonia, so an adult is prescribed immunoglobulins and special procedures for sucking out fluid in the lungs. Treatment is complemented by a complex of vitamins and antipyretic.
Another complex form of pneumonia is the radical one. It is difficult to diagnose, because the symptoms are similar to tuberculosis and central lung cancer. Drugs for treatment are appointed immediately after diagnosis, with several drugs at the same time, so that the condition was relieved in 2-3 days and the patient could be prescribed warming up and exercise therapy.
Treatment of pneumonia in the hospital
Indications for hospitalization are deterioration of the patient's condition or inability to apply the necessary drugs at home. With timely treatment, relief comes in 2-4 days, but possible complications increase the duration of stay in the hospital to 10 days, and often up to 4 weeks. The patient is given injections or drips with antibiotics, then physiological saline is injected in the same way to detoxify the body. In combination with these drugs, adults are prescribed expectorant and antipyretic agents.
How much is pneumonia treated?
Treatment of community-acquired pneumonia in adults is done at home and takes 7 to 10 days. It adds a period for the restoration of the body, which can take from 1 to several months. The same amount can be used to fight chronic pneumonia. The duration of treatment depends on the timeliness of therapy. In addition, the effectiveness of the selected drugs is also important. Inpatient therapy has an average duration of 9-10 days with severe form. Stagnant pneumonia can be cured in 20-25 days.
Video about respiratory gymnastics with pneumonia
Treatment of lower lobe right-sided pneumonia
Pneumonia is lower-right-sided is diagnosed much more often than left-sided. This is due to the peculiarities of the structure of the respiratory system on this side. The lower section of the right bronchus lies at an angle, which contributes to the accumulation of viruses and bacteria. With a decrease in immunity and inhibition of local protective reactions, pathogenic microorganisms begin to multiply rapidly. The x-ray image at the same time reflects the symptoms of bronchopneumonia: the presence of darkened focal regions.
If you do not start treatment on time, the disease leads to the destruction of lung tissue and the violation of gas exchange between them and blood. Due to lack of oxygen in the blood, the functions of the remaining organs are violated and the immune system is suppressed. Pneumonia can be focal (infiltrates have sizes up to 11 cm), segmental (affects part of the lung), total (inflammation of the entire organ) and bilateral (both lungs suffer). The diagnosis of right-sided lower-lobe pneumonia means that the inflammatory process is localized in the lower part of the right lung.
Right-sided pneumonia in children
In children, this disease develops very quickly, without proper treatment, focal infiltrates soon turn into segmental or lobar inflammation. This is due to the fact that the body of the child is not able to produce antibodies to the causative agent of such infection, since he has not yet met with it. The body's response to the penetration of pathogenic microorganisms into the lungs is expressed in the increased activity of alveolar macrophages, which destroy bacteria.With a large number of pathogenic microorganisms, macrophages can not cope with their task. At some point, the number of microorganisms is so high that macrophages become unable to destroy them in a timely manner. If the pathogens of infection win in this fight, they begin to multiply intensively.Reception of antibiotics allows to avoid the spread of infection and the occurrence of serious complications.
Pneumonia in children has the following symptoms: elevated body temperature, cough with sputum discharge, runny nose, rapid breathing. Low-floor pneumonia can lead to the following complications: a decrease in the volume of lung tissue, fluid accumulation in the pleural cavity, narrowing of the lumen of the bronchi, allergic reactions from other organs, abscess of the lung.
Low-risk right-sided pneumonia is characterized by the following features, according to which the disease can be diagnosed even without radiography: pain in the right part of the chest, intense fever, fever, separation of viscous sputum when coughing, the appearance of blood in it, severe pain in the chest with a deep breath. In children, these symptoms are less pronounced, making it difficult to make a final diagnosis. The lost time contributes to the development of complications. According to statistics, pneumonia in children in the early stages is detected only in half the cases. This is due to the fact that parents are not always able to notice the first symptoms of this disease in their child, taking pneumonia for an ordinary cold. Pneumonia, complicated by pleurisy, is treated only in a hospital.Therapy of right-sided pneumonia is outpatient rather complicated. Even with all the necessary medications, the inflammatory focus can expand, capturing the whole lung.
