Mainly observed in the adult and youth population, in children it is extremely rare. Lobar pneumonia exposed to people who abuse alcohol and taking drugs. Among this category of persons cases like pneumonia often are fatal.
Lobar inflammation extends to one lobe (about a third of the lung), all easy on the one hand, in rare cases, a double-sided defeat.
Acute infectious process is dangerous in terms of possible serious complications such as cardiac and respiratory failure, and cerebral anoxia.
CLASSIFICATION
Forms of manifestation of lobar pneumonia:
- Community-acquired. The disease begins in the home or in the first two days of hospitalization. This form is characterized by a mild and favorable prognosis. Fatal accidents are recorded in 10-12% of patients.
- Hospital. The first signs of lobar pneumonia developed after more than two days of hospitalization. The disease occurs in severe form, mortality reaches 40%.
- Aspiration or chemical pneumonitis may develop content after penetration of the oral cavity into the lower airways. This most often happens during an epileptic seizure or alcohol poisoning.
- Immunodeficient typical for cancer patients, people with lowered immunity, and for patients taking immunosuppressants.
See also: What is pneumonia - Treatment and Prevention
CAUSES
The main pathogens lobar pneumonia are the bacteria pneumococcus four types, more precisely detect type IV. Occasionally lobar pneumonia causes diplobatsilla Friedlander. These microorganisms have the ability to toxicity and tissue destruction.
Sometimes the cause of lobar pneumonia may be staphylococcal and streptococcal microflora. The combination of bacterial and viral infections can not be excluded. Pneumococci as pathogens have lost their practical significance due to the wide use of chemotherapy and antibiotics.
Causes croupous form of pneumonia are not only pathogens of great importance in the development of infection are contributing factors that trigger depression of immunity.
Predisposing factors:
- chest injuries;
- hypothermia;
- colds;
- nervous and physical stress;
- alcohol or drug intoxication;
- inflammation of the upper airway;
- chronic congestion in the lungs.
Susceptibility to the pathogen depends on the state of immunity, which is under the influence of the nervous system. The teams within the family and the infection usually comes from a patient with meningococcal meningitis or another carrier of pneumococcal infection. The causative agent of lobar pneumonia penetrates through the bronchi in the lungs and accumulates in the lymph vessels. Further lobe covers fibrinous exudate which causes nekrotizirovanie tissues.
SYMPTOMS
Lobar pneumonia usually referred to one of the most severe types of pneumonia. It causes lobar pneumonia or share segmental lesion, sometimes pathological process extends to the pleura.
The characteristic symptom of pneumonia is an abrupt onset of the disease without any precursors, typical of other infectious diseases.
The main symptoms of lobar pneumonia:
- chills;
- severe headaches;
- sweating;
- rapid rise in temperature to 40-41 ° C;
- stabbing chest pain from lesions (usually in the lower regions of the lungs), which become stronger with a deep breath;
- dyspnea;
- aches in the arms and legs;
- lethargy;
- cough.
Sometimes the symptoms of intoxication symptoms connected CNS. They manifest confusion, severe migraine and vomiting.
During the first days of cough occurs after the onset of symptoms. Vitreous and thick sputum is separated with difficulty. With a strong cough chest pain aggravated. Two days later, detects a change in sputum - due to blood impurities it becomes rusty hue.
On examination, pay attention to the feverish glow of the patient, which is more pronounced by the inflammation of the lungs. Often at an early stage of lobar pneumonia in the lip area can be considered herpetic rash.
Considerable pressure increase in pulmonary (small) systemic circulation leads to increased stress on the heart muscle. When listening to the top of the heart observed noise and rhythm disturbance. The pulse rate up to 120 beats per minute, and the blood pressure falls. Percussion zone over an area of inflammation helps to identify a characteristic dull sound.
Such symptoms of lobar pneumonia as pallor and cyanosis of the mucous membranes, are the result of oxygen starvation in the defeat of the heart muscle.
Staging of disease and morphological changes that occur under his influence, give reason to carry a similar reaction to the allergic reactions of the immediate type.
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FEATURES pathological processes
Infectious disease over a long period of sick observations concluded that lobar pneumonia is a disease which is characterized by cyclical and the pathological changes of lungs at every stage.
Stages of development of lobar pneumonia:
- Step tide. Microbial damage causes swelling and redness of the lung. Permeability and tone of capillaries and alveoli increased. This period of 12 hours to 3 days.
- Step red hepatization usually fixed on the second day. On the background of swelling and redness of the high permeability of blood vessels within the alveoli accumulate the red blood cells and neutrophils. Hypertrophied regional lymph nodes, lymphatic vessels are dilated. lung parenchyma becomes a rich red color and density can be compared to the liver.
