What is pneumonia (inflammation of the lungs) and how to recognize its symptoms. Causes of lung inflammation: viral, fungal and bacterial infections. Treatment and prevention measures at home.
What is pneumonia, lung inflammation?
Pneumonia (or inflammation of the lungs) is an inflammatory disease with lung damage. Heavy pneumonia is the most common diagnosis of COVID-19 heavy form.
There are several varieties of pneumonia:
- Bacterial pneumonia - the reason is most often the bacteria of streptococcus;
- Viral pneumonia provoked by viral infection, coronairus, for example, or influenza virus;
- Aspiration pneumonia - associated with the ingress of the foreign body into the lungs, for example a piece of food, which leads to inflammation;
- Fungal pneumonia caused by lesions of lungs fungus, such as Coccidioides.
Regardless of the type of symptoms, it is similar.
The first symptoms of pneumonia
- - cough.
- - Hard breath, shortness of breath.
- - Green or rusty wet.
- - Pain in the chest when inhaling (pleurisy).
- - lack of oxygen, rapid breathing.
- - Heart palpitations.
- - chills.
- - Fatigue.
- - Muscle pain.
- - sweating.
- - Nausea.
- - diarrhea.
The first symptoms of pneumonia resemble signs of influenza, with high temperatures and highlighting wet cough
How to distinguish influenza pneumonia
Pneumonia, as a rule, is a consequence of a viral disease, such as influenza or cowid. High temperature and chills are characteristic of both diseases. Symptoms of inflammation are associated with the lesion of the lungs when the body is not enough oxygen. Permanent lack of oxygen may damage various organs, causing renal failure, heart failure and other life-threatening conditions.
Inflammation of the lungs (pneumonia) is distinguished by pain in the lungs, wheezing with inhale, more difficulty breathing.
Effective drugs from pneumonia
Effective medicine from pneumonia is selected depending on the cause of infection.
Viral pneumonia Vaccination to some extent can reduce the likelihood of a disease from a viral infection and facilitate the course of the disease, in the case of infection. In some cases, with viral pneumonia, the doctor may prescribe antiviral drugs to reduce viral activity. This treatment is usually most efficient when the virus is at an early stage of infection of the body.
Bacterial pneumonia Antibiotics are the main way to deal with the type of pneumonia caused by Streptococcus Pneumoniae bacteria. This type of pneumonia usually occurs heavily than viral pneumonia.
Fungal pneumonia Fungal species of pneumonia are treated with antifungal drugs. This type of lung inflammation meets less frequently.
Healthy habits and strong health - the basis of an easily transferred disease. With proper care, pneumonia can be cured at home.
Increased risk groups
It should be treated with a lot of caution to the disease of those belonging to a higher risk group.
According to WHO, the increased risk group includes:
- People over the age of 65;
- Children under 5 years old;
- Persons with chronic health impairment (such as chronic heart disease, lungs and kidney, metabolic disorders, disorders of neurological development, liver and blood disease);
- People with weakened immunity (as a result of HIV / AIDS, chemotherapy or steroid treatment, as well as in connection with malignant neoplasms).
Preventive measures - a true way to prevent the disease.
Infection prevention tips include:
- Observe the social distance;
- Observe Hygiene Rules: Wash your hands with soap;
- Maintain a strong immune system, observing a balanced nutrition;
- Refuse alcohol and smoking - they provoke complications, cause severe course of the disease.
Diagnose pneumonia should a doctor, based on symptoms and medical examination data. Hard breathing, wheezing when listening to the chest through a stethoscope are the most common distinguishing features.
Character and type of disease, as well as a method of treatment, help identify additional analyzes and activities:
- Pulse oximeter - a device that is powered by a finger allows you to quickly, in real time, determine the saturation of the blood oxygen - saturation. Low values are a reason for a more detailed study.
- Rengen chest - explores the lungs for the presence of affected areas.
- CT - Computed tomography - more accurate X-ray study of the lungs.
- Blood Analysis - Analysis of the structure allows you to determine the nature of infection: viral, fungal or bacterial.
- Wet analysis - helps determine which organism causes pneumonia.
- Bronchoscopy - the inspection of the lungs under anesthesia is carried out by a special tube, a bronchoscope descended into the lungs for a detailed study.
Treatment of pneumonia at home
Doctors usually prescribe non-prescription medicines to help cope with the symptoms of pneumonia. They include symptomatic antipyretic drugs from temperature, nonsteroidal anti-inflammatory drugs to reduce pain, as well as means from cough when it leads to exhaustion.
It is important to get a warm drink to getting wetting. At the first symptoms of the disease, it is necessary to reduce the load on the body and relax more.
In normal care, pneumonia is cured for 1-3 weeks. Hospitalization may be required with a weakened immune system when the body does not cope with the disease and there is a progression of symptoms. People with difficulty breathing may be required artificial ventilation of lungs or oxygen therapy.
Some types of pneumonia have an uncharacteristic course of the disease and treatment, therefore are called atypical pneumonia.
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What is pneumonia?
Pneumonia is inflammation of the lungs caused by bacterial or viral infection. During pneumonia there is a lesion of pulmonary alveoli. They are filled with pus or liquid, gas exchange is broken. Pneumonia often accompanies cough, shortness of breath, as well as heat and chills.
Pneumonia can threaten life. The risk is especially high for small children, the elderly, for those who have immunity weakened.
According to Rosstat, in Russia in 2019, 23.9 thousand people died from pneumonia. According to WHO, pneumonia in 15% of observations is the cause of death in children under 5 years of age all over the world.
Causes of pneumonia
Inflammation of the lungs almost always cause viruses or bacteria (Fig. 1). The risk of getting becomes increased by reducing immunity if a person breathes polluted air or smokes if he has chronic heart disease, endocrine or other diseases.
Pneumonia is most often over-off. This means that a person sicks it outside of medical institutions due to infection with a bacterial or viral infection.
The main pathogens of bacterial pneumonia are:
- Streptococcus Pneumoniae - detect in 38% of cases;
- Chlamydophila pneumoniae - 21% of cases;
- Haemophilus influenzae - 13% of cases;
- Mycoplasma Pneumoniae - 8%.
Until 2020, respiratory viruses caused only 17% of the total pneumonia, the treatment of which was carried out outpatient. After the propagation of the new coronavirus infection, the proportion of viral pneumonium increased.
Complete pneumonia can also cause bacteria-like organisms, fungi. Natural distribution pneumonia develops if a person is ill during hospitalization due to another disease or medical intervention.
Who is in the risk group?
The risk is inflamped by the inflammation of the lungs or encounter its heavy complications above for the following groups:
- Children under 5 years old and adults over 65 years old.
- People suffering from chronic obstructive diseases of the lungs, bronchial asthma, other diseases of the respiratory organs.
- People with reduced immunity (infected HIV or undergoing chemotherapy);
- People having severe chronic diseases (including cardiovascular diseases and diabetes), as well as those who have long observed bed regime.
After hypothermia, when overwork or stress, the serious course of respiratory diseases, the likelihood of the development of pneumonia increases.
When to consult a doctor?
When symptoms of pneumonia, it is necessary to contact the therapist. Among the signs of lung inflammation can be (Fig. 2):
- cough with sputum;
- Breast pain with coughing or breathing;
- difficulty breathing and shortness of breath even alone or at low loads;
- Fast fatigue, weakness;
- The body temperature is above 38.5 ° C (in the elderly and in people with a weakened immunity there is a decrease in temperature).
If the condition is rapidly deteriorating, the temperature remains high or low, and shortness of breath, cough and other signs of inflammation of the lungs increase, you need to call an ambulance care.
The doctor will begin diagnostics with a survey and inspection. It is necessary to tell him about the available symptoms, as well as about the general state of health. In case of inspection, it will measure the body temperature and blood pressure, examines the chest, will listen to the lungs to identify noise, wheezing, respiratory features. For diagnostics you need to contact the therapist. He can send a patient for consultation to a narrow specialist - a pulmonologist.
For diagnostics, a clinical analysis of blood is needed to obtain information about general health indicators. With severe pneumonia, the biochemical blood test is additionally prescribed. Deviations in its results may indicate violations in the work of some organs, on the development of complications. The results of biochemical analysis are taken into account in determining the possible cause of pneumonia (first of all - viral or bacterial), the choice of drugs and the determination of their dosages.
In complications, a study of pleural fluid may be conducted, an analysis of blood-blooded gases, coagulogram. To establish a causative agent of the disease, microbiological diagnostics can be carried out (study of sputum or blood, PCR diagnostics, express tests).
With pneumonia, several methods of tool diagnostics can be used.
- Fluorography or radiography of chest organs. Receives signs of inflammation in the lungs, allows you to estimate its localization, distribution, availability of complications.
- CT of the organs of the chest. Computer tomography allows you to specify the diagnosis, evaluate the volume of lung damage when inflammation, see the change in tissues. It is carried out if X-ray or fluorography reveals changes that are not typical for pneumonia if the inflammation of the lungs is recurring or poorly treatable, if the symptoms of pneumonia, radiography does not reveal changes in the lungs.
- If the disease occurs seriously, it may be necessary to need an ECG to estimate the condition of the heart and transducer ultrasound of the chest, if there is a suspicion of the appearance of pleural effusion (the accumulation of fluid in the pleural cavity).
How and what to treat pneumonia?
Pneumonia treatment must appoint the therapist. It will depend on the causes of inflammation of the lungs, from its severity, the presence of chronic diseases, the general state of health. With pneumonia, the infection is treated, which caused it, conduct symptomatic and supportive therapy, prevent the appearance of complications. Those who are in the risk group or are hard to transfers the inflammation of the lungs, hospitalization may be required. If respiratory failure develops, need respiratory support.
It is prescribed only in bacterial pneumonia and in cases where viral pneumonia is complicated by a bacterial infection. If inflammation of the lungs is caused by a virus and proceeds without complications, antibacterial drugs are not used, their use can be dangerous.
Antibiotics of several species can be used for the treatment of bacterial pneumonia: macrolides, cephalosporins, fluoroquinolones, aminopenicillins. To properly choose the drug, the doctor must define the causative agent of infection - what bacteria caused inflammation of the lungs.
Antiviral therapy is used if pneumonia is caused by the influenza virus, paragrippa, adenovirus and others. In the development of viral pneumonia on the background of infection with the influenza virus, neuraminidase inhibitors (oseltamivir and zanamivir) may be assigned. Antibiotics are applied only in the case of attachment of a bacterial infection.
Supporting and symptomatic treatment
To reduce the increased temperature and relieve pain, the therapist may prescribe paracetamol, ibuprofen or other non-steroidal anti-inflammatory agents. It is possible to the appointment of musolithic preparations that dilute the wet and stimulate its removal: ambroxol, acetylcysteine, etc. During the treatment period, it is recommended to comply with bedding and drink more liquid.
With the development of acute respiratory failure, respiratory support is needed. The method of such support is chosen by the severity of the state:
- Oxygen therapy. It assumes inhalation of pure oxygen through the facial mask, it helps to increase the flow of oxygen into the blood.
- Non-invasive or invasive lung ventilation. It is used if oxygen therapy does not provide sufficient oxygen intake into the blood, if respiratory failure is accompanied by stopping respiration, disruption of consciousness, a sharp decrease in blood pressure (systolic below 70 mm Hg. Art.) And cardiac frequencies.
- ECMO (Fig. 3). Blood saturation technology with oxygen using a special apparatus. It "takes" the blood from the venous bed, purifies, saturates with oxygen and sends it to venous or arterial bed (depends on the method of connecting the device). ECMO is used in acute respiratory failure if other ways of respiratory support do not provide the necessary results.
Is it possible to cure pneumonia at home?
Pneumonia treatment is almost always an outpatient - that is, it is carried out at home, without hospitalization. With outpatient treatment, it is important that it passes under the control of the physician. It is necessary to come to a reception to a general practice doctor, a therapist or a pulmonologist so that he prescribes treatment.
Inflammation of the lungs can be treated at home if the symptomatic treatment (the reception of the antipyretic, painkillers, musolithic preparations) gives a good effect. Another condition - a person has no respiratory failure. It can be checked whether oxygen is sufficient with breathing, with a pulse oximeter, a special sensor. You can also assess the respiratory rate. If a person makes 20 or more breaths per minute at rest, this is a disturbing sign. In acute respiratory failure, a person makes more than 24 breaths per minute.