Inflammation of the lungs in children is most often associated with viral infections, usually this disease occurs in the autumn-winter season. With weakened immunity against the background of influenza most often it is right-sided pneumonia. Viral inflammation of the lungs in children has the following features: acute form of the disease, dry cough during the first stages of the disease, fever, extensive infection of lung tissue.
Treatment of right-sided pneumonia in adults
Timely diagnosis of the disease not only allows you to properly treat it, but also significantly reduces the timing of therapy. Proper treatment of pneumonia involves taking antibiotics. If the use of an antibacterial agent does not give a proper result, it is considered that the causative agent of the infection is insensitive to the drug. Antibiotics should only help the body cope with the infection, so treatment should be is directed not only to the destruction of pathogens, but also to the enhancement of the protective reactions of immunity.
Very often doctors either increase the dose of the drug, or choose stronger antibiotics. However, in the treatment of pneumonia this is unacceptable: such drugs can lead to pathologies of other organs. Long-term use of antibiotics is allowed only in the chronic course of the disease.
Treatment of right-sided pneumonia in childrenIn the treatment of this disease, antibiotics are also used in children. Therapy must be started immediately. It is carried out under bacteriological control even before determining the causative agent of infection. To this end, sputum smear microscopy is performed and the pathogen is injected into the nutrient medium. Antibiotics are prescribed in such doses that they are constantly present in the blood throughout the course of treatment. Usually they are used until the body temperature drops to normal. Then the body's own defenses must turn on. Many doctors believe that the patient must necessarily undergo a 5-day course of treatment with antibacterial drugs, otherwise pathogenic microorganisms will develop antibiotic resistance.
However, in the course of recent studies, it was found that with the correct dosage of the drug, bacteria die in the first days of treatment. A longer reception of antibiotics in a child is not advisable, as this leads to undesirable side effects. To monitor the disappearance of foci of inflammation, an X-ray examination is performed. The damage from irradiation will be less than from the wrong reception of antibiotics.
The cause of pneumonia in children is most often caused by infections caused by streptococci, pneumococci and hemophilic rod.
These bacteria die after 4 days of taking antibiotics. If the inflammation of the lungs is caused by mycoplasma, legionella or chlamydia, the course of treatment is increased to a week. If the effect of taking the drug is not observed within 2 days, the treatment is replaced. In severe complications of right-sided pneumonia, administration of several antibacterial agents is prescribed.
With prolonged use of antibiotics, children may develop symptoms of intestinal dysbiosis. Therefore, antibiotic therapy should be combined with the intake of B vitamins. After the abolition of antibiotics prescribe drugs that restore healthy intestinal microflora.When treating a physician should carefully monitor the immune system of the child: antibiotics contribute to the suppression of his functions.
The effectiveness of the therapy is assessed by the following criteria: normalization of the general state of the body, a decrease in the number of leukocytes in the blood, a drop in temperature, the absence of dyspnea and pus in the sputum.
With symptomatic treatment, the amount of sputum to be separated should decrease, small bubbling rales and hard breathing cease.
Treatment of pneumonia with folk remedies
The drugs described below do not replace traditional treatment, but they can be a good addition to it. To support the immunity of the child with antibiotic therapy, the following remedy helps: 750 g of honey is boiled with 100 g of birch buds for 5-7 minutes. After that, honey is filtered. 1 hour l. medicines are bred in a glass of water and taken every night before going to bed within a year.
Compresses with leaves of plantain help well in the treatment of pneumonia. They need to be rinsed with warm water and allowed to dry. After that, the leaves are applied to the back, chest and sides, covered with cellophane and woolen cloth. The procedure is best done before bedtime. Such a compress can be made from honey. Back and chest should be smeared with honey and covered with a tissue moistened with vodka.
Polyethylene and warm cloth are put on top. The procedure is recommended to be performed 2 times a day.
How dangerous is pneumonia.
