What happens to the lungs with pneumonia. How to determine the symptoms of pneumonia at an early stage of the disease

Inflammation of the lungs (officially pneumonia) is an inflammatory process in one or both respiratory organs, which is usually infectious in nature and is caused by various viruses, bacteria and fungi. In ancient times, this disease was considered one of the most dangerous, and although modern treatments allow you to quickly and without consequences get rid of the infection, the disease has not lost its relevance. According to official figures, in our country every year about a million people suffer from pneumonia in one form or another.

Description of the disease

The signs of pneumonia were described in his treatises by the legendary Hippocrates, but a real breakthrough in the treatment of this infection happened only at the beginning of the 20th century, after the discovery of penicillin by Alexander Fleming. Pulmonary disease is very insidious: it develops rapidly, while successfully disguising itself as a classic cold, which is why it is not always easy to recognize it.

Scientists distinguish between 2 main types of pneumonia - primary, which begins as an independent disease, and secondary - develops against the background or other ailments, most often with reduced immunity. The disease can be transmitted in three ways, the most common is the classic airborne droplet, when the infection enters the lungs of a healthy child or adult from a sick person.

Another way is hematogenous, the pathogen penetrates along with the blood (with blood poisoning and other severe infections). The third way is endogenous, when the bacteria living in the nose and throat are activated and become a source of infection. Thus, the question of whether pneumonia is contagious has an unequivocal answer: yes, it is contagious.

Varieties

Features of the course of pneumonia in both an adult and a child often depend on the type of infection:

Focal (a small area of the lung suffers - one or more alveoli).
Segmental (one or more lung segments are affected).
Lobar (inflammation in the whole lung lobe).
Total (infection captures the respiratory organ completely).

One of the varieties of lobar lung damage is dangerous croupous pneumonia, which, without proper treatment, often becomes bilateral pneumonia.

Causes

The causes of pneumonia in children and adults are the same - directly the causative agent of the infection and reduced immunity.

The main causative agents of lung infection are:

Enterobacteria;
Mycoplasma;
Legionella;
Chlamydia;
Haemophilus influenzae.

The first three pathogens cause typical, the last 4 groups of microorganisms cause atypical pulmonary inflammation.

The most common infectious agent is streptococcus. It is usually present both on the skin and in the respiratory tract, and with a weakened immune system against the background of other diseases, it can penetrate the lungs and provoke their inflammation. Enterobacteria usually cause pneumonia in people with chronic kidney disease, staphylococcal infection is mainly diagnosed in elderly patients.

Chlamydial pneumonia is more often found in a child after 5 years. The most effective method of its treatment is antibiotics, the minimum period is 3 weeks. Mycoplasma usually causes lung inflammation in young people, and Haemophilus influenzae traditionally affects smokers. Legionella infection is the least common, but such a pathology can cause serious consequences.

There are additional risk factors that can provoke the appearance of symptoms of pneumonia:

Chronic lung diseases;
Chronic infections of the nasopharynx (for example,);
Constants and ;
Immune deficiency;
birth trauma;
Heart defects.

Symptoms

The first and most characteristic symptoms of pneumonia are cough, shortness of breath, chest pain, fever, which is accompanied by sweating, and later signs of intoxication. Dry cough occurs when the body tries to get rid of dangerous bacteria, then shortness of breath occurs. Dyspnea is especially pronounced in elderly patients against the background of chronic cardiovascular diseases.

Temperature fluctuations are one of the main signs of an infection in the lungs. Before the first rise in temperature, a long chill may appear, then the numbers on the thermometer soar to 38-39 degrees. Temperature drops of 1.15 degrees during the day usually last about 10 days, with full-fledged inpatient treatment, this period can be reduced to 3-4 days.

Intoxication in pneumonia is the poisoning of the body with the decay products of infectious pathogens and toxins after tissue breakdown. You can determine intoxication in a child and an adult by the following signs: headache, feeling unwell, confusion, later - disturbances in the work of other organs (bad stools, abdominal pain, flatulence and poor appetite).