Important! If the therapist permits to be treated with an outpatient basis, it is necessary to strictly fulfill its recommendations and destination: on time to take medicines, follow wellness, drink more fluid, comply with bedding.
Treat pneumonia at home is undesirable to people in the risk group. Hospitalization recommended:
- To old people,
- Little children,
- pregnant women
- People with chronic diseases.
The risk of complications with inflammation of the lungs depends on the effectiveness of treatment, and on the overall state of health. It is higher if a person has chronic respiratory diseases or cardiovascular system, endocrine diseases, if a person smokes. Complications may be pulmonary (affect respiratory organs) and extractive (affect other organs). Pneumonia's pulmonary complications include:
- shortness of breath, the development of acute respiratory failure, hypoxia (oxygen starvation of the body);
- Purrites - inflammation due to the accumulation of fluid in the pleural cavity;
- Light abscess - pus education;
- Atelectaz is a sharp decrease in the volume of lung due to falling out of its fabrics.
Related to extractive complications:
- Heart diseases - myocarditis (inflammation of the tissues of the heart muscle), pericarditis (inflammation with fibrous changes), endocarditis (inflammation of endocardium).
- Secondary meningitis is developing if the infection affects the tissues of the head or spinal cord.
- Infectious-toxic shock is developing as a reaction to toxins if bacteria fall into the bloodstream, accompanied by polyorgan deficiency.
- DVS syndrome - the formation of thrombus and massive bleeding due to disorders of the opposite and coagulating blood systems.
Pneumonia treatment should assume the risk assessment of complications and their prevention. To do this, extended antibacterial therapy, cardiophrotective, antombose and other drugs can be used.
There are several ways to reduce the risk of lung inflammation:
- Vaccination. Protect against inflammation of the lungs helps vaccinations from pneumococcal infection and influenza, a new coronavirus infection.
- Security and hygiene measures. They are especially important during seasonal epidemics. You need to wash your hands more often, try less in contact with sick people, if necessary, use the means of protection (medical masks, gloves).
- Proper treatment. Pneumonia often becomes a complication of sharp respiratory viral infections. For its prevention, effective treatment of ARVI is needed: You need to turn to the therapist on time and fulfill its recommendations.
- Strengthening health. It is important to abandon bad habits: do not smoke, reduce alcohol consumption. Strengthening immunity, physical activity, proper nutrition will help reduce the risk of lung inflammation.
The treatment of pneumonia can be carried out outpatient, at home, but it is important that the therapist can be prescribed and controlled. If the inflammation of the lungs proceeds in severe form, with complications or if the risk of complications is raised, it will take hospitalization. Pneumonia can be dangerous, and therefore, when it is treatment, it is necessary to comply with all the recommendations of the doctors.
- MSDMANUALS. Complete pneumonia.
- Ministry of Health of the Russian Federation. Clinical recommendations. Complete pneumonia in adults. - 2019.
- Healthline. Pneumonia: Symptoms, Causes, Treatment and More.
Publication date July 31, 2018. Updated April 26, 2021.
Definition of the disease. Causes of the disease
Pneumonia (inflammation of the lungs) - a variant of acute respiratory infection, affecting a lightweight fabric. Lights consist of small fabricated formations (Alveol), which during the respiratory act of a healthy person must fill with air. With pneumonia, the alveoli is filled with liquid (exudate) and pus, which worsen gas exchange. [one]
Complete Pneumonia (VP) - This is an acute infectious disease, especially common among residents of cities. According to the statistics provided by different authors, about 1,500,000 people are ill in pneumonia annually. In the mortality structure, pneumonium in Russia in 2015 accounted for up to 50% (in the group of diseases of the respiratory organs), in 2016 the mortality from this disease reached 21 for every 100 thousand inhabitants. 
The list of possible causative agents of VI includes more than a hundred microorganisms (viruses, mushrooms, simplest, but mainly bacteria). However, most often the disease is associated with a relatively small circle of microbial agents, including:
- Pneumococcus (S. pneumoniae);
- Mycoplasma (M. pneumoniae);
- Chlamydofila (C. pneumoniae);
- Hemophilic stick (H. Influenzae) ;
- respiratory viruses;
- Golden Staphylococcus (S. aureus);
- Legionella Pneumophila (L. Pneumophila).
The greatest risk of the development of pneumonia is subject to:
- children up to two years;
- People over 65 years old.
Other risk factors include:
- treatment in the hospital;
- Chronic diseases - asthma, chronic obstructive pulmonary disease (COPD) or heart disease;
- Weakened immune system - patients with HIV, as well as people who have transferred transplants receiving chemotherapy or long-receiving steroids are at high risk;
- smoking  .
An unfavorable outcome risk factors are: age, male floor and related diseases  .
Pneumonia can cause many different microorganisms. Many of them are transmitted from a person to a person, but not all when exposed to the same microbes develop pneumonia.
How pneumonia is transmitted
Viruses and bacteria leading to the development of pneumonia can be transmitted by air-drip and contact-domestic way. Mushroom pneumonia is usually developing when people inhale microscopic particles of the environment.
When you find similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!
Symptoms of pneumonia
The supercooling of the body often becomes the cause that runs the process of developing inflammation of the lungs in adults. Then the symptoms of the disease appear consistently.
How to recognize the symptoms of pneumonia:
- unexpected and very fast rise body temperature to febrile digits (over 38 ° C);
- nonspecific manifestations of systemic intricensication of the body (depression, lethargy, fatigue, muscle weakness, drowsiness, headache);
- After 3-4 days, a dry cough occurs, which after a few more days becomes wet - the mucus (sputum) begins to flick, often it has a rusty or brown color;
- There may be pain in the chest on the side of the affected light (or on both sides, if the inflammation is bilateral), which is enhanced by coughing and breathing;
- When breathing may be listened to wheezing in the chest (not all patients are heard);
- shortness of breath (frequent breathing) - is the result of massive lesion of the lung and manifestation of respiratory failure;
- One of the sides of the chest (amazed) can fall behind with breathing. [four]
Signs of pneumonia in an adult:
Signs of pneumonia at the child
In children, the symptoms of pneumonia are usually pronounced more - they are sick with a higher temperature at which febrile cramps may develop. In addition, children, especially very small, often badly know how to dig a sputum, so it is not always possible to notice her purulent character - yellow or green color and an unpleasant smell.
Pathogenesis of pneumonia
Leading mechanisms that lead to the development of VP:
- penetration into the lower respiratory paths of the content of the rotogling (aspiration);
- Inhalation of aerosol suspension containing various microbial agents;
- penetration of microorganisms from the focus of infection, located outside the lungs, through blood;
- Moving infectious agents from neighboring affected organs (direct contact) or as a result of attachment of infection with invalid objects (weapons) into the chest. 
Attachment (adhesion) of microbial agents to the surface membrane cell epithelium cells of the bronchi, especially the preceding dysfunction of the celibery epithelium and change of mukiciliary clearance, is becoming the starting pulse of the development of pneumonia of lungs.
The next step in the formation of inflammation is the reproduction of the microbial agent in the cells of the bronchial epithelium. The disorder of the integrity of the membrane of these cells leads to intensive products of biologically active substances - cytokines. They cause directional motion (chemotaxis) of macrophages, neutrophils and a number of other cells in the inflammation area.
In the following stages of the inflammatory process, consistent penetration (invasion), the vital activity of microorganisms inside the cells and products of toxins plays a very significant role. All these processes ultimately end with exudative inflammation inside Alveol and bronchiol. The phase of clinical manifestations of the disease occurs. [four]
Classification and stage of development of pneumonia
In the international classification of the diseases of the 10th revision (ICD-10) in the section "H. Respiratory diseases »allocate the following types of pneumonia:
- non-classified viral pneumonia (adenovirus and others);
- Pneumococcal pneumonia ( S. Pneumoniae. );
- Pneumonia caused by hemophilic stick ( H. INFLUENZAE. );
- non-classified bacterial pneumonium caused by the impact of Klebsiella ( Klebsiella Pneumoniae. ), staphylococcus ( Staphylococcus SPP. ), streptococcus group in and other fiefococcus, intestinal sticks ( Escherichia Coli. ), other aerobic gram-negative bacteria and micallopasms ( Mycoplasma pneumoniae. ). Also, this group includes other bacterial pneumonia and pneumonia of unspecified etiology.
- Pneumonia, which emerged due to the impact of other infectious pathogens: Chlamydia (Chlamydia SPP), as well as other infections established pathogens.
- pneumonia arising from diseases classified in other categories (with actinomycosis, Siberian ulcer, gonorrhea, nocardiosis, salmonellosis, tularemia, abdominal title, coughus; for cytomegalovirus disease, measles, rubella, wind pump; under the Mikosakh; under parasitosis; under ornithosis, ku-fever, acute rheumatic fever, spirochetose);
- Pneumonia without refining the pathogen.
This classification is built on the etiological principle, that is, it is based on the form of a pathogen who caused the cause of inflammation of the lungs. [five]
Also separately allocated Aspiration pneumonia , which has been attributed to inhalation or passive getting into light different substances in a large amount, most often vomit, which cause an inflammatory response.
Aspiration pneumonia leads:
- the regulation of the gastric content in the respiratory tract at reanimation, shock, disorders of consciousness (including in alcohol and heroin intoxication);
- Violation of swallowing in various neurological disorders and diseases of the esophagus.
Features of the treatment of aspiration pneumonia is the use of endoscopic methods for washing and purifying respiratory tract, antibacterial and expectorant drugs.
In modern clinical practice, the most popular classification is the classification that takes into account the three main factor: the conditions for the appearance of pneumonia, the features of infection of the pulmonary tissue and the status of the patient's immune system. In this aspect it is very important to distinguish Complete-headed pneumonia (VP) and Non-community pneumonia (Nosocomial, NP), since the concepts of their treatment will differ. The community is considered pneumonia, which developed outside the hospital or detected in the first 48 hours after hospitalization in the hospital. Since 2005, a number of authors outreach Pneumonia associated with medical intervention .
Signs of community-friendly, nosocomial (nosocomial) and related to the provision of medical assistance of pneumonia
Complications of pneumonia
Many authors allocate two categories of complications developing at pneumonia - "light" and "extreme".
К "Easy" complications relate:
- parapneumonic pleurisy;
- Empiama pleura;
- abscess and gangrene lung;
- acute respiratory failure;
- Respiratory Distress syndrome.
"Extreme" complications are:
- septic shock;
- polyorgan deficiency;
- DVS syndrome.
Currently, such a division is very conditional, since intoxication syndrome in pneumonia applies to the entire body.
Pleurisy - an inflammatory disease in which an excess amount of liquid accumulates in the pleural cavity. It is observed especially often with the bacterial and viral nature of the pathogen.
Abscess liga - Pathological infectious process, manifested by the formation of a more or less limited cavity in a lightweight tissue (> 2 cm in diameter) due to the local intake of tissues and the subsequent purulent decay. Very often, the development of abscesses is infected with anaerobic microorganisms.
Empiama pleura - The accumulation of pus in the pleural cavity, quite often becomes the extremely adverse outcome of the flow of exudative pleuritis.
Acute respiratory failure - A sharp impairment of breathing, in which the oxygen transport is reduced into lungs, and ensuring the proper gas composition of arterial blood becomes impossible. As a result of insufficient oxygen intake, "oxygen starvation" (hypoxia) occurs. Significant oxygen deficiency threatens the life of the patient and may require deploying measures of emergency intensive therapy.
Sepsis - It is the most formidable and severe complication of pneumonia. It develops when the infectious agent penetrates the infectious agent, and then its circulation on the bloodstream occurs. The feature of sepsis is to form purulent foci throughout the body. The clinical manifestations of sepsis are very bright: the body temperature rises to febrile numbers, there is a heavy intoxication syndrome, manifested by headache, nausea, vomiting, less often diarrhea, the skin becomes an "earthy" shade).
DVS syndrome - Pathology from the hemostasis system (the resulting and anticorant blood system), leading to a change in normal microcirculation in the vascular channel due to massive bleeding with the simultaneous formation of thrombov. 