She is dangerous because of her complications, because with her in the lungs pus, there may be lung abscess, lung edema, and also as a complication of rheumatoid arthritis, acquired heart disease. We had a case, an 11-year-old boy was not diagnosed with genyantritis and was not treated, he died from it.
You can die from it, if you do not treat that in general khan
If there is no temperature, then it's not so scary. Pills drink.
Danger of treatment, lie in the hospital!
it all boils down to pumping loot... result, (_ | _).... try not to overcool yourself ....
pneumonia are inflammatory processes in the lungs, if not treated with antibiotics (precisely at the doses that you were prescribed), the inflammation will intensify and spread. Severe pneumonia can result in pulmonary edema, lack of oxygen - and hello!
It's dangerous, I got sick myself, now I'm afraid of every cold. I had bronchopneumonia, I could not put the diagnosis for a long time, I thought all the "kayuk" had emaciated heavily, after curing for another 5 months I coughed like a dog. My advice, go to the hospital and go through the treatment and yet the regime is there. At home you can not be cured.
The most frequent way of penetration of microorganisms into the pulmonary tissue is bronchogenic - and this is facilitated by: aspiration, inhalation of microbes from the environment, the migration of pathogenic flora from the upper parts of the respiratory system (nose, pharynx) to the lower, medical manipulations - bronchoscopy, intubation of the trachea, artificial lung ventilation, inhalation of medicinal substances from seeded inhalers, etc. The hematogenous path of infection (with blood flow) is less common - with intrauterine infection, septic processes and drug addiction with intravenous drug use. Lymphogenous path of penetration is very rare. Further, with pneumonia of any etiology, fixation and multiplication of the infectious agent occurs in the epithelium of respiratory bronchioles - develops acute bronchitis or bronchiolitis of various types - from mild catarrhal to necrotic. The spread of microorganisms beyond the respiratory bronchioles causes inflammation of the lung tissue - pneumonia. Due to the violation of bronchial patency, foci of atelectasis and emphysema appear. Reflexively, with the help of cough and sneezing, the body tries to restore the patency of the bronchi, but as a result, the infection spreads to healthy tissues, and new foci of pneumonia form. Oxygen deficiency develops, respiratory failure, and in severe cases, heart failure. The most affected II, VI, X segments of the right lung and VI, VIII, IX, X segments of the left lung. Often the regional lymph nodes - bronchopulmonary, paratracheal, bifurcation - are involved in the process.
Community-acquired pneumonia: diagnosis, treatment. Prevention of community-acquired pneumonia
Community-acquired pneumonia is considered to be the most common infectious diseases of the respiratory tract. Most often, this ailment is the cause of death from various infections. This occurs as a result of a decrease in the immunity of people and the rapid adaptation of pathogens to antibiotics.
What is community acquired pneumonia?
This is an infectious disease of the lower respiratory tract. Community-acquired pneumonia in children and adults develops in most cases as a complication of a viral infection. The name of pneumonia characterizes the conditions of its occurrence. The person is ill at home, without any contact with the medical institution.
Pneumonia in an adult
Adults most often get pneumonia due to ingestion of bacteria, which are the causative agents of the disease. Community-acquired pneumonia in adults does not depend on geographical zones and socio-economic relations.
Throughout life on the airways and lungs of a person are constantly affected by pathogens: viruses and parasites. On the way to the lungs, bacteria encounter protective barriers, which are represented by the upper respiratory tract and the oropharynx. If these barriers are overcome by pathogenic organisms - bacteria, viruses and fungi, infection begins to develop.
What is pneumonia?
This disease is divided into three types:
- Light pneumonia is the largest group. She is treated out-patiently, at home.
- The disease is of medium severity. Such pneumonia is treated in the hospital. The peculiarity of this group is that most patients have chronic diseases.
- Severe form of pneumonia. She is treated only in the hospital, in the intensive care unit.
Community-acquired pneumonia happens:
- Focal. A small area of the lungs is inflamed.
- Segmental. Characteristic is the defeat of one or at once several parts of the organ.