Symptoms of croupous inflammation of the lungs

Croupous pneumonia is one of the most dangerous varieties of this disease, in which a whole lobe of the lung is affected, up to one- and two-sided inflammation.

Symptoms of pneumonia of this type include:

A sharp increase in body temperature;
Pain in the side on the one hand, when coughing and inhaling intensify;
Shortness of breath and dry cough develops, at first rare, then increases;
The neck is covered with red spots from the side of the diseased lung or completely reddens;
The lips turn blue a little, the nasolabial triangle swells;
After a few days, brownish sputum streaked with blood may appear in the cough;
With severe intoxication, the patient periodically loses consciousness and raves.

Symptoms of atypical pneumonia

If pneumonia is caused by atypical pathogens, signs of pneumonia in adults and children may differ slightly from the classic picture.

With mycoplasma infection, the first symptoms of pneumonia are rhinitis, sore throat, fever, dry cough. Later, muscle and joint pains, nosebleeds, inflammation of the lymph nodes are added. More often, such a disease is diagnosed in a child, for example, during an outbreak in a kindergarten.

The first signs of chlamydial pulmonary inflammation in a child and in an adult are rhinitis, a temperature jump of up to 38–39 degrees, an increase in lymph nodes, later allergic reactions, dermatitis appear against the background of the disease, and bronchitis may develop.

Obvious symptoms of inflammation of the lungs of the legionella type can be called a strong fever up to 40 degrees with chills and severe headaches and dry cough. This form of pneumonia is most often fatal (50–60%) and usually affects the elderly.

Symptoms of chronic inflammation of the lungs

Chronic, or recurrent, inflammation of the lungs begins against the background of an untreated acute illness, if a small inflammatory focus remains in the lungs, or is a complication of severe pneumonia.

How does pneumonia manifest itself in a chronic form? The main signs are:

Hard breath;
Periodic wet cough, sometimes with purulent discharge;
palpitations and shortness of breath;
Inflammation of the nasopharynx and oral cavity;
Weak immunity and polyhypovitaminosis;
General weakness and signs of intoxication;
Sweating at night;
Poor appetite and weight loss;
In the period of exacerbation - exhausting cough and fever.

In the chronic form of a pulmonary infection, the respiratory organs do not cope with their work and cannot fully provide the tissues with oxygen, so the heart has to work in double mode. As a result, cardiovascular insufficiency becomes the most common complication of chronic pneumonia.

Symptoms in adults

Pneumonia in adults can be identified primarily by the classic dry cough. Other typical signs of pneumonia in these patients include:

Chills, then a rapid rise in temperature;
Shortness of breath even with minimal exertion;
(more than 100 heart beats per minute);
Chest pain (with damage to the pleural sheets - pleurisy);
Severe headaches, dizziness;
Rashes due to weakened immunity;
Problems with the stool (diarrhea or increased frequency of bowel movements).

Other symptoms of pneumonia depend on the type of pathogen, the state of immunity and the degree of lung damage. In severe forms of pulmonary disease, complications may occur:

Pulmonary edema;
Abscess (formation of cavities with pus);
, delusions and hallucinations;
Pneumothorax (accumulation of air in the pleural region).

Symptoms in children

In children, pneumonia is rarely a primary disease, most often pneumonia develops against the background of a severe cold, untreated flu, bronchitis, etc. During this period, it is especially important for parents to distinguish the symptoms of pneumonia in time and start active treatment.

A typical pneumonia in a child begins with the usual malaise, then weakness, fever, sweating are added, and later - dizziness and appetite disorders. In addition to temperature, rapid breathing is observed (more than 50 breaths per minute at a rate of 20–40).