Diagnosis of pneumonia
Diagnostic studies with VI are aimed at clarifying the diagnosis, determination of the pathogen, the assessment of the severity of the flow and forecast of the disease, as well as to detect complications.
The diagnostic algorithm for suspected VP includes:
- detailed collection of anamnesis;
- Analysis of patient complaints;
- physical examination;
- Laboratory and instrumental studies, the volume of which can be determined individually and is due to the severity of the EP's flow, the emergence and character of complications concomitant patient diseases.
The diagnosis of VP is proven when identifying a patient focal infiltration of light tissue confirmed radiologically And, at least two of the signs listed below:
- acutely occurring fever at the beginning of the disease (body temperature> 38.0 ° C);
- cough with sputum;
- Physical signs identified during the full physical examination (local attitudes or small-pushed wheezes, bronchial respiration, dulling sound at percussion);
- An increase in the total number of leukocytes (> 10 · 109 / l) and / or a halochloride shift (> 10%).
Important! In the absence or inaccessibility of x-ray confirmation of focal infiltration in the lungs, the diagnosis of "VP" is considered unspected. At the same time, the diagnosis of "pneumonia" can be justified by the data of epidanamnesis (medical history), the presence of relevant complaints and local manifestations. 
A very important point in the diagnosis of pneumonium is the use of pulse oximetry method. In all clinical recommendations, the need to measure saturation from EVERY Patient with inflammation of lungs. [nine]
Currently, there are a number of diagnostic techniques that allow you to divide all VN into two categories - heavy and notching. Thus, the main task of the gravity assessment scale (ballroom systems) is to identify patients with an unfavorable forecast and a high risk of complications. [eight] Examples of such scales are:
- PSI - gravity index of pneumonia;
- CURB-65 scale;
- SMART-COP scale.
After determining the severity, the attending physician decides on the place of treatment - outpatient surveillance or hospitalization.
How to distinguish inflammation of the lungs from ARVI, flu and bronchitis
To distinguish the inflammation of the lungs from seasonal ARVI, influenza and bronchitis, visualization of lungs - radiography of the chest organs, digital fluorography or computer tomography of the chest organs. These methods allow you to detect infiltrates in lightweight fabric.
Treatment of pneumonia
Which doctor treats the disease
Pneumonia treats the therapist or pulmonologist.
When to consult a doctor
To the doctor should be applied when problems with breathing, chest pains, a permanent fever (over 38 ° C) and cough, especially with a sputter.
Indications for the disease
Treatment of patients with VI is comprehensive and based on several basic principles:
- appointment of antimicrobial drugs;
- adequate respiratory support if necessary;
- the use of nonantibacterial drugs (only in the event of indications);
- Prevention of complications.
It is extremely important to the timely detection and treatment of decompensation or exacerbation of related diseases, since their presence / severity can radically affect pneumonia. 
Important! Antibacterial therapy (ABT) can only be appointed by a doctor, otherwise the risk of drug sustainability (resistance) of microorganisms increases sharply.
The main groups of antimicrobial preparations used in the treatment of pneumonia are:
- Beta-lactam antibiotics (penicillins and cephalosporins);
- Respiratory fluoroquinolones.
In some cases, in the presence of special indications, preparations of other groups (tetracycles, aminoglycosides, lincoosamides, vancomycin, linoxolid can be used.
In viral pneumonia (usually associated with the influenza virus), inhibitors of neuraminidase (oseltamivir and zanamivir) are most important, which have high activity against influenza a and b. viruses
In the treatment of outpatient patients, preference is given to oral antibiotics (usually in tableted form). In the treatment of patients in the hospital, a stepped approach is used: begin with parenteral administration of antibiotics (intravenous path preferred), in the future, as the patient's clinical stabilization is translated to oral administration (tablets).
The duration of antimicrobial therapy of the Night EP is determined individually, with a heavy VP of unspecified etiology - continues at least 10 days. The implementation of longer courses ABT (from 14 to 21 days) is recommended only in the development of the complications of the disease, the presence of foci of inflammation outside of light tissue, infection S.Aureus. , Legionella SPP. ., Nonfernifying microorganisms ( P.aeruginosa. ).
In clinical practice, it is very important to decide on the possibility of stopping AMT at the right moment. For this, sufficiency criteria have been developed:
- resistant decrease in body temperature <37.2ºС for at least 48 hours;
- lack of manifestations of intoxication syndrome;
- normalization of breathing frequency (<20 / min);
- No purulent sputum;
- Reducing the number of leukocytes in the blood (<10 · 109 / l), neutrophils (<80%), young forms (<6%);
- Lack of negative dynamics on the radiograph. 
Acute respiratory failure (ODN) is the leading cause of the death of patients with VP, therefore adequate respiratory support is the most important component of the treatment of such patients (of course, in conjunction with systemic antibiotic therapy). Respiratory support is shown to all patients with VEs with RO2 <55 mm Hg. or SrO2 <88% (with air breathing). [four]
Oxygen therapy It is carried out in the case of a moderate lack of oxygen in the blood with a simple nasal mask or mask with a consumable bag.
Artificial ventilation lungs (IVL) is used in the event that even with oxygen inhalations, the target level of blood saturation oxygen is not achieved.
Indications to the IVL at one on the background of the VP:
- Absolute: Stop breathing, violation of consciousness (copor, coma), psychomotor excitation, unstable hemodynamics (blood pressure <70 mm Hg, heart rate <50 / min);
- Relative: ChDD> 35 / min RAO2 / FIIO2 <150 mm Hg, Raising Raso2> 20% of the initial level, violation of consciousness.
Presented by three major grades of drugs:
- Systemic glucocorticosteroids (GKS);
- intravenous immunoglobulins (IG);
- Some immunostimulants.
The question of the appointment of GCS is considered primarily for the heavy EP, which is complicated by septic shock. GKS contribute to the limitation of the destructive influence of systemic inflammation using various genomic and non-mentioned effects.
The use of the IG for the treatment of infections complicated by sepsis is based on a variety of effects: from neutralizing bacterial toxins until the cell reactivity is reduced during the phenomenon of the "immune paralysis".
In the treatment of sepsis, polyclonal ig, which, compared with placebo, reduce the relative risk of death. The routine use of intravenous IG patients with severe VP complicated by sepsis is impractical.
Interest in these drugs is associated with their ability to strengthen phagocytosis, education and maturation of neutrophils. However, due to the lack of a convincing evidence base, they currently have practically not used in routine practice.
Contraindications for the disease
At pneumonia, it is extremely recommended to engage in self-medication, especially using antibiotics. At the moment there are many groups of antibacterial drugs, for the selection of adequate therapy, the doctor will ask several questions about the history of the disease, drug intolerance, the previous use of antibiotics and what other preparations the patient takes regularly. In the acute period of the disease, it is recommended to refrain from the active use of physiotherapeutic treatment methods, especially related to the heating of tissues.
A favorable or unfavorable outcome of the VP depends on several factors:
- the age of the patient;
- the severity of the flow;
- The presence / absence of concomitant diseases.
The risk of death is minimal in young and middle-aged patients with the well-mentioned pulp and non-accompanying diseases. In patients of elderly and senile age, there is a risk of fatal outcome in the presence of significant concomitant pathology (COPD, malignant neoplasms, alcoholism, diabetes, chronic heart failure), as well as in situations of development of heavy VP.
The main cause of the death of patients with severe VP is a steady lack of oxygen, septic shock and insufficiency of all organs and systems. According to research, the main factors associated with the unfavorable prognosis of patients with severe VI, are:
- Age> 70 years;
- Conducting IVL;
- bilateral localization of pneumonia;
- Septic and infection with a blue-purulent stick.
Speaking of Russia, it should be mentioned later to refer to patients for qualified medical care. This becomes an additional risk factor for an unfavorable outcome.
How to prevent pneumonia
At the moment, highly effective means are available throughout the world, allowing themselves to protect themselves and their relatives from this formidable disease - pneumococcal and influenza vaccines.
In order to specific prophylaxis of pneumococcal infections, including pneumonia, two vaccines are used in adults:
- 23-valence non-conjugated vaccine (contains purified capsular polysaccharide antigens 23 serotypes S.pneumoniae. );
- 13-valence pneumococcal conjugated vaccine.
All patients with high risk of pneumonium should be protected by such vaccines. [eleven]
Pneumonia - acute defeat of light infectious inflammatory character, in which all structural elements of lung tissue are involved, mainly alveoli and interstitial lung tissue. The pneumonia clinic is characterized by fever, weakness, sweating, pain in the chest, shortness of breath, a cough with a wet (mucous, purulent, "rusty"). Pneumonia is diagnosed based on the auscultation pattern, lung radiography data. In the acute period, treatment includes antibiotic therapy, disinfecting therapy, immunostimulation; reception of flux, expectorant, antihistamine; After the cessation of fever - physiotherapy, LFK.
Pneumonia is inflammation of the lower respiratory tract of various etiology, which flows with intrastallyolar exudation and accompanied by characteristic clinical and radiographic signs. The sharp pneumonia occurs in 10-14 people out of 1000, in the age group over 50 years old - 17 people from 1000. The relevance of the incidence of acute pneumonia is preserved, despite the introduction of new antimicrobial drugs, as well as the high percentage of complications and mortality (up to 9% ) From pneumonia.
Among the causes of mortality, pneumonia stands on a 4th place after heart disease and vessels, malignant neoplasms, injury and poisoning. Pneumonia can develop in weakened patients, joining the flow of heart failure, oncological diseases, violations of cerebral circulation, and complicates the outcome of the latter. Patients with AIDS pneumonia is the main direct cause of death.
Causes and mechanism for the development of pneumonia
Among the etiphorts causing pneumonia, there is a bacterial infection in the first place. Most often, the pathogens of pneumonia are:
- Gram-positive microorganisms: pneumococci (from 40 to 60%), staphylococci (from 2 to 5%), streptococci (2.5%);
- Gram-negative microorganisms: Fredlender wand (from 3 to 8%), hemophilic stick (7%), enterobacteria (6%), protea, intestinal wand, legionella, etc. (from 1.5 to 4.5%);
- Mycoplasma (6%);
- viral infections (herpes, influenza and paragrippa viruses, adenoviruses, etc.);
- fungal infections.
Also, pneumonia can develop due to the impact of noncommunicable factors: injuries of the chest, ionizing radiation, toxic substances, allergic agents.
The risk group for the development of pneumonia includes patients with stagnant heart failure, chronic bronchitis, chronic nasopharyngeal infection, congenital lung defects, with severe immunodeficiency states, weakened and exhausted patients, patients, long-term beddown, as well as senior and senile facial .
Particularly subject to the development of pneumonia smokers and alcohol abusers. Nicotine and alcohol pairs damage the mucous membrane of the bronchi and oppress the protective factors of the bronchopulmonary system, creating a favorable environment for the introduction and reproduction of infection.
Infectious pathogens of pneumonia penetrate into light bronchogenic, hematogenic or lymphogenic paths. With the reduction of the protective bronchopulmonal barrier in Alveoli, infectious inflammation develops, which through permeable intervalolar partitions is distributed to other departments of lung tissue. In Alveola, the formation of an exudate that prevents oxygen gas exchange between the pulmonary fabric and blood vessels. Oxygen and respiratory failure develop, and with a complicated flow of pneumonia - heart failure.
In the development of pneumonia 4 stages are allocated:
- the stage of the tide (from 12 hours to 3 days) is characterized by a sharp blood flow of vessels of lungs and fibrinous exudation in the alveoli;
- Stage of red oven (from 1 to 3 days) - a piece of lung tissue occurs, according to the structure resembling a liver. Erythrocytes in large quantities are found in alveolar exudate;
- The stage of gray compelling - (from 2 to 6 days) - is characterized by the decay of the red blood cells and the massive leakocyte output in the alveoli;
- The resolution stage is restored by the normal structure of the lung tissue.
1. Based on epidemiological data, pneumonia distinguishes:
2. On the etiological factor, with the clarification of the pathogen, pneumonia happens:
3. Under the development mechanism, pneumonia is distinguished:
- Primary, developing as independent pathology
- Secondary, developing as a complication of concomitant diseases (for example, stagnant pneumonia)
- Aspiration, developing in the affiliation of foreign bodies in bronchi (food particles, vomit, etc.)
- Post traumatic
- Infarction pneumonia, developing due to thromboembolism of small vascular branches of the pulmonary artery.