- The equity. Some part of the body is damaged.
- The total. The defeat is all the lungs.
Community-acquired pneumonia is one-sided and two-sided, right-sided and left-sided.
- The body temperature rises.
- There is a chill and weakness.
- Decreased efficiency and appetite.
- Sweating appears, especially at night.
- The head, joints and muscles aches.
- The consciousness gets confused and the orientation is broken, if the disease is in severe form.
- Pain in the chest.
- Herpes can appear.
- Pain in the abdomen, diarrhea and vomiting.
- Shortness of breath, which occurs during exercise. When a person is at rest, this does not happen.
Community-acquired pneumonia develops when microbes enter the weakened human body and cause inflammation. The causes of the disease are as follows:
- Subcooling the body.
- Viral infections.
- Concomitant diseases: diabetes, heart, lungs and others.
- Weakened immunity.
- Excessive consumption of alcoholic beverages.
- Long stay on bed.
- Postponed operations.
- Elderly age.
Pathogens of the disease
- Pneumococci (most often the cause of the disease).
- Atypical pathogens: mycoplasma and chlamydia.
- Intestinal bacillus.
- Haemophilus influenzae.
During the examination, it is very important to identify and evaluate the clinical symptoms of the disease, such as fever, chest pain, cough with phlegm. Therefore, if a person has community-acquired pneumonia, the history of the disease is mandatory for every patient. In it, the doctor records all the patient's complaints and appointments. To confirm the diagnosis, a radiological examination is carried out: chest x-ray. Clinical manifestations of community-acquired pneumonia are:
- Cough with discharge of muco-purulent sputum, in which veins of blood are present.
- Pain in the chest during breathing and coughing.
- Fever and shortness of breath.
- Trembling of the voice.
Sometimes the symptoms differ from those typical for this disease, which makes it difficult to establish the correct diagnosis and determine the method of treatment.
The patient is assigned radiography if he has community-acquired pneumonia. Diagnosis by the radiation method involves the examination of the organs of the chest cavity in the anterior part of it. The image is taken in a straight and a side view. The patient underwent an X-ray examination as soon as he consulted a doctor, and then half a month after the treatment with antibacterial agents began. But this procedure can be carried out earlier, if the treatment has complications or the clinical picture of the disease has changed significantly.
The main sign of community-acquired pneumonia during X-ray examination is the compaction of lung tissue, a darkening is determined in the picture. If there are no signs of densification, then there is no pneumonia.
Lower-lobe right-sided pneumonia
Many patients go to the hospital when they are disturbed by symptoms such as shortness of breath, cough accompanied by discharge mucous sputum, an increase in temperature to 39 degrees, pain with a sensation of tingling on the right side under the rib. After hearing complaints of the patient, the doctor examines it, listens and probes where necessary. If it is suspected that the patient has a community-acquired right-sided pneumonia, which, as a rule, occurs much more often (why we pay special attention to it), he is given a full examination:
- Laboratory tests: general, clinical and biochemical blood analysis, urine and sputum analysis.
- Instrumental studies, including chest radiography, fibroblochoscopy and electrocardiograms. The form of darkening on the radiographic image allows us to clarify the diagnosis, and fibroscopy - to reveal the involvement of bronchi and trachea in the process of inflammation.
If the results of all tests confirm that the patient has a right-side community-acquired pneumonia, the medical history is supplemented. Before starting therapy, the patient's chart records the results of studies on all indicators. This is necessary in order to carry out its adjustment as necessary.
Laboratory and instrumental studies can show inflammation of the lower right lobe of the lung. This is another story of the disease. Community-acquired lower-lobe pneumonia - this will be the diagnosis. When it is accurately established, the doctor prescribes a treatment that is individual for each patient.
How to treat community-acquired pneumonia?
Patients with this diagnosis can be treated both in a hospital and at home. If a patient has community-acquired pneumonia, the history of the disease is mandatory, regardless of the place of treatment. Patients in out-patient treatment are conventionally divided into two groups. The first refers to people under 60 years of age who do not have concomitant diseases. The second - over 60 or people with concomitant diseases (of any age). When a person has community-acquired pneumonia, treatment is performed with antibacterial drugs.
For patients of the first group, the following are appointed:
- "Amoxicillin" with a dosage of 0.5-1 g or "Amoxicillin / clavulanate" - 0.625 grams at a time. Accepted during the day 3 times.
- An alternative to these drugs may be: "Clarithromycin" or "Roxithromycin" in a dosage of 0.5 g and 0.15 g respectively. Take twice a day. Can be appointed "Azithromycin", which is taken once a day in an amount of 0.5 g.
- If it is suspected that the disease is caused by an atypical pathogen, the doctor may prescribe "Levofloxacin" or "Moxifloxacin" for 0.5 g and 0.4 g respectively. Both drugs are taken once a day.
If patients of the second group have community-acquired pneumonia, the treatment is performed using the following drugs:
- "Amoxicillin / clavulanate" is prescribed three times a day for 0.625 g or twice a day for 1 g, "Cefuroxime" should be taken in an amount of 0.5 g at a time twice a day.
- Alternative drugs may be prescribed: "Levofloxacin" or "Moxifloxacin" for 0.5 g and 0.4 g, respectively, once a day per day. "Ceftriaxone" is prescribed for 1-2 grams intramuscularly, too, once a day.
Treatment of the disease in children
Community-acquired pneumonia in children with uncomplicated form of the disease, depending on age, is treated with the following drugs:
- Children under 6 months are prescribed: "Josamycin" twice a day for a week in the calculation of 20 mg per one kilogram of body weight. Maybe "Azithromycin" - the daily norm should not exceed 5 mg per kilogram of body weight, the duration of treatment - 5 days.
- Children under the age of 5 years are prescribed "Amoxicillin" inside 25 mg / kg twice a day, the duration of treatment is 5 days. Can appoint "Amoxicillin / clavulanate" in recalculation per kilogram of body weight 40-50 mg or "Cefuroxin aksetil" dosage of 20-40 mg / kg, respectively. Both drugs are taken twice a day, the duration of treatment is 5 days.
- Children older than 5 years are prescribed "Amoxicillin" with a dosage of 25 mg / kg in the morning and in the evening. If there is a suspicion of SARS, prescribe "Josamycin" inside, increasing the dosage to 40 mg / kg in day during the week or "Azithromycin" according to the scheme: 1 day - 10 mg / kg, then 5 mg / kg for 5 days. If there is no positive result in treatment, you can replace "Amoxicillin" at a rate of 50 mg / kg once a day.
Preventive measures for the prevention of disease
Preventive maintenance of community-acquired pneumonia is carried out using pneumococcal and influenza vaccines. If necessary, they are injected simultaneously, only in different hands. For this purpose, a 23-valent unconjugated vaccine is used. It is introduced:
- People who are over 50 years old.
- Persons living in nursing homes.
- Adults and children with chronic lung, heart and vascular disease or under constant medical supervision.
- Children and adolescents (from six months to adulthood) who have been taking aspirin for a long time.
- Pregnant women 2-3 rd term.
- Doctors, nurses and the rest of the hospital staff and outpatient clinics.
- Employees of nursing departments.
- To family members of those people who are at risk.
- Medical workers caring for the sick at home.
Prevention of community-acquired pneumonia is:
- The correct way of life, which involves exercise, regular long walks in the fresh air, active rest.
- A balanced healthy diet with a normal content of proteins, vitamins and trace elements.
- Annual vaccination of children and adults against influenza, which is done before the onset of the cold season. Very often, the flu gives a complication. A person gets pneumonia, which is difficult.
- Life without hypothermia and drafts.
- Daily cleaning and airing of the room.
- Frequent washing of hands and rinsing of nasal passages.
- Restriction of contacts with patients with ARI.
- In the period of mass spread of infection, the intake of honey and garlic. They are excellent immunostimulating agents.
- If you become infected with flu yourself or your child, do not self-medicate, but call a doctor.