Pulmonary inflammation in a small child can be determined by a whole range of symptoms:

After a flu or a cold there is no improvement, or after a short glimpse there are again jumps in temperature and great weakness;
The child suffers from shortness of breath regardless of whether there is a fever or cough;
In addition to the classic signs of SARS - cough, fever, runny nose - there is a strong pallor of the skin;
When the child's temperature rises, antipyretic drugs do not work;
Babies change their behavior: they are naughty, bad or, conversely, sleep too much, refuse to eat or become lethargic and lethargic.

Diagnostics

Most often, if a patient is suspected of having pulmonary inflammation, the attending physician performs the diagnosis. But the patient can always ask for an additional medical examination if he finds one or more of the classic symptoms of pneumonia.

The most effective and popular methods for diagnosing pneumonia are:

X-ray examination. Allows you to detect inflammation and its size: one or more foci, segments, an entire lobe of the lung or a total lesion.
Analysis of sputum content (if the cough is wet). Helps to detect infection, determine the type of pathogen and prescribe appropriate treatment for pneumonia.
Blood test. Changes in blood composition and quantity will help determine the nature of the disease and the type of causative agent of pneumonia.
. It is carried out only as a last resort and allows not only to make an accurate diagnosis of pneumonia, but also to fully explore the affected bronchi.

Treatment

How to treat pneumonia, in the hospital or at home? This question is of great concern to patients and their families, but there is no definite answer here. With advanced and complex forms of the disease, inpatient treatment is necessary, but with a mild form of pneumonia, the doctor may allow complex treatment at home, subject to strict adherence to all his recommendations and regular tests.

The main methods of treating inflammation of the lungs:

Antibacterial drugs. Antibiotics for pneumonia are the main therapeutic method. In mild forms of the disease, antibiotics are recommended in tablets and capsules, with complex and atypical inflammation - intravenous or intramuscular injections.
Non-pharmacological methods of treatment in a hospital setting. These are physiotherapy procedures, ultraviolet radiation, etc.
Home treatments. At home, in addition to antibiotics, you can use such effective methods as mustard wraps, breathing exercises, and herbal treatment.
Balanced diet. During the period of treatment for pneumonia, both the child and the adult need complex nutrition with a high content of vitamins, a large amount of liquid, products to stimulate the intestines.

Prevention

Prevention against inflammation of the lungs is, first of all, strengthening immunity at home: good nutrition, taking multivitamin complexes in the off-season, regular walks, moderate physical activity.

In order not to provoke the development of secondary pneumonia against the background of other diseases, the following preventive measures will help:

For persons over 65 years of age - regular vaccinations against certain types of streptococcal pathogen.
Annual flu vaccinations for the whole family.
In the cold season, limit physical activity and avoid hypothermia.
During epidemics of influenza and SARS, wash your hands more often with soap and water to remove microorganisms.
Do not smoke - cigarettes reduce the resistance of the lungs and bronchi to cold infections.
Timely treat such chronic ailments as sinusitis, tonsillitis and ordinary caries.
Avoid contact with people with pneumonia.

Pulmonary inflammation in various forms is a very common disease among both adults and children. Everyone needs to know the main signs of this disease in order to distinguish lung damage from a cold or flu in time and begin full-fledged treatment in a hospital or at home.

What is pneumonia?

Inflammation of the lungs (pneumonia) is today classified as a serious disease, despite a wide range of antibacterial drugs - the most effective drugs in the fight against the disease. Before the discovery of antibiotics and their widespread use in medical practice, pneumonia was considered a fatal disease that caused the death of millions of people of all ages and classes.

When diagnosing pneumonia, the patient is most often sent to a hospital, where doctors have the opportunity to control the treatment process with the help of X-ray and laboratory studies.

Causes of pneumonia

The main cause of pneumonia are viruses, bacteria and fungi with severe pneumotropism. These include staphylococci, streptococci, pneumococci, mycoplasmas, viruses and respiratory viruses, Candida fungi.

In most cases, pneumonia occurs against the background of inflammatory diseases of the upper respiratory tract, but in some cases, the inflammatory process develops directly in the lung tissue.

