Pneumonia - a viral or microbial infectious-inflammatory disease of the lungs, giving focal, segmental or total destruction of lung tissue.
Pneumonia can be an independent disease or a secondary complication of many infectious and noninfectious processes. Occurs more often in children because of the immaturity of the organism and weakening of immunity, although it is possible and in adults under stress and hypothermia in severe illness.
Pneumonia is approximately 30% of all the inflammatory diseases of the lower respiratory tract.
Causes
For reasons of pneumonia can be divided into several groups - microbial, viral, fungal, parasitic and caused by protozoa. In this case, the pathogens can be both typical for lung tissue, that is often enough causing pneumonia and atypical - then called atypical pneumonia.
Today, more often there are pneumococcal, klebsielleznye, Legionella, Proteaceae, or staph, hemophilic pneumonia, mycoplasma, Chlamydia, influenza, adenovirus.
Basically, there are primary pneumonia in children because their bodies are not yet familiar with the majority of pathogens and has a weak immune system.
In adults, mainly for pneumonia specific predisposing factors are necessary:
- being in the hospital - in this case, a nosocomial pneumonia,
- being on mechanical ventilation (ALV)
- long-term smoking and drinking,
- persistent hypothermia,
- the presence of acute and chronic diseases of the digestive, respiratory or heart and blood vessels, kidneys.
Predisposes to pneumonia diabetes, Drug addiction, constant stress, contact with animals and allergies, frequent travel and flights with acclimatization.
Pneumonia more often and harder to occur in young children and the elderly.
Kinds
For the development of pneumonia is divided into
- primary, or independent,
- secondary pneumonia, as a complication arising.
Morphology pneumonia divided into:
- focal, lesions with wedges or segments,
- croupous lesion with one or two light, in combination with bronchial lesions.
According to severity:
- sharp,
- low-intensity,
- chronic.
According to the appearance:
- street or community-acquired,
- nosocomial, hospital or nosocomial.
development mechanism
Microbe or virus can enter the lungs hematogenous or lymphogenous way, the airborne route. The result is a single or multiple foci of inflammation in the lung tkni that leads to disruption of ventilation, and the development of severe toxicosis state.
pneumonia symptoms
Symptoms of pneumonia depends on the agent and the patient's age, but in general, there are a number of specific manifestations.
Pneumonia usually starts acutely with severe chills and high fever, headaches and pains when breathing from the defeat, cough with pain, usually wet initially. Pain can range from mild to strong language in which patients restrain a deep breath and a cough that would not hurt.
Gradually joined cough, sometimes with a lot of phlegm in different colors - from transparent to mucous greenish, purulent and even rusty, bloody.
When pneumonia expressed tachycardia, wherein the pressure is reduced, the overall condition is severe, severe weakness.
By toxicity may be nausea and even vomiting, can be diarrhea and abdominal pain because of which patients come to the surgery and the diagnosis of pneumonia, it turns out there already.
When listening to the lungs can hear major and minor crackles on the inflammation area, muting breathing, especially on the affected side, sparing it with the act of breathing, the backlog at the affected side breathing.
Severe pneumonia can produce symptoms of neurotoxicity with headaches, meningism, delusions and impaired consciousness, insomnia. Without such treatment of pneumonia may end fatally.
Diagnostics
The basis of the diagnosis - clinical picture, lung auscultation and change analysis with the clinic of acute and severe inflammation. But these symptoms can give many other diseases, so it is necessary radiological confirmation of the diagnosis, and in doubtful cases, a CT scan of the lungs.
Also conduct sputum on abjection and its sensitivity to antibiotics, research sputum Mycobacterium tuberculosis, if necessary - take the blood for antibodies to specific pathogens.
In general blood analysis revealed marked leukocytosis with a high ESR, neytrofillez, toxic granularity.
In severe possible changes in the biochemical analysis (increase ALT, AST, Seromucoid, CRP and etc.)
When conducting spirography detected respiratory volume changes.
Also, be sure to conduct an ECG to exclude concomitant diseases and complications in the heart.
*consult Federal standard for pneumonia treatment, according to which this article is written.
treatment of pneumonia
The mainstay of treatment of pneumonia - the impact of the cause. This antimicrobial or antiviral therapy in combination with antibiotics.
Treatment can be performed on an outpatient basis only in mild in adults, in other cases, it is recommended hospitalization.
Treatment includes:
- regime and diet
- antibiotics,
- application of pathogenic agents (expectorants, antiallergic, anti-inflammatory)
- struggle with toxemia,
- symptomatic drugs - antipyretics, analgesics, sedatives,
- physiotherapy in the period of recovery and rehabilitation,
- spa aftercare.
Antibiotic therapy has held a full rate (not less than 7-10 days), in the absence of an adequate response in the first three days of treatment to change the antibiotic.
Major groups of antibacterial drugs applied in case of pneumonia:
- protected penicillins (Augmentin, amoxiclav)
- macrolides (fromilid, sumamed, vilprafen)
- the so-called 'New' fluoroquinolones (tavanik, aveloks)
- cephalosporins (ceftriaxone).
To combat fever using paracetamol or ibuprofen.
For treatment of cough and expectoration improve - mucolytics (ACC, Mucosolvan combined means Codelac broncho-thyme, Asorey, dzhoset). Effective draining breathing exercises, chest massage, inhalation via nebulizer mucolytics.
Physiotherapy: used UHF, SMV-therapy, exposure to an alternating magnetic field, microwave electromagnetic field, physiotherapy, massage chest.
The prognosis for treatment
Pneumonia is an average cured for 2-3 weeks, but may be protracted cases to a month.
The prognosis depends on the age and severity, comorbidities and reasons.
Until now, high mortality from pneumonia, especially among elderly patients.
Dispensary observation for recovering from pneumonia lasts at least six months, as well as sharply increased sensitivity to lung disease.
The section on treatment of pneumonia is written in accordance with the Federal standard primary care for diseases.