4. According to the degree of interest of lung tissue there are pneumonia:
- One-sided (with the defeat of the right or left light)
- Total, equity, segmental, subdollated, roasting (central).
5. By the nature of the flow of pneumonia can be:
- sharp protracted
6. Taking into account the development of functional disorders of pneumonia proceeds:
- With the presence of functional disorders (indicating their characteristics and severity)
- With the lack of functional disorders.
7. Taking into account the development of complications of pneumonia there are:
8. Based on clinical and morphological features, pneumonia distinguishes:
- Parenchimato (Burent or Share)
- Focal (bronchopneumonia, pneumonia)
- interstitial (more often with mycoplasma lesion).
9. Depending on the severity of the flow of pneumonia divide on:
- Easy degree - It is characterized by poorly pronounced intoxication (clear consciousness, body temperature up to 38 ° C, blood pressure, tachycardia is not more than 90 liters. In min.), Shortness of breath is missing, x-ray is determined by a small focus of inflammation.
- Middle degree - Signs of moderately pronounced intoxication (clear consciousness, sweating, pronounced weakness, body temperature up to 39 ° C, the hell is moderately reduced, tachycardia is about 100 ° C. in min.), Respiratory rate - up to 30 per minute. At rest, radically determined pronounced infiltration.
- Heavy degree - It is characterized by pronounced intoxication (fever 39-40 ° C, turbidity of the creation, adamiya, nonsense, tachycardia over 100 liters. In min., Collapse), shortness of breath to 40 per minute. At rest, cyanosis, radiologically determined extensive infiltration, the development of complications of pneumonia.
Symptoms of pneumonia
It is characteristic of a sharp beginning with a fever over 39 ° C, chills, pain in the chest, shortness of breath, weakness. The cough is worried: first dry, unproductive, further, for 3-4 days - with "rusty" sputum. The body temperature is constantly high. With a bruboral pneumonia, fever, cough and sputum of sputum hold up to 10 days.
With a severe degree of flow of brunt pneumonia, the hyperemia of the skin and cyanosis of the nasolabial triangle is determined. On lips, cheeks, chin, nose wings are visible herpetic rash. Patient condition is severe. Surface breathing, rapid, with inflating the wings of the nose. Auscultatively listened to the crepitution and wet small-pushed wheezes. Pulse, frequent, often arrhythmic, Hell is reduced, heart tones deaf.
It is characterized by a gradual, lowest beginning, more often after transferred by ORVI or acute tracheobronchitis. The temperature of the body febrile (38-38.5 ° C) with daily oscillations, cough is accompanied by the disheve of the mucous-purulent sputum, sweating, weakness, with breathing - chest pain on the breath and with cough, acrocyanosis. With focal drain pneumonia, the patient's condition deteriorates: pronounced shortness of breath, cyanosis appear. With auscultation, hard breathing is listened, exhalation is elongated, dry fine and medium-reported wheezes, attitudes above the hearth inflammation.
Complications of pneumonia
Features of the flow of pneumonia are due to the degree of severity, the properties of the pathogen and the presence of complications. The amount of pneumonia is considered complicated, accompanied by developing in the bronchopulmonary system and other organs of inflammatory and jet processes caused directly by the inflammation of the lungs. The presence of complications largely depends on the course and outcome of pneumonia. Complications of pneumonia can be pulmonary and extractive.
Light complications for pneumonia can be:
Among the extravalous complications of pneumonia often develop:
When diagnosing pneumonia, several tasks are solved at once: the differential diagnosis of inflammation with other pulmonary processes, the clarification of the etiology and the severity (complications) of pneumonia. Pneumonia in the patient should be suspected on the basis of symptomatic signs: the rapid development of fever and intoxication, cough.
- Physical research. The sealing of the pulmonary tissue is determined (based on the percutive dullness of the pulmonary sound and the amplification of the bronchophone), a characteristic auscultation pattern - focal, wet, fine-duct, sonorous wheezes or crepitations.
- Laboratory diagnostics. Changes in the general blood test in pneumonia are characterized by leukocytosis of 15 to 30 • 109 / l, with a launching shift of the leukocyte formula from 6 to 30%, with an increase in ESP to 30-50 mm / h. In general, urine analysis can be determined by proteinuria, less often microhematuria. Bakanalize sputum at pneumonia allows you to identify the pathogen and determine its sensitivity to antibiotics.
- Lung radiography. Radiographs for pneumonia are usually made at the beginning of the disease and after 3-4 weeks to control the permission of inflammation and exclusion of other pathology (more often of bronchogenic lung cancer). With any kinds of pneumonia, the process captures the lower lobes of the lung. On radiographs, with pneumonia, the following changes can be detected: parenchymal (focal or diffuse darkens of various localization and length); Interstitial (pulmonary pattern is strengthened due to perivascular and peribroscial infiltration).
- Ultrasound. According to echocardiography and ultrasound of the pleural cavity, the pleural effusion is sometimes determined.
CT OGK. Plot of pneumonic infiltration in the upper share of the left lung.
Treatment of pneumonia
Patients with pneumonia, as a rule, are hospitalized into a general-merating department or a branch of pulmonology. For the period of fever and intoxication, bedding is prescribed, abundant warm drinking, high-calorie, rich in vitamins. With discharged respiratory failure phenomena, patients with pneumonia are prescribed oxygen inhalation. The main directions of therapy:
- Antibiotic therapy. The main in the treatment of pneumonia is antibacterial therapy. Antibiotics should be prescribed as soon as possible, without waiting for the determination of the pathogen. The selection of the antibiotic is carried out by the doctor, no self-treatment is unacceptable! In extractive pneumonia, penicillins are prescribed more often (ampicillin with clavulano k-th, ampicillin, etc.), macrolides, cephalosporins. The choice of a method for administering an antibiotic is determined by the severity of the flow of pneumonia. Penicillins, cephalosporins, fluoroquinolones (ciprofloxacin, ophloxacin, etc.), carbapenes, aminoglycosides are used to treat internal hospitals pneumonium. With an unknown pathogel, combined antibiotic therapy of 2-3 drugs are prescribed. The course of treatment can continue from 7-10 to 14 days, an antibiotic change is possible.
- Symptomatic therapy. In pneumonia, it shows the conduct of disinfecting therapy, immunostimulation, the appointment of antipyretic, expectorant and musolitic, antihistamine.
- Physical. After the discontinuation of fever and intoxication, the regime is expanding and prescribed physiotherapy (calcium chloride electrophoresis, potassium iodide, hyaluronidase, UHF, massage, inhalation) and leafc for stimulating the resolution of the inflammatory hearth.
Treatment of pneumonia is carried out until the patient's complete recovery, which is determined by the normalization of state and well-being, physical, radiological and laboratory indicators. With frequent repeated pneumonia, the same localization is solved by the issue of surgical intervention.
With pneumonia, the forecast is determined by a number of factors: the virulence of the pathogen, the patient's age, background diseases, immune reactivity, adequacy of treatment. The complicated variants of the flow of pneumonium, immodeficiency states, the stability of pathogens to antibiotic therapy, are unfavorable. Especially dangerous pneumonia in children under 1, caused by staphylococcus, a blue rod, Chlebseyella: mortality with them ranges from 10 to 30%.
With timely and adequate medical events, pneumonia ends with recovery. According to changes in pulmonary fabric, the following outcomes of pneumonia may be observed:
- the complete restoration of the structure of the pulmonary fabric is 70%;
- the formation of a portion of local pneumosclerosis - 20%;
- the formation of the local carnigation section is 7%;
- Reducing the segment or share in size - 2%;
- Warming segment or share - 1%.
The prevention measures of the development of pneumonia are to harden the body, maintaining immunity, the exclusion of the factor of hypothermia, the rehabilitation of chronic infectious foci of nasopharynx, the fight against dusting, stopping smoking and alcohol abuse. In weakened lying patients in order to prevent pneumonia, it is advisable to conduct respiratory and medical gymnastics, massage, the purpose of antiagregants (pentoxyfalline, heparin).
Coronavirus infection has become the most discussed themear time. This is a respiratory disease, and especially its threatening presences, became the main horror of modernity, although in 80% of cases it is easily and relatively without consequences. Only 20% of the fallen "crown" flows in severe form. As you know, the virus causing it may occur to the occurrence of pneumonia, i.e., the inflammation of the lungs, in 2-5% of the sampling to heavy complications that affect life.
Features of pneumonia during coronavirus
For coronavirus infection, typically, the development of viral native pneumonia, which can develop both almost immediately after the presentation, and after the occurrence of the main symptoms of the disease. Just in the lungs and bronchops, or rather in their smallest components, alveoli of ibronchilaces, there is an acute inflammatory process, but often this is a lubricated clinical picture, which is distinguished by atypical epneamonia.
The development of pneumonia is dangerous not only at coronavirus, but in general. After all, despite all the progress of medicine, it remains a dangerous disease in the first ten diseases leading to the death of patients even in the most developed countries.
Pneumonia after coronavirus can be primary iconic. In the first case, it is caused by the SARS-COV-2 virus itself and, as a rule, it flows atypically. In the second case, it is a viral-bacterial nature and can be combined with primary inflammation, or to act as a late complication, that is, such a pneumonia is developing after the transfer of coronavirus infection. It was noticed that allowacutterial flora most often joins the virus for 4-7 days and we can make the main reason for the inflammation of the lungs.
Other types of viruses, including flu, paragrippa, measles, adenovirus, etc., cause pneumonia after coronavirus, if, after reconditioning from the "crown" with these infections.
When a virus from the nasal or oral cavity in the bronchip is the swelling of the mucous membranes, the pH changes, which disrupts the motionlessness responsible for the natural purification of the lower respiratory tract. The gradual binds swell more and more, and their lumens overlap with mucus, which seriously recalls the passage of air. As a result, the gas exchange of the lungs suffers greatly, the population flows less oxygen, which leads to hypoxia. This is significant affects the work of the whole organism, including headheads, and not just the lungs. In addition, when damaged to the lungs SARS-COV-2, there is a violation of the synthesis of a surfactant - a special substance designed to ensure the correct operation of the alveoli and protects them from the branch tissue, i.e. the development of fibrosis. As a result, viral pneumonia is developing.
Viral particles penetrate the alveoli cells, tammond and subsequently released into the lungs, and the cell perishes. Such, at the same time a large amount of alveoli is affected, their integrity is disturbed by the permeability of the walls. This leads to the fact that they have violated processes, the fluid penetrates into the intercellular space, which leads the disorder of water-salt metabolism. Since in the affected alveols, accumulated cell elements, leukocytes, erythrocytes, it leads to swelling. When the damaged cells of the walls are destroyed, the alveoli is falling down, which provokes breathing disorders whose severity depends on the volume of lung damage.
As a rule, the beginning of the development of coronavirus infection capabilities. Initially, the temperature is raised to subfebrile values, i.e. up to 37.5 ° C, and weakness occurs. This may be accompanied by a minor fierce burned, redness, tear eye. The sars-cov-2 caused by the SARS-COV-2 virus is usually developing at 8-9 days from the beginning of the disease. In many cases, this proceeds asymptomatic, which is the main cunning of inflammation of the lungs of this type. Sometimes appears already on 5-6 days from the beginning of the disease. A number of patients are etched by violations of the work gastrointestinal tract, including nausea, diarrhea, a sequee, and sometimes the appearance of rash on the skin. According to the collected data, such a disease of the disease is typical to transfer the "crown" in less heavy form.
At the later stages of the development of pneumonia, there is an emerging dry cough, chest pain and shortness of breath. The appearance of such signs is adopted by the reason for the immediate treatment for medical care, since characteristic for coronavirus inflammation of the lungs can lead to heavy prevasses, including irreversible fibrosis, which will significantly reduce the limits, the cause of disabilities or even the death of the patient will increase.
When progressing the inflammatory process, the occurrence of acute distress syndrome, which is accompanied by:
- an increase in body temperature to high values, up to 39 ° C;
- reduced arterial pressure;
- greeting heartbeat (tachycardia);
- The progression of respiratory failure, the current circuit in the amplification of shortness of breath, cyanosis (scinting) of the nasolabial triangle, involving the breathing of auxiliary muscles (abdominal muscles, neck), etc.