Risk factors include reduced immunity, colds, burns of the mucous membrane of the upper respiratory tract, damage by toxic substances that cause suffocation, inhalation of gaseous substances that irritate the upper respiratory tract, such as dichlorvos.

Symptoms of pneumonia

Inflammation of the lungs can occur in acute and chronic forms, in turn, an acute inflammatory process can manifest itself in the form of lobar or focal pneumonia.

Croupous pneumonia manifests itself in the form of a lesion of an entire lobe of the lung. The causative agents of the disease are pneumococci. Most often, the pathology is not preceded by acute respiratory infections or any other infection. Symptoms of pneumonia appear suddenly and are acute.

The patient's body temperature rises sharply, reaching high numbers, chills, pain in the side on one side. Pain is aggravated during a deep breath and when coughing. Shortness of breath develops rapidly, which may soon be accompanied by a dry cough. At the initial stage of the disease, the cough is rare, with time its intensity may increase, the cough becomes obsessive. In some cases, in the first day after the onset of the first symptoms of the disease, there may be no cough.

The appearance of the patient changes: the neck acquires a bright red color or becomes covered with red spots on the side of the affected lung, the nostrils swell, the lips turn slightly blue. In some cases, the patient loses consciousness and becomes delirious. After a couple of days, the cough becomes not as dry as at the beginning of the disease, a small amount of transparent viscous sputum with streaks of blood appears, in the next day the blood in the sputum becomes more pronounced and gives it a brownish tint, the color of the cough secretion resembles rust.

Pain during breathing is associated with the presence of nerve fibers in the pleura (a thin film located on the surface of the lung). In a healthy person, the pleura does not take part in the act of breathing, but in a patient with pneumonia, it is involved in this process. Croupous pneumonia almost always causes disturbances in the cardiovascular system, patients have tachycardia and a change in heart rhythm. The disease can continue for a long time. In the first two weeks, patients, as a rule, retain all the symptoms of pneumonia, making the course of the disease quite severe, after about a half-moon, the disease begins to gradually recede. The consequence of the pathology can be a lung, as well as diseases of the heart and blood vessels.

Focal inflammation of the lungs is characterized by inflammation of a separate area of the lung. Symptoms of the disease also develop acutely, the disease begins with a rise in body temperature to high values and with symptoms characteristic of severe intoxication (general weakness, malaise). Cough in most cases appears immediately, it can be dry or wet. Since the inflammation proceeds without the formation of pus, when coughing, serous sputum is released, in which streaks of blood can occur. Pain in the chest may be absent altogether or be moderately expressed. With the further course of the disease, the volume of the secret increases, and the discharge itself can become purulent. Focal inflammation of the lungs most often occurs against the background of previous viral or bacterial infectious diseases of the upper respiratory tract.

With timely treatment and properly selected drug therapy, the patient's temperature drops five days after the onset of the inflammatory process, at about the same time the patient's condition begins to improve. The duration of the disease averages 3-4 weeks. An urgent problem today is the asymptomatic course of focal pneumonia and the transition of an acute form of the disease to a chronic one, experts see the reason for this in self-treatment, namely in the frequent use of antibiotics without a doctor's prescription.

Chronic inflammation of the lungs most often develops after acute pneumonia, if the focus of infection persists in the affected organ. Each exacerbation leaves a trace in the lung in the form of connective tissue formed in the focus of inflammation instead of lung tissue, thus, pneumosclerosis becomes a complication of recurrent pneumonia. The consequences of chronic inflammation of the lungs are reflected in the functioning of the organ, the supply of tissues with oxygen is disrupted, the load on the heart doubles, and diseases of the cardiovascular system develop. All this leads to the occurrence of pulmonary heart failure.

Symptoms of pneumonia occurring in a chronic form are chest pain on one side (from the side of the affected lung), a slight increase in body temperature to subfebrile, malaise, weakness, and in rare cases hemoptysis is noted.