- Stage gray hepatization develops 4-6 days after onset of illness. The bubbles accumulated neutrophils and alveolar fibrin. Here begins an active process of phagocytosis of pathogens. The number of hemolyzed red blood cells is reduced, decreased intensity of redness. Easy acquires gray color, its surface becomes grainy. Analysis of lung lymph node tissue indicates an acute inflammatory reaction.
- Step resolution. Exudate inside the lungs are gradually resorbed, its elimination occurs through the lymphatic vessels and during expectoration of sputum. Fibrinous deposits also gradually disappear.
In total, the whole process described takes about 9-11 days. Sometimes standard cycle lobar pneumonia undergoes changes - gray step ahead step hepatization red.
DIAGNOSTICS
Typical lobar pneumonia not pose difficulties for the identification of the disease. Pathology is characteristic traits by which the skilled artisan can easily diagnose. Appointed by blood tests, urinalysis and chest radiograph. The results of studies depend on the stage of lobar pneumonia.
Radiographic signs of lobar pneumonia:
- uniform darkening share part of the lung or segment thereof;
- convex border of the affected area of the lung;
- a clear reaction of the pleura.
Diagnosis is difficult with current atypical disease.
TREATMENT
After establishing the diagnosis of the patient hospitalized immediately. Treatment of lobar pneumonia is antibiotics.
Pneumococci exhibit enhanced sensitivity to penicillin, so as the main drug prescribed antibiotics of this group. Often lobar pneumonia pathogen exhibits resistance to penicillin, the ineffectiveness of such therapy over 72 hours is used antibiot other.
In pneumonia therapy is widely used sulfonamides which, if extended maintain the necessary the concentration of drug in the blood provide an effective fight against different types of pneumococcus, and wand Friedlander streptococci. When they nephrolithiasis contraindicated.
The effectiveness of treatment depends on strict compliance with the dosage and frequency of administration of the antibiotic. Violation regimen leads to the development of pathogen resistance to the drug.
Before treatment to avoid allergic reactions do intradermal antibiotic test to check individual tolerance.
treatment agent for lobar pneumonia:
- expectorant drugs;
- bronchodilators;
- antiherpethetical drugs;
- anti-inflammatory drugs, including hormonal;
- antifungal drugs in the development of candidiasis in patients receiving antibiotics;
- painkillers;
- distracting procedures;
- Oxygen therapy;
- light diet;
- nutrition when a appetite;
- ventilation of the room;
- drinking regimen about 3 liters per day;
- physiotherapy (for recovery).
COMPLICATIONS
With lobar pneumonia is quite high probability of severe complications, so the disease is deadly.
Complications of lobar pneumonia:
- Pulmonary: purulent pleurisy; exudative pleurisy; lung abscess; carnification or cirrhosis of the lung (in rare cases).
- Extrapulmonary sepsis; serous or purulent meningitis; toxic shock; pericarditis; changes in pulmonary vascular circulation; inflammation of the peritoneum, kidneys and joints, liver failure.
Current drugs that inhibit pathogen lobar pneumonia, with proper and timely treatment reduces the risk of complications to a minimum.
See also: Bilateral pneumonia - Causes, Symptoms and Treatment
PREVENTIVE ACTIONS
Lobar pneumonia Prevention includes measures aimed at the general strengthening of the organism and prevention of harmful influences that may reduce the body's defenses.
Preventive measures:
- Hardening: wet wiping, air baths.
- Proper treatment of viral infections.
- Prevention of atelectasis and hypostasis with prolonged bed rest associated with the disease (breathing exercises, periodic turns from side to side).
- Prevention of stagnation in the pulmonary circulation through the timely treatment of cardiovascular pathologies.
- Rational exercise.
- Prevention of alcohol and drug addiction.
- hygiene compliance.
- Prevention of hypothermia.
- Normal conditions of life and work, in which there is no crowding people.
- Balance between work and leisure.
- The creation of normal conditions for workers by ventilation, purification facilities of dust and air pollution, maintain its optimum temperature and humidity.
- Early treatment of inflammatory diseases of the upper respiratory tract.
- Antipnevmokokkovaya vaccinated according to the schedule of inoculations.
FORECAST
Prior to putting into practice the active sulfonamides mortality in the treatment of pulmonary inflammation was about 10-20%. The most common cause of deaths were heart failure and blood poisoning.
The use of antibiotics significantly affected the decrease in mortality rates. Currently it is about 3%, and the prognosis with lobar pneumonia be considered favorable.
Deaths often locked with heart failure in the elderly and chronic alcoholics, as well as the nature of meningeal complications.
Late onset of therapy and underestimated dosages lead to a prolonged treatment, the disease can sometimes become chronic.
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