With severe shortness of breath, patients are trying to take a forced position of the body: sitting, pending hands in front of him in a chair, bed or knees.
If at this time it is to make CT lungs, the bilateral changes caused by viral damage to the remnants are visible in the lungs in the lungs of the darkening of the rounded shape, prone to merge among themselves and the formation of the X-ray sign "The effect of matte glass". The after-solencing of the inflammatory process, dead areas of the lungs by replacing the final scars. X-ray does not give such comprehensive information as CT, and religious situations with a minor volume of lung lesions can be useless, since the changes will not be visible.
Also conditioned by coronavirus pneumonia is accompanied by the walls of the lung vessels with a blood coagulation impairment. Etchoids to the formation of blood clots and a sharp increase in the risk of hydrochromboambolism.
But if the disease is complicated by the addition of bacterial phlora, i.e., the development of secondary viral-bacterial pneumonia, clinical cardina becomes much brighter from the first days. In such situations, it will take off first the bake-like dry cough, gradually wetted with a thickness of thick, mucous-purulent sputum.
A pronounced fever is a typical sign of bacterialine infectirations. At the same time, it can persist long enough and poorly succumb to antipyretic means. Often there are pain in breasts of different-dimensions, amplifying with cough, sneezing, movements.
In general, viral pneumonia with adequate treatment lasts from 2 weeks to 4-6 weeks.
Pneumonia is especially dangerous for older people over 65-70 years old, as well as persons having concomitant diseases, in particular:
- The pathology of the cardiovascular system, since the presence of raising the risk of severe disease and fatal outcome;
- diabetes mellitus, as chronic endocrine proof, accompanied by the damage to small blood vessels, in the lung volume, high blood sugar concentrations;
- bronchial asthma, chronic obstructive diseases of the lungs, as there is already a permanent inflammatory process of religious;
- HIV, cancer, including patients passing therapy or chemotherapy, as it reduces the resistance to infections and increases the risk of pneumonia in severe.
The diagnosis of pneumonia after the coronavirus is comprehensive in the same way as in other cases, i.e., it includes the collection of anamnesis, which the doctor finds out when the first signs of the disease appeared, as the deterioration of the lungs appeared, and so on The time of which you can hear the characteristic wheezes, notice the participation of heartbeat and breathing. Also necessarily measure saturation, t. e. determine the level of blood saturation with oxygen. This non-invasive procedure is less than a minute and is carried out using a pulse oximeter, the patient's finger is supervised.
The PCR is determined by the SARS-COV-2 test, as well as the radiography of the chest organs orcomputer tomography. As part of the diagnosis of pneumonia, it is also necessary:
- OAK - shows the EE, the rise of concentrations of globalocytes and lymphocytes, leukocyte formula, as well as a number of other parameters, which allows to establish the presence of a bacterial infection, although it does not give data from nature;
- OAM - helps to establish characteristics;
- Biochemical blood test - makes it possible to detecting metabolic disorders;
- Sowing sputum - allows you to clarify the diagnosis to determine the pathogen of pneumonia or eliminate the joining Baucterial or fungal microflora;
- blood test for the presence of LG M and LG G on mycoplasma and chlamydia;
- Blood test on LG M and LG G COVID-19.
All these analyzes are extremely important because it allows you to establish the development of inflammation of the lungs, its causative agent and sensitivity by crazing drugs. This allows you to develop the most efficient treatment tactics of pneumonia.
Pneumonia treatment after COVID-19
Inflammation of light lightweight severity can be treated with strict control of the therapist or pediatrician. It is important to ensure maximal insulation of the patient from other family members. If possible, and is responsible for servicing himself, it is worth a while to move to another housing for the Final self-insulation. In the absence of such a possibility, the patient should be obtained to allocate a separate room, dishes, towel, etc. Although it is also necessary to regularly air the room and carry out a wet harvesting of infection of other family members.
The patient passing the treatment of pneumonia at the coronavirus injecting conditions, it is necessary to provide abundant drink, and it is desired to be preferred with warm drinks, such as compote, water, water. But incho-containing drinks, in particular coffee, tea, power engineers, are better looking forward, as they have a stimulating effect on the nervous system, increasing the activity and "distracting" the body from the fight against infection.
Mandatory hospitalization are subject to:
- patients in serious condition with signs of oscortiss-syndrome;
- children under 2 years old;
- Older people over 65;
- pregnant women;
- patients having so much diabetes, bronchial asthma, COPD, IBS and other severe concomitant diseases;
- Oncoboles, especially undergoing chemotherapying course of radiation therapy.
When diagnosing an isolated viral pneumonia, t. E.Pri obtaining negative results of analyzes for bacterial microflora, patients are prescribed drugs 4 groups:
- antiviral agents;
- disintellation preparations;
- means of symptomatic therapy;
Thus, the specific treatment of viral pneumonia does not exist, and all activities are aimed at maintaining the body while the immune system is fighting the virus and caused by changes in the lungs.
When the secondary bacterial infection is connected, antibiotics are prescribed. But at pneumonia, after the coronavirus, they are prescribed, even in the absence of confirmation of the presence of bacterial miforoflora in order to reduce the risk of complication of the flow of the lungs. Therefore, antibiotics are often appointed to all the patients with a diagnosed diagnosis of COVID-19 and pneumonia after it.
In particularly severe cases, the composition of drug therapy includes corticosteroids, which have pronounced anti-inflammatory properties and help protect the walls of alveoli vessels from damage. They are injected intravenously short courses.
With the development of respiratory failure and low levels of patients, patients are treated in the separation of intensive therapy with the use of ascorporal membrane oxygenation, i.e., artificial administration in the elderly acidor, through the use of probes and other means. In particularly complex luminescence, patients are introduced into an artificial to whom and connect to the equipment of the lungs to stabilize the state of the patient and eliminating the fatal outcome.
Pneumonia, due to the SARS-COV-2-new phenomenon for modern medicine, which has become a challenge for it, the task of choosing and synthesize new effective to this strain of virus drugs. Thus, today for the treatment of inflammation in such situations, drugs on bihibitories proteases are used, in which Lopinavir, Ritonavir, Avifavir acts as an active substance.
Also, the antimalarial preparations accomplice to SARS-COV-2 are also well established in the fight against SARS-COV-2. But they adversely affect the structural-vascular system, so the decision on their use, especially the decorates with diseases of the heart and vessels, is accepted strictly individuals of careful weighing risks and expected benefits.
In recent years, the pharmaceutical market has emerged by the mass of the general purpose of general purpose: Arbidol, Amixin, Olilocqing, etc., even before the appearance of COVID-19, they were often appointed by pediatricians and therapists with ORVI, flu and other viral infections. Their effectiveness was confirmed during clinical studies and it was proved that drugs of this kind contribute to the increase in the natural protective forces of the body, and also stop or at least slow down the breeding of the virus. Therefore, they are also often recommended to be taken with pneumonia at coronavirus infection or after its transfer.
Interferons are natural biologically active substances that are generated in the human body in response to viral invasion. Today, their chapsev is obtained by genetic engineering methods. Interferon-based drugs are prescribed from the very first days of transferring viral infections from the very first days of viral infection, in the volume provoked the development of inflammation of the lungs, since they are with controversial and immunomodulating properties. But so far the imputed evidence base of their effectiveness.
Since at pneumonia, the body is experiencing intoxication, especially with the difficult course, patients are often prescribed by means cleansing it from harmful substances. In the overwhelming majority of cases, it is carried out in the hospital, as it assumes intravenine infusion of glucose, saline solution, polyglyukin, as well as an introduction to the risk of the development of vascular disorders.
Means of symptomatic therapy
Mandatory with pneumonia after coronavirus, prescribes the preparations that improve the health of the patient. It:
- Mulcolitis - a group of medicines that contribute to a decrease in sputum viscosity, which leads to the relief of the lungs from the lungs and bronchi without increasing the secret in the amount;
- Expectorant - drugs that have an irritant to bronchial receptors, provoking the cough reflex, which is the promotion of respiratory tract from sputum;
- antipyretic - drugs, detecting the body temperature;
- Broncholitics - a group of drugs, providing bronchi and a decrease in bronchospasm, which contributes to the elimination and relief of breathing;
- Inhalation corticosteroids - drugs designed to quickly stop the inflammatory process in bronchops and lungs.
With viral, as well as viral-bacterial pneumonia, Poshonoronavirus treatment includes the use of vitamins. First of all, the vitamin D, C, A, as well as groups of V. They contribute to the acceleration of the restoration of damaged sludge lung shells, hemoglobin synthesis, improved blood circulation, strengthening of vessels, normalizing the flow of metabolic processes.
When diagnosing secondary viral-bacterial Pneneviation, the antibiotic is selected in accordance with the results of Bakposposev. Outstrands are prescribed an antibacterial preparation of a wide range of action.
Thus, the preparations of choice can be:
- beta-lactam antibiotics;
- Hinolone 3rd generation.
Against the background of receiving antibiotics, and after the end of the course is assigned a reception of pre- and probiotics. These drugs contribute to the restoration of the normal intestinal microflora, which is also part of the body's immune system.
With pneumonia, due to coronavirus infection, for the public categories, the forecast is favorable. In 50-60% of cases, atproof in a light form. Complications occur only in 3-10% of patients, an aletal outcome is observed in 1-4% of people, but in the older age group 65 + mortality in different countries reaches 20%.
At the same time, the assessment of the dynamics of the patient's condition during the impartialness after the coronavirus is carried out on the basis of the existing clinical cardin. Radiological indicators are paid significantly less attention, since even a month later, CT can show the same changes in the lungs that Iv the midst of the disease. Therefore, the control tomography should be conducted no earlier than 3-6 months after the start of the disease.
Inflammation of the lungs and pneumonia What is pneumonia? The difference between pneumonia and lung inflammation. Symptoms of pneumonia at coronavirus How much temperature is held at pneumonia Types of pneumonia Pneumonia without temperature Polycegimentary pneumonia Heat pneumonia Atypical pneumonia Complete pneumonia Viral pneumonia Brewing pneumonia Pneumonia without cough Interstitial pneumonia Pneumatic pneumonia Mycoplasma pneumonia Pneumonia in children Inage pneumonia Treatment of pneumonia How many days is the pneumonia Bilateral pneumonia in an adult. Duration of treatment Clinical recommendations Treatment of pneumonia at home Treatment with folk remedies Preparations for the treatment of pneumonia Antibiotics at pneumonia Breathing exercises For the prevention of pneumonia For rehabilitation after pneumonia
Inflammation of the lungs and pneumonia
What is pneumonia? The difference between pneumonia and lung inflammation.
Pneumonia or lung inflammation is a group of diseases in which inflammatory processes develop in the lungs. There is no difference between pneumonia and lung inflammation . These processes most often become the results of infections, viruses, microbes, and pneumonia is often infectious. Irriters are striking the pulmonary tissue, and an inflammatory process develops intensive treatment.
Pneumonia can be a consequence:
- unrealized colds, ARVI, flu or bronchitis;
- the effects of viruses, bacteria and fungi, for example, chlamydia, legionell, mycoplasmas;
- noncomfortable temperature (supercooling of the lungs);
- the effects of poisonous particles in air or radiation;
- Complications after an allergic cough.
Symptoms of pneumonia
- temperature increase;
- shortness of breath and cough;
- chills, fever;
- weakness , headache;
- complicated inhale, chest pain with deep breath;
- Signs of intoxication.
Increased temperatures up to 38-39 degrees - one of the main signs of lung inflammation. It is accompanied by a strong chills, can rise and descend during the day within 1-1.5 degrees. Increased temperature can last up to 10 days.
In many ways, severe weakness, increased sweating, headache, violation of the chair and abdominal pain in pneumonia are associated with the intrication of the body, its poisoning of tissue decay products and toxins.
Today, much attention is paid to psychosomatics of pneumonia. Long stress, weakening the body, chronic diseases and serious overloads of an unprepared organism can become soil for the development of pulmonary diseases and lead to inflammation of the lower respiratory tract.
At the same time, the usual therapy with antibiotics can be unsuccessful, a long recovery period is necessary to normalize the functions of the nervous system and the restoration of the body's forces.
Symptoms of pneumonia at coronavirus
Pneumonia can be caused by a number of viruses, the main of which is called adenoviruses, influenza viruses and coronaviruses (including those dangerous SARS-COV-1, Mers-COV and the SARS-COV-2 pandemic).
If the coronavirus causes pneumonia, usually this process is "launched" by conventional cold symptoms: a temperature of 37.5-38 degrees, pain in the throat, a loss of smell, cough, blessed body and pain in the muscles. As a rule, these symptoms last about 7 days. After that, the temperature rises up to 40 degrees, intoxication is rapidly increasing, shortness of breath and thoracic pain appear. Fever, chills, high sweating and severe weakness - also symptoms of the development of coronavirus infection in pneumonia.
The cough is dry, or with unseen wet, sometimes it can be a rusty shade due to the destruction of capillaries.
One of the distinguishing symptoms of pneumonia at Coronavirus is a limited breath, with a serious course of the disease, almost the impossibility of independent breath. With non-complicated inflammation of the lungs, heavy shortness of breath is observed in the defeat of several pulmonary fractions and is not manifested alone. Pneumonia caused by coronavirus is characterized by a frequency of breathing more than 22, the patient constantly experiences a sense of lack of air, the impossibility of a full breath.
Respiratory failure leads to the sinusiness of the nasolabial triangle, the patients have a forced breathing, in which intercostal muscles are actively involved. Patients seek to accept unusual postures to relieve inhale. Due to the lack of oxygen intake in the brain, patients may experience confusion, panic attacks or fainting.
How much temperature is held at pneumonia
There are two types of temperature at lung inflammation - subfebrile and high.
With pneumonia, the temperature can sharply grow to the indicators of 39-40 degrees and can hold over two weeks. It is important to remember that the decrease in temperature is important to carry out a doctor under observation and fully comply with the individual protocol of antibacterial therapy. Although the high temperature is a symptom, often for pneumonia, a decrease in it is part of the total treatment.
When the body temperature indicators reaches marks in 40 degrees, you need to call an ambulance . This increase in temperature can say that the immunity of the body does not cope with infection, and he needs emergency assistance.
Subfebrile temperature at pneumonia is within 37-38 degrees. In the absence of severe shortness of breath, it is usually not recommended to bring down this temperature. It provides the body with the possibility of an immune response to a viral attack. Increased temperature signals the lack of organism's own resources to suppress viral infection.
The temperature is normalized when the organism's viral lesion is reflected after antibacterial therapy.
Types of pneumonia
Pneumonia without temperature
Pretty dangerous view - asymptomatic pneumonia not manifested with increased temperature. In this case, there may be no symptoms except weakness. The body may not signal the disease even a cough. Often, such a situation is a consequence of a weak immune response and the inability of the body to deal with the virus.
Doctors advise to pay attention to the complexion of a person, often on it is characteristic spotted blush against the background of very pale leather. Human breathing occurs with a whistle. When moving, shortness of breath and a frequent pulse appear. The body is weak, quickly tires, pain in the chest and difficult to breathe.
Asymptomatic pneumonia is dangerous in that the cough is not manifested, and the unnecessary sputum does not go out. The infectious process is stood in the lungs. Often it is a consequence of unrealistic colds or bronchitis.
For diagnosis, the chest radiograph is carried out in 2 projections. The main sign of pneumonia is limited darkening of the pulmonary fabric.
Two-sided polysegnatory pneumonia strikes several fabric segments of both lungs. Children are often ill under the age of one year and people with low immunity. The first stage of the disease may be asymptomatic or similar to ORVI .
The development of symptoms of bilateral pneumonia is a cough with a springs, shortness of breath, wet wheezes in lungs, chest pain. This clinical picture is accompanied by an increase in temperature to 39-40 degrees, fever, high sweating, tachycardia, headaches and change in consciousness. With a regular pneumonia in bronchi, a wet wet occurs, which is difficult to depart due to the progressive edema.
Acute form of the disease with the flow of the inflammatory process on a limited piece of lung tissue (loss). The symptoms of this form of pneumonia are fever, dry cough or a slight compartment of sputum, pain in the chest, general weakness.
Often, focal pneumonia is a complication of sharp respiratory infections and bronchitis. This diagnosis increases during seasonal ORVI and flu.
The body temperature rises to 38-39 degrees, sometimes it can be normal or have subfebris. Breathing is rapid up to 25-30 units, tachycardia is shown to 110 ° C. in min.
Fever is usually terminated after 3-5 days after the start of antibacterial therapy. The term of removal of symptoms of focal pneumonia is 3-4 weeks.
Atypical pneumonia is an infectious disease accompanied by inflammation. This lung defeat causes uncharacteric pathogens - viruses, mycoplasma, chlamydia and other numerous infectious agents.
This type of disease differs from the "typical" pneumonia caused by the bacterial cockkalo flora. Symptoms of atypical pneumonia:
- Head and muscle pain,
To diagnose atypical pneumonia, it is necessary to determine the pathogen, for which the methods of PCR, reef, culture sowing are used. It is necessary to carry out the lung radiography. After identifying the pathogen, medication is prescribed.
Atypical pneumonia caused by coronavirus is called the "sharp respiratory disease syndrome" (SARS). It is difficult to identify the infectious agent, and therefore for treatment, due to the rapid mutation of the virus.
Infection of atypical pneumonia is airborne droplet. The incubation period is from 3 to 10 days. Depending on the causative agent, atypical pneumonia is divided into:
- Fever Q,
- chlamydial pneumonia
- legionell pneumonia,
- Heavy acute respiratory syndrome,
- Mycoplasma pneumonia, etc.
Among the drugs recommended for the treatment of atypical pneumonia, the basis is Ribavirin, which is widely used today for the treatment of pneumonia caused by coronavirus. After the start of treatment, corticosteroids are introduced into the protocol, the blood plasma transfusion is used in severe cases. Oxygen therapy, diuretics are used to prepare for the prevention of pulmonary edema, infusion therapy for removing intoxication, symptomatic treatment from cough and symptoms of respiratory syndrome.
Community-hospital pneumonia is not associated with the stay of the patient in the hospital. This diagnosis is made when the sick was not atponed or sick with pneumonia, no less than 14 days after discharge or no later than two days after hospitalization.
Complete-headed pneumonia develops due to the impact of pathogenic microorganisms on the respiratory tract. This happens with an imaginary history of cardiovascular or metabolic diseases, the unhealthy lifestyle of the patient, weak immunite, the state of old age or with a strong overcooling.
Pneumococci, streptococci, hemophilic stick, staphylococci, chlamydia, legionells, adenoviruses penetrate the human body in living conditions, in places of large accumulation of people with air-droplet, falling into the air when coughing and sneezing From the respiratory tract of the patient.
With reduced immunite and other adverse factors, the drainage system of the lungs is broken, and pathogenic microorganisms remain in them, causing an inflammatory process.
Medical therapy under the protocol associated with identified bacteriological analysis is applied to the treatment of community-acquired pneumonia.
Viral pneumonia is caused by respiratory viruses, often well familiar to us. These are influenza viruses, paragrippa, enteroviruses, adenoviruses. Therapy of viral pneumonium is the reception of antiviral and symptomatic means.
Symptoms of viral pneumonia sharp:
- sharp rise in temperature
- Inxication syndrome,
- strong productive wet cough,
- Pain in the lungs.
The diagnosis of viral pneumonia is carried out on the basis of laboratory data.
Often, viral pneumonia develops on an ARVI, in this case, typical symptoms of respiratory disease are aggravated for several days with a strong fever, cyanosis, a cough with a "rusty" color, wheezing in lungs and chest pain.
Viral pneumonia caused by the influenza virus is often double-sided, with focal lung lesions. At the same time, among viral pneumonia, there are often cases of relatively light shape of the disease with moderate symptoms and rapid recovery.
In childhood, viral pneumonia accounts for 90% of all types of this disease. In severe cases, viral pneumonia occurs in children hard:
- with high temperatures
- intense symptoms of intoxication,
- lack of appetite or full eating failure,
- Strong cough.
In severe cases, inpatient treatment is appointed.
Adults are sick with viral pneumonia less often than children (the percentage of viral pneumonium among other types of disease does not exceed 35%). More often than 65 years old viral pneumonia suffer. The frequency of the disease increases in the autumn-winter period.
Brewing pneumonia is an acute infectious disease. This diagnosis is made by the defeat of one or more lung fractions when the fibrinous traffic and fibrinous overlaps on Plegre appeared in the alveoli.
The most frequent causative agents of bruboral pneumonia - pneumococci, and the main cause of the disease is to reduce immunity.
The disease begins acutely, with an increase in temperature to 39 degrees, chills, pain in the chest. The dry cough is replaced by the release of "rusty" sputum. Six expressed shortness of breath. Breath hard, with wet and dry wheezes. Subsequently, voice jitter is detected due to impaired breathing. Brewing pneumonia may be accompanied by a violation of cardiac rhythms, a decrease in pressure and strong headaches.
At the end of the acute phase of the disease, respiration is normalized, with a frequent pulse and a decrease in blood pressure can still be disturbed by the patient.
The bruboral inflammation of the lungs is the disease of adults, and it is treated in the hospital in the therapy separation.
Pneumonia without cough
Pneumonia is most often accompanied by a characteristic set of symptoms, however, it happens that the disease occurs in a hidden form. Asymptomatic pneumonia is difficult to diagnose, as the patient cannot recognize the health problem according to explicit features. Latent pneumonia can occur without temperature and even without wheezing in the lungs.
Most often, the hidden pneumonia is ill people over 60 years old.
Violations in the work of the immune system is the main cause of asymptomatic pneumonia. It can also develop due to improper reception of cough drugs during the respiratory disease. With a bad sputum removal, it accumulates in the lungs and becomes a medium for breeding pathogenic flora.
Complication after influenza, bronchitis or ORVI is another cause of asymptomatic pneumonia.
If there is no cough, but there are suspicions of the disease, you need to listen to the following symptoms:
- strengthening weakness
- Reduced performance
- Strong headaches.
In the patient, strong sweating, frequent pulse, shortness of breath and pain in the chest. Temperature can increase.
To detect pneumonia with hidden symptoms, it is necessary to carry out deep diagnostics, which will help determine the stage and severity of the disease.
Interstitial pneumonia is an inflammatory process, in which the alveoli walls and the parenchyma junction tissue suffer. Disease cause infectious agents:
- Respiratory viruses
- Herpes virus.
Also, interstitial pneumonia can be a reaction to dust. Defeat with interstitial pneumonia focal or diffuse, and it can cover a share or everything easy.
Symptoms of the disease:
- dry cough,
- Pain in the chest,
- temperature up to 38 degrees,
- Cardiopulmonary failure.
The disease is determined using CT and laboratory diagnostics.
The disease can occur hard, when it is high, the likelihood of lung fibrosis. In the risk group:
- People with alcoholism.
Interstitial pneumonia can flow in chronic form (more than 12 months), all this time the patient is limited in activity, suffers from severe breath, high fatigue. Often there is a strong weight loss.
Treatment includes oxygen therapy, corticosteroids, cytostatics. By reducing the respiratory function, the IVL is prescribed.
Pneumatic pneumonia refers to atypical pneumonia. Her infectious agents - Simple microorganisms Pneumocists. The disease is transmitted by air-droplet and often develops in people with an affected immune system.
In the risk risk group of pneumatic pneumonia:
- elderly people,
- Sick HIV,
- Patients with blood diseases,
- Patients taking immunosuppressants.
The disease may have relapses. In particular, in patients with HIV infection in the AIDS stage, the likelihood of re-illness is 25%.
Pneumocists fall into the body through the respiratory tract, actively multiply, provoke the appearance of a large amount of mucus and exchange products. Finding into the blood, infectious agents provoke the formation of specific antibodies. Alveola are amazed, gas exchange is broken. In conditions of respiratory failure, fibrosis of lungs is developing, subsequently - emphysema and pneumothorax.
Symptoms of the disease first look like signs like ARVI or Larygitis. The period of the first stage is up to 10 days. Weakness, strong cough, decreased body weight in the second stage of the disease is enhanced by a strong breath. Skin covers acquire a shiny shade. Cough becomes productive with difficult wetting.
The third stage brings relief symptoms, but wheezes in the lungs and symptoms of weakness can still be maintained.
Treatment of pneumatic pneumonia occurs in the hospital and includes antibacterial and symptomatic treatment.
Mycoplasma pneumonia is an atypical pulmonary infection. Infectious agent - Mycoplasma Pneumoniae. This type of pneumonia is characterized by:
- obsessive cough
- pain in the chest and muscular pains,
- Aclays and violations in the work of the gastrointestinal tract.
Mycoplasma pneumonia more often sick children, teens and adults up to 35 years old.
With a high prevalence of the disease, mycoplasma is malpressible in external conditions. They react to change in temperature (in particular, on heating), do not grow in dry environments.
These microorganisms often become causes of bronchitis, bronchial asthma, they are also able to cause a respiratory pathology (otitis, encephalitis, meningitis, anemia).
The incubation period in mycoplasma pneumonia is usually 12-14 days. The disease rarely begins acutely, more often is the appearance of symptoms of laryngitis, less often - bronchitis. Weakness, sweating, temperature rise to 38 degrees also accompanies the beginning of the disease.
Complications of mycoplasma pneumonia can be:
- Stevens-Johnson's syndrome,
- Hyien Barre Syndrome,
Recognizing the disease at an early stage, it can be cured for two or three weeks. Macrolids, fluoroquinolones, bright agents, expectorant means are prescribed for treatment, immunomodulators, physiotics, massages, respiratory gymnastics.
Pneumonia in children
Pneumonia in children is an acute infectious damage to the lungs. She proceeds short. Cough and symptoms of intoxication.
The intrauterine infection of pneumonia occurs due to herpes viruses, chlamydia. Medicine already known cases of intrauterine pneumonia caused by coronavirus.
In the first year of life, the sorcerer and hemophilic wand. Preschoolers are sick pneumonia, the reason for which is:
- infection with hemophilic and intestinal chopsticks,
- Golden Staphylococcus
- Sinnaya wand.
Schoolchildren more often sick atypical pneumonia.
In the risk risk group of pneumonia - children with immunodeficiency, suffering stress, cooling or suffering from chronic infectious diseases.
Treatment of pneumonia in children consists of antibiotics, antipyretic, expectorant, bronchoditics. After the acute phase and during the rehabilitation period, physiotherapy, massage and therapeutic physical education are shown.
Children's pneumonia in case of timely detection is treated at home, and serious cases in the hospital, and quite successful. At children's pneumonia, hospitalization is not always shown, and if parents will continue to receive receptions, children's pneumonia is cured within 2-3 weeks.
Pneumonia or not - depends on its type and causes of the disease. At the same time, directly pneumonia cannot be infected, but the pathogenic microflora, penetrating another person in the body, can become a source of inflammatory process, in that force and pneumonia.
Inflammation of the lungs can cause bacteria, viruses, fungi, simplest. The greatest danger to others, the person is at the initial stage of the disease, when coughing and the cough is distinguished by infectious agents.
But it is important to remember that even when infected, the development of the inflammatory process may not happen. Strong immunity does not give to develop pneumonia, and the whole struggle with the infectious agent occurs in the upper respiratory tract. In other words, the same infectious agent may cause different reactions from different people: from light ARVI to severe pneumonia.
The risk of sick pneumonia is present more:
- in children up to 1.5 years,
- old people,
- those who suffer immunodeficiency
- suffering from chronic pathologies of the cardiovascular system, bronchi and lungs, kidneys,
It is important to remember, some types of pneumonia are not contagious. These are the types of disease that are not related to infection. For example, the inflammation of the lungs, which arose due to the stagnation of the liquid in the respiratory tract.
Treatment of pneumonia
How many days is the pneumonia
The duration of treatment depends on the root causes of pneumonia. Pneumococcal infection can be defeated in 7 days. Legionells or staphylococcus cause pneumonia that needs to be treated at least three weeks. The cynical wand will force therapy to forty-two days. Complicated pneumonia has to be treated until two months.
The focal pneumonia is treated faster than secrecy. In the first case, the clinical picture becomes favorable for ten days, in the second treatment takes about a month.
Bilateral pneumonia in an adult. Duration of treatment
In predicting the treatment of bilateral pneumonia, an adult should always take into account chronic diseases, the state of immunity and causes of the disease. Patients with severe damage to metabolism, diabetes mellitus, high degree of hypertension, heart diseases are chances of longer treatment and long rehabilitation after pneumonia. The clinical picture can detect the symptoms of pneumonia to two months from the beginning of therapy, while the strong body can cure in one month.
The latest clinical recommendations for the treatment of pneumonia are contained in the letter of the Ministry of Health of the Russian Federation of March 6, 2020 N 30-4 / I2-2702 "On the algorithm for the provision of medical assistance to the adult population with community-hospital pneumonia." The document is relevant, and determines the procedure for the diagnosis and treatment of all types of community-hospital pneumonia (those that have developed outside the hospital, or diagnosed in the first 48 hours from the moment of hospitalization). The letter determines the rules of hospitalization in pneumonia, the deadlines for the start of antibacterial therapy after the diagnosis, the classification of the forms of the disease according to the severity, based on the symptoms.
Clinical recommendations give the most detailed information on the diagnosis and treatment of pneumonia, but they are addressed to doctors and medical personnel. Everyone can find on the network and read them to raise awareness of the disease, but In no case should not be engaged in self-diagnosis and self-treatment for prescribed protocols of antibacterial therapy . At the first signs of ailment, you should consult a doctor.
Treatment of pneumonia at home
Clinical recommendations give clear criteria for hospitalizing patients with pneumonia. Patients with a light form of the disease and many of the pneumonia suffering from the middle severity without burdened history are home treatment.
The main rules for the treatment of pneumonia at home:
- compliance with the protocol of antibacterial therapy;
- compliance with the beddown first days and abundant drink for removing the symptoms of intoxication;
- the need to get up every 5-6 hours and slightly move up to 20 minutes;
- After the normalization of the clinical picture, short walks are shown;
- Full, but light food;
- Complete smoking;
- Support for air humidity in the room within 60-70%.
Treatment with folk remedies
Many in the treatment of pneumonia drugs are resorting to people supporting treatment with funds. The most common of them are medicinal herbs. Herbraises help expectoration, reduce the inflammatory process, remove bronchospasms.
Herbs reduce the swelling and possess a diuretic effect, activate the activity of the immune system, which is well supported by the therapeutic course.
It is useful to drink drinks with a rich content of vitamin C: a decoction of rosehip, cranberries, lingers, viburnum.
In the treatment of pneumonia, garlic, honey, are used by folk remedies, make various compresses and tincture. With the abundance of folk recipes for the treatment of pneumonia it is important to remember that Consultation with the doctor is necessary in each case of their application . Each folk remedy should be built into therapy and do not interfere with its successful flow. Therefore, if you wish to resort to the help of traditional medicine, it is worth not overloading the body and follow the principles of rationality and consistency with the main protocol of treatment.
Preparations for the treatment of pneumonia
Antibiotics at pneumonia
Treatment of patients with a light form of pneumonia takes place at home. It is usually possible to cure it with pills or suspensions. The doctor prescribes the antibiotics of the β-lactam row (amoxicillin, amuxyne, solutab). For older patients or with severe chronic diseases, protected penicillins and fluoroquinolones are prescribed (amoxiclav, Flemoclav Soluteab, Aveoks).
For the treatment of patients with severe and extremely severe pneumonia, drugs III and IV generations are used, which have a bactericidal effect, fully destroying the cells of the pathogen. Among the representatives of cephalosporins III generation are oral and parenteral forms. In the first subgroup, supraks are common in capsules and suspensions, cedaxes in capsules and spectroseph in capsules, cepditogen, ceftazidim, cefoperazone
To destroy mycoplasm at pneumonia, antibiotics of macrolides are suitable against atypical flora, tetracyclines - reserve drugs, doxycycline (Unidox Solutab).
Adequate therapy of pneumonia can not do without antibiotics. This is the only modern and effective measure to eliminate the cause of the disease - microorganisms. All prescriptions of drugs must be controlled by the doctor, self-medium is fraught with the aggravation of the course of the disease and the development of the immunity of bacterial cells to the effects of antibiotics.
For the prevention of pneumonia
Today, the prevention of pneumonia is one of the most important in the complex of health practices and care for the state of the human body. It became obvious that lung damage is a real threat, much more massive and relevant than it seemed recently many of us. The coronavirus pandemic made adjustments not only to our lifestyle, but also made the most relevant care of our respiratory system, about its healthy and full-fledged state.
One of the most efficient ways of preventing pneumonia is regular respiratory training with a simulator "Samolader". And there are reasonable causes and many years of indisputable confirmation.
The breathing exercises strengthen the respiratory muscles, which increase the mobility of the chest and the diaphragm. Effective movements of the respiratory muscles increase the amount of chest and lungs. This provides maximum driving ventilation and air circulation in the alveoli and increases the use of oxygen use in the lungs and its admission to the tissues.
Maintaining normal light volumes and regular respiratory tracting forms the right respiratory rhythm. As a result, the respiratory frequency is normalized, its minute volume and other indicators that are violated due to stress, hypodynamine, chronic diseases. Physiologically correct breathing is preserved for a long time.
Breathing training maintain elasticity of light tissue. This increases the vital capacity of the lungs, prevents the development of fibrosis and other changes in light tissue. CO2 eliminates the spasm of the bronchi, which also increases the effectiveness of breathing.
Breathing training increases the effectiveness of a small circle of blood circulation. This is especially important for the people of old age, because one of the frequent causes of the pneumonia of the elderly - blood in a small circle.
As a result of the restoration of the functions of the respiratory system and blood circulation, a decrease in the inflammatory process occurs, the prevention of stagnant phenomena in bronchops and lungs and resorption of mucus and exudate is carried out.
In addition, the "self-sharp" compensates for the lack of physical activity, and respiratory training, as well as exercise, contribute to the production of natural antioxidant (superoxiddismutase) impeding the development of pneumonia.
All these arguments are the result of deep numerous studies related to the study of the effects of respiratory training with the "self-coach" on human lungs and the prevention of pneumonia, as well as the experience of people of different ages and a different level of health.
Today, millions of people from different countries of the world are trained with "self-coastal" for the sake of preventing the development of pneumonia - one of the main dangers for the body during the pandemic period.
If you want to get one of the most effective ways of care about your respiratory system, an indispensable assistant for the prevention of pneumonia, acquire the respiratory simulator "Samolader". Many years of experience proved its effectiveness, availability and the highest results in maintaining the health of the lungs.
For rehabilitation after pneumonia
In a difficult period of threats to a high viral load on the body, it is important to know how to quickly return the shape after pneumonia and give your easy to earn money again. First, it is important to comply with general rules for concerns about yourself and your health. Sleep at least 8 o'clock at night and a couple of hours in the afternoon, well eat, not forgetting about vitamins A, B, C and calcium, to air the room every three hours.
Special attention should be paid to your light, devote time to respiratory training to improve the pulmonary muscles. Due to the respiratory training with the simulator "Samozdrav" will be dissolved exudate, the wet branch will be easier, the respiratory tract will be cleaned, the pulmonary fabric will retain health and elasticity, normalizes the tissue exchange and inxication will be eliminated, accompanying the acute stage of the disease. Healthy breathing and normal amount of breath will be restored, the sword will leave due to the normalization of the level of oxygen in the body,
In the process of breathing training with the simulator "Samolader", rehabilitation after inflammation of the lungs will be successful, will pass quickly and comfortably, and you will be able to regain their vital energy in a natural way - training through proper and healthy breathing.
Pneumonia (lung inflammation) is inflammation of the fabric in one or both light caused by infection.
At the end of the breathing tubes in the lungs (alveolar strokes) there are tiny bags filled with air (alveoli) collected in bundles. With pneumonia, these bags are inflamed and filled with liquid.
The most common symptoms of pneumonia:
- labored breathing.
The most common cause of pneumonia is a pneumococcal infection, however there are many other types of bacteria and viruses causing pneumonia.
Patients with a light form of pneumonia are usually treated at home. They give antibiotics, abundant drink and provide peace. People with good health usually recover without any consequences.
In patients with other diseases, pneumonia can be in severe, and they may need treatment in the hospital. This is caused by the fact that pneumonia can give complications, which, depending on the state of health and the age of the patient, can even lead to a fatal outcome.
According to various data in Russia, pneumonia sicks every year 1-2 million people. People often sick pneumonia in autumn and winter. Mortality from community-hospital pneumoniums in Russia is of different data from 1% to 5%, but among patients requiring hospitalization and in older people, this indicator is many times more. Pneumonia can be sick at any age.
Symptoms of pneumonia
Symptoms of pneumonia can develop very quickly (for 24 to 48 hours) or relatively slowly, within a few days. The manifestations of the disease differ and can be similar to the symptoms of other respiratory infections, such as acute bronchitis.
For pneumonia is characterized by cough. It may be dry or accompanied by the release of sputum (thick mucus) of yellow, green, brownish color or even bleeding.
Other common symptoms:
- Difficult breathing - the breaths are frequent and shallow, possibly shortness of breath even during rest;
- heart palpitations;
- a strong increase in body temperature;
- common poor well-being;
- sweating and chills;
- lack of appetite;
- Pain in the chest.
Among the less common symptoms are the following:
- cough with blood (hemopying);
- whistling breathing;
- pain in the joints and muscles;
- Loss of orientation in time and space (especially in the elderly).
If you have discovered the symptoms of pneumonia, consult a doctor to diagnose. If you have pronounced symptoms, in particular, rapid breathing, pain or disorientation in space, consult a doctor immediately.
Causes of pneumonia
The most common cause of pneumonia is infection, usually bacterial origin.
However, pneumonia causes various types of bacteria, viruses and (occasionally) fungi, depending on where pneumonia began. For example, microorganisms causing pneumonia, praised in the hospital, differ from those that can cause it in ordinary life.
Microorganisms that cause infection usually fall into the lungs when inhaled. In rare cases, pneumonia can be caused by infection in another body part. Then the pathogen of pneumonia penetrates into the lungs through blood.
Below in detail the four types of pneumonia are described.
The most common cause of pneumonia in adults - Bacteria Streptococcus Pneumoniae. This form of pneumonia is sometimes called pneumococcal.
Less often, the causative agents of pneumonia are other types of bacteria, including:
- Haemophilus influenzae;
- Staphylococcus aureus;
- Mycoplasma Pneumoniae (outbreaks of morbidity occur on average every 4-7 years, usually among children and young people).
In very rare cases, pneumonia causes the following bacteria:
- Chlamydophila Psittaci: This bacterium is a rare form of pneumonia, which is called ornithosis or psitactosis, which is transmitted to people from infected birds, such as pigeons, canary, long-tailed and wavy parrots (this form of pneumonia is also called a parrot disease or a parrot fever);
- Chlamydophila pneumoniae;
- Legionella Pneumophila: Causes Legionells, or "Legionnaire Disease", an unusual form of pneumonia.
Viruses can also cause pneumonia, most often it is a respiratory syncitial virus (RSV) and sometimes influenza virus type A or B. Viruses are most often becoming pathogens of pneumonia in young children.
In rare cases, the cause of pneumonia is getting into the lungs
- foreign bodies, such as peanuts;
- harmful substance, such as smoke or chemical.
An inhaled object or substance causes irritation of the lungs or damages them. This phenomenon is called "aspiration pneumonia."
Pneumonia caused by fungal infection of the lungs is rarely found in people with strong health. More often, it affects people with a weakened immune system (see below). Although fungal pneumonia is rare, people travel more often traveling to the places where this type of infection is more common: individual regions of the United States, Mexico, South America and Africa.
Some medical names of fungal pneumonia: histoplasmosis, cocidioidomycosis and blastomicosis.
Risk Groups for Lung Inflammation
People in the following groups are more susceptible to risk of pneumonia disease:
- Breast babies and young children;
- elderly people;
- patients with other diseases;
- People with a weakened immunity.
Diseases increasing the likelihood of pneumonia disease:
- Other lung diseases, such as asthma or fibrosis (fibrous-cystic degeneration or cystic fibrosis);
- heart diseases;
- diseases of the kidneys and liver;
- Weed immunity.
Your immunity can weaken:
- recently suffered disease, such as influenza;
- cancer treatment, such as chemotherapy;
- Some medicines taken after the transplantation of the body (they are specifically taken to weaken the immune system, thereby reducing the rehabilitation of the transplanted organ);
- HIV or AIDS.
Diagnosis of pneumonia
The doctor often can diagnose pneumonia, interviewing you about the symptoms and inspected the chest. In some cases, additional research may be required. Sometimes pneumonia is difficult to diagnose, as many symptoms coincide with other diseases, such as colds, bronchitis and asthma.
To make a diagnosis, the doctor may first ask:
- Do you breathe more often than usual;
- Do you suffer from shortness of breath (you feel the fattened);
- How long do you have a cough;
- Expectors are you sputum, and what color is it;
- Chest pains in breathe or exhale are enhanced.
The doctor will most likely measure the temperature to you and listens to the stethoscope in front and behind, to determine whether characteristic crackling or rattling sounds are heard. It can also listen to your chest, tapping on it. If your lungs are filled with liquid, they make a sound, which differs from the wrong, healthy lungs.
To confirm the diagnosis, the doctor will send you to the chest x-ray and other studies. The chest x-ray can show how much your lungs are amazed. X-ray also helps the doctor to distinguish pneumonia from other infectious diseases of the lungs, for example, bronchitis. In addition, a sputum analysis and blood test is carried out. Analysis of sputum or blood samples helps determine the cause of infection - bacterium or virus.
Screening on lung cancer
Although it is rarely found, but pneumonia can be a symptom of hidden lung cancer in smokers and people over the age of 50. If you fall into one of these groups, your doctor can direct you to the chest x-ray. Lung cancer on X-ray usually looks like a lot of "white-gray".
If X-ray examination has not revealed cancer, it is recommended to make a re-image after 6 weeks. This is done in order to accurately make sure that with your lungs are all right.
Treatment of pneumonia (inflammation of the lungs)
Patients with a light form of pneumonia are usually successfully treated at home. They give antibiotics, abundant drinking and provide complete peace. In more severe cases, treatment may be required in the hospital.
Treatment of inflammation of light houses (outpatient)
Cough can last another 2-3 weeks after the end of the course of antibiotics, and the feeling of fatigue can remain even longer, because your body will be recovered after the disease. If the symptoms are not started to take place within two days after the start of treatment, report it to your doctor. The effect of treatment may not be for the following reasons:
- Bacteria causing an infection may be resistant to those antibiotics that you have taken - your doctor can register you another antibiotic in return or in addition to the first;
- The infection can cause a virus, and not bacterium - antibiotics do not act on viruses, and the immune system of your body will have to struggle with a viral infection, producing antibodies.
To facilitate the symptoms of pneumonia, you can take painful, such as paracetamol or ibuprofen. They will help relieve pain and knock down a high temperature. You should not take ibuprofen if you have:
- Allergies to aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs);
- Asthma, kidney disease, stomach ulcer or digestion disruption.
It is not recommended to take a cough medicine that hovering the cough reflex (codeine, libeksin, etc.). Cough helps to clean the lungs from sputum, so if you stop the cough, the infection can remain in the body longer. In addition, there is little evidence that the cough funds are effective. Warm drink with honey and lemon will help to remove discomfort caused by cough. Drink a lot of fluid to prevent dehydration, and a lot of rest to your body recover.
If you smoke, now it is ever important to quit smoking, as it harms your light.
Pneumonia is rarely transmitted from one person to another, so the patient can be surrounded by people, including family members. However, people with a weakened immune system should avoid contact with pneumonia patients before it starts to get better.
After facilitating the symptoms, you may need some time for complete recovery. At the same time, the cough can be preserved. If it bothers you, talk to your attending physician.
Treatment of pneumonia in hospital (stationary)
With severe symptoms, you may need to go to the hospital for treatment. Treatment in the hospital will include the reception of antibiotics and fluids intravenously through the dropper and / or the supply of oxygen through the oxygen mask to relieve respiration.
In very severe cases of pneumonia, air supply to the lungs can be carried out through the device for artificial ventilation of the lungs in the resuscitation and intensive therapy.
The doctor will most likely ask you to come again after 6 weeks after the start of taking antibiotics. In some cases, it can prescribe repeated studies, for example, an x-ray of the chest if:
- Symptoms did not appear less;
- Symptoms returned;
- Do you smoke;
- You are over 50 years old.
Complications of pneumonia
Complications at pneumonia are more often observed in the elderly, small children and people with some chronic diseases, for example, diabetes. In case of complications, you will be guided by treatment to the hospital.
The most common complications for pneumonia - pleurisy, lung abscess and blood infection (sepsis) are described below.
Pleurisy - Inflammation of the pleura, thin shell between the lungs and chest. In more rare cases, liquid can accumulate between the lungs and walls of the chest cavity. This phenomenon is called "pleural effusion". Pleural effusion is observed by half of people treated from pneumonia in the hospital.
Liquid can put pressure on the lungs, makes it difficult to breathe. Pleural effusion usually passes as pneumonia treatment. Approximately in one of 10 cases of treatment of pneumonia in the hospital there is a liquid in the pleural cavity by bacteria, which causes the accumulation of pus - the so-called empy.
Typically, purulent releases are displayed using a needle or thin tube. In the most difficult cases, surgical intervention may be required to remove pus and eliminate the harm caused by Plegre and easy.
Abscess light - A rare complication of pneumonia, which most often happens in people with already existing serious diseases or in persons abusing alcohol. The abscess of the lung is filling the cavity in the lung tissues. Wet excavation with an unpleasant smell, swelling of the fingers and legs - the symptoms of the lung abscess.
Abscesses are often treated with antibiotics. Usually prescribed the course of antibiotics intravenously, then the reception of antibiotics in the form of tablets for 4-6 weeks. Most patients have improved well-being for 3-4 days. It is important not to throw the prescribed course of antibiotics, even if you feel completely healthy to avoid re-infection of the lungs. Approximately one of 10 people with lung abscess requires an operation to pump a pus from an abscess or removing the affected part of the lung.
Blood poisoning - Another rare and severe complication of pneumonia, also known as sepsis. Sensis symptoms:
- High body temperature (heat) - 38º C or higher;
- Hardness and breathing;
- Low blood pressure (hypotension), in which dizziness is felt in the vertical position of the body;
- change behavior, for example, disorientation in space and time;
- reduced urination;
- Cold, pale and sticky leather;
- loss of consciousness.
When infecting blood, the infection may spread to other organs, such as:
- External brain shells (meningitis);
- Abdominal shell (peritonitis);
- The inner sheath of the heart (endocarditis);
- joints (septic arthritis).
These types of infection are also called "metastatic infections" (from the word "metastasis" - a remote secondary center of the pathological process) and usually occur hard. For their treatment, large doses of antibiotics intravenously prescribe.
What doctor to contact with pneumonia?
With the help of the service, you can find a good therapist or pediatrician who are usually involved in diagnosing and outpatient treatment of lung inflammation. If you are offered hospitalization, you can independently choose an infectious hospital.
How not to infect others at pneumonia
Stop the spread of microorganisms from you to other people can be compliance with hygiene rules. For example, when coughing or sneezing, close the mouth and the nose with a disposable handkerchief. Severate used disposable handkerchiefs used in the garbage bucket or toilet - microorganisms can live a few hours after the nasal or mouth cavity leaves. We wash your hands regularly to prevent the transmission of pathogens to other people and their transfer to various items.
To protect against pneumonia, people from high-risk groups must make vaccinations. The following vaccinations are recommended:
- Village from pneumococcus (pneumococcal vaccine);
- Influenza vaccination.
Smoking, alcohol abuse and drug use intravenously can increase the likelihood of pneumonia. Smoking harms your lung, and as a result they become more susceptible to infection. Therefore, if you smoke, the best way to prevent pneumonia is to quit smoking.
There is evidence that the non-harmony and long-term use of alcohol weakens the natural mechanisms of protection of the lungs from infections, which makes them more susceptible to pneumonia. According to one study, 45% of people hospitalized with the diagnosis of pneumonia, abused alcohol.
Alcohol abuse is a regular use of over permissible norm. Under regular use it is understood as the admission of alcoholic beverages every day or most of the days of the week. Alcohol abuse not only increases the risk of pneumonia, but also increases the likelihood that it will leak in a more severe form. According to statistics, the likelihood of death from pneumonia among those abusing alcohol, from 3 to 7 times higher than on average in the population.