Treatment of pneumonia

Patients with acute pneumonia and exacerbation of a chronic infectious process require hospitalization. In all forms of this disease, regardless of the nature of its course, antibacterial drugs are prescribed. The resistance of modern strains of bacteria and viruses to penicillins does not allow doctors to limit themselves to using only this group of antibiotics in the treatment of pneumonia.

The most popular among specialists are cephalosporin, amoxicillin, clavulanate, levofloxacin, sulfamethoxazole. With the slow development of symptoms of the disease, it is recommended to use antibiotics, which include sulfur.

Therapy of viral pneumonia requires the appointment of not only antibacterial drugs, but also drugs with antiviral activity. With fungal forms of pneumonia, the doctor must prescribe drugs that suppress the vital activity of a certain type of fungus.

For patients diagnosed with pneumonia, it is important to remember the dangers of self-treatment: it can turn into the most tragic consequences. Patients must undergo fluoroscopy, do a blood test, it is also desirable to examine sputum in the laboratory.

Expert editor: Mochalov Pavel Alexandrovich| MD general practitioner

Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

Despite the fact that pneumonia is not a death sentence in the 21st century, pneumonia is still quite dangerous. In addition, it is not so easy to assess its seriousness at home. How not to catch an infection, what symptoms should alert and why it is not necessary to go to the hospital, we tell below.

Pneumonia is an infectious disease that affects the lung alveoli. Alveoli are small "vesicles" that are found at the ends of the thin branches of the bronchi. They are connected to the circulatory system by a capillary network. In the body of a healthy person, oxygen enters the alveoli through the bronchi, and from there into the blood. In pneumonia, the infection affects the alveoli: they enlarge, fill with fluid or pus. Because of this, oxygen enters the body in insufficient volume.

Reasons for the development of the disease

There are quite a few causes of pneumonia, and microbes do not always play a major role.

Vasily Shtabnitsky

Pneumonia occurs when the body's specific and nonspecific defenses are weakened and the body is faced with an increased microbial load. Let me give you an example: a person weakened after a long operation lies a lot, cannot take care of himself, including brushing his teeth. A large number of microorganisms accumulate in the oral cavity - they enter the lungs, but the body cannot immediately destroy them. That is, pneumonia is not just an infection, it is a confluence of adverse factors. In addition, the development of the disease largely depends on the person himself.

The causative agents of pneumonia can be:

viruses;
bacteria;
fungi;
foreign particles that have accidentally entered the lungs (for example, chemicals).

In addition to microbes, the likelihood of developing pneumonia increases:

Symptoms of pneumonia

Finding out which microorganism caused pneumonia is not so easy. The most common symptoms are:

heat;
cough with yellow or greenish sputum;
shallow breathing and shortness of breath;
heart palpitations;
increased fatigue;
chills;
chest pain.

Vasily Shtabnitsky

Candidate of Medical Sciences, pulmonologist at the Chaika and Rassvet clinics

Unfortunately, there is no specific symptom or group of symptoms that accurately indicate pneumonia. However, persistence of a temperature above 38 degrees for more than one week, cough with purulent or bloody sputum, chest pain, shortness of breath, rapid breathing, severe weakness, hypotension, and impaired consciousness should alert.

In order to determine the correct treatment, the doctor must prescribe certain tests and studies:

x-ray - will show the focus of inflammation;
complete blood count - will show how actively the immune system fights the infection;
a blood culture test - will answer the question of whether bacteria have entered the bloodstream.

To rule out other lung conditions, your doctor may order a sputum test, a bronchoscopy, and a pleural fluid test.

Treatment of pneumonia

Inflammation of the lungs is a serious disease, there can be no talk of any self-treatment. However, going to the hospital is not always necessary. If within a few days you observe several symptoms of pneumonia, then the first thing to do is to see a doctor.

