Pneumonia is a viral or microbial infectious-inflammatory disease of the lungs, giving focal, segmental or total lesions of the lung tissue.
Pneumonia can be an independent disease or a secondary complication of many infectious and non-infectious processes. Most often occurs in childhood due to the immaturity of the body and weakening of the immune system, although it is quite possible in adults in conditions of stress and hypothermia, with serious illnesses.
Pneumonia accounts for approximately 30% of all inflammatory diseases of the lower respiratory tract.
For the reasons for the development of pneumonia can be divided into several groups – microbial, viral, fungal, parasitic and caused by protozoa. At the same time, pathogens can be both typical for lung tissue, that is, quite often causing pneumonia, and atypical – then pneumonia is called atypical.
Today, pneumococcal, klebsiella, legionella, proteic or staphylococcal, hemophilic pneumonia, mycoplasma, chlamydial, influenza, adenovirus most often occur.
Most primary pneumonia occurs in children, because their bodies are not yet familiar with most pathogens and have weak immunity.
In adults, mainly predisposing factors are necessary for pneumonia:
- hospital stay – in this case, nosocomial pneumonia occurs,
- stay on artificial lung ventilation (ALV),
- long-term smoking and drinking,
- permanent hypothermia
- the presence of acute and chronic diseases of the digestive system, respiration or the heart and blood vessels, kidneys.
It contributes to pneumonia, diabetes , drug addiction, constant stress, contact with animals and allergies, frequent travel and flights with acclimatization.
Pneumonia is more frequent and more severe in early childhood and old age.
According to the development of pneumonia is divided into
- primary, or independent,
- secondary pneumonia arising as a complication.
According to the morphology of pneumonia are divided into:
- focal lesions or segments,
- croupous with a lesion of one or two lungs, in combination with a lesion of the bronchi.
- sluggishly flowing
- street or community-based,
- nosocomial, hospital or nosocomial.
A microbe or a virus can enter the lungs by hematogenous or lymphogenous , aerogenic. As a result, single or multiple foci of inflammation are formed in the pulmonary tissue, which leads to impaired ventilation, toxicosis and the development of a serious condition.
The symptoms of pneumonia depend on the pathogen and the patient’s age, but in general, a number of specific manifestations can be identified.
Pneumonia usually begins acutely, with severe chills and high fever, headaches and pain when breathing from the side of the lesion, cough with pain, usually wet initially. The pain can range from minor to severe, in which patients hold back deep breathing and coughing so that it does not hurt.
A wet cough gradually joins, sometimes with a lot of sputum of different colors – from transparent, mucous to greenish, purulent and even rusty, bloody.
When pneumonia is pronounced tachycardia, this decreases the pressure, the general condition is severe, severe weakness.
Nausea and even vomiting can be caused by toxemia, there may be diarrhea and abdominal pain, which causes patients to undergo surgery, and the diagnosis of pneumonia is found out there.
When listening to the lungs, large and small moist rales over the area of inflammation, muffled breathing, especially over the affected side, sparing it during the act of breathing, lagging of the affected side when breathing are heard .
Severe pneumonia can produce manifestations of neurotoxicosis with headaches, meningism , delusions and impaired consciousness, insomnia. Without treatment, such pneumonia can end in death.
The basis of the diagnosis is a clinical picture, listening to the lungs and changing tests with a clinic of acute and severe inflammation. But such symptoms can give many other diseases, therefore, radiological confirmation of the diagnosis is necessary, and in doubtful cases, computed tomography of the lungs.
Also, sputum is sown for the release of the pathogen and its sensitivity to antibiotics, the study of sputum for Mycobacterium tuberculosis, if necessary, blood is taken for antibodies to specific pathogens.
In general, a blood test revealed pronounced leukocytosis with high ESR, neutrophillosis , toxic granularity.
In severe cases, changes are also possible in biochemical analysis (increased ALT, AST, seromucoid, CRP, etc.)
During spirography, changes in respiratory volumes are detected.
An ECG is also required to exclude associated diseases and heart complications.
The basis of the treatment of pneumonia is the effect on the cause. This is antimicrobial or antiviral therapy in combination with antibiotics.
The treatment can be carried out on an outpatient basis only with a mild course in adults; in other cases, hospitalization is recommended.
- regimen and diet
- antibiotic use
- the use of pathogenetic drugs (expectorant, antiallergic, anti-inflammatory),
- fight against toxicosis,
- symptomatic drugs – antipyretic, analgesic, sedative,
- physiotherapy in the period of recovery and rehabilitation,
- sanatorium and aftercare
Antibacterial therapy should be carried out in full (at least 7-10 days), in the absence of a sufficient response during the first three days of treatment, a change of antibiotic is recommended.
The main groups of antibacterial drugs used for pneumonia:
- protected penicillins ( Augmentin, amoxiclav )
- macrolides ( fromilid, sumamed, vilprafen ),
- so-called “New” fluoroquinolones ( tavanic, avelox ),
- cephalosporins ( ceftriaxone ).
Paracetamol or ibuprofen is used to combat fever.
For the treatment of cough and improve sputum discharge – mucolytics (ACC, lasolvan , codelac-broncho combination with thyme, asoril , djoset ). Effective drainage breathing exercises, massage the chest, inhalation through the nebulizer mucolytics.
Physiotherapy treatment: UHF, MWT-therapy, exposure to an alternating magnetic field, microwave electromagnetic field, therapeutic physical training, chest massage.
Pneumonia on average cures in 2-3 weeks, although there may be protracted cases up to a month.
The prognosis depends on age and severity, comorbidity and cause.
Until now, pneumonia is high lethality, especially among elderly patients.
Dispensary observation of recovering from pneumonia lasts at least six months, as the sensitivity of the lungs to diseases is sharply increased.