Vasily Shtabnitsky

Candidate of Medical Sciences, pulmonologist at the Chaika and Rassvet clinics

Not every pneumonia requires hospitalization, but it is worth remembering that with the mildest variant of the course of the disease, the probability of death is almost zero, and with the most severe it can exceed 50%. This means that the doctor must assess the severity of the patient's condition and the need for hospitalization. For a patient with mild pneumonia, hospitalization can do more harm than good, as being in a hospital increases the risk of so-called nosocomial infection and complications from intravenous therapy. It is believed that patients with mild pneumonia should stay at home, while patients with severe and extremely severe pneumonia should be treated in a hospital. Patients with moderate pneumonia may be hospitalized at the discretion of the physician.

If you have pneumonia that does not require hospitalization and you can take medication on your own, then you will only need pills to treat it. In most cases, inhalation, UHF therapy, vibration massage and other physiotherapy methods are not needed. The effectiveness of various manual exposure techniques is also.

Vasily Shtabnitsky

Candidate of Medical Sciences, pulmonologist at the Chaika and Rassvet clinics

Electrophoresis, UHF, and other physical therapy options (not to be confused with physical therapy) play no role in the treatment of pneumonia. This means that such interventions are unable to affect such indicators as mortality, length of stay in the hospital, and the likelihood of complications.

Disease prevention

If you follow simple rules, then the risk of pneumonia can be minimized.

Get vaccinated

Most often, pneumonia occurs against the background of other diseases. Therefore, the first step for those who do not want to get sick is a flu shot. In addition, pneumococcal vaccination has been included since 2014. It is recommended for children under five years of age and adults over 65 years of age - at this age the body is more susceptible to infections. Of course, such a vaccination will not save you from all types of pneumonia, but it will protect you from the most common ones.

Wash your hands

Handshakes, doorknobs, and keyboards expose your hands to millions of microbes every day. And when you touch your eyes or nose, they can easily get inside and cause various diseases. Therefore, it is important not only before meals, but also during the day. This banal advice from childhood.

Quit smoking

Smoking increases the chances of not only catching pneumonia, but also. Smoking causes processes in the lungs that make you more vulnerable to infections. For example, the number of cells that produce sputum increases, but some of the sputum remains in the lungs. In addition, the work of the ciliated epithelium is disrupted - this is the type of tissue that covers the mucous membrane of the respiratory tract. The cells of the ciliated epithelium are covered with fine hairs - they do not allow dust and microbes to enter the lungs. Cigarette smoke destroys these cells.

Pneumonia is an acute infectious and inflammatory pathology characterized by damage to all structures of the lung - alveoli and interstitium. The disease always proceeds with intraalveolar exudation and characteristic clinical and radiological signs.

Symptoms and treatment of pneumonia depend on the cause of the disease, the state of the patient's immune system, and the method of infection.

Acute pneumonia currently remains an urgent problem. Despite the emergence of effective antimicrobial drugs, the mortality rate from this disease is about 10%. Inflammation of the lungs in mortality is second only to diseases of the cardiovascular system, oncopathology, trauma and poisoning. Pneumonia is the cause of death for AIDS patients.

Pneumonia is an acute infectious inflammation of the lungs, often of bacterial etiology, which is contagious for malnourished and debilitated patients who have undergone surgery, childbirth, and also those suffering from endocrine pathology, oncopathology. Pneumonia is transmitted by airborne droplets from a sick person to a healthy one. Hypothermia, physical and nervous strain contribute to the development of the disease and the appearance of symptoms of pneumonia in adults and children.

Etiology

Pneumonia is a polyetiological disease, most often of an infectious origin.

Bacterial infection is the most common cause of pathology. Streptococcus pneumoniae is the main causative agent of pneumonia. Other pathogens:

Gram-positive cocci - pneumococci, Staphylococcus aureus, streptococci,
Gram-negative rods - Acinetobacter,
"Atypical" - chlamydia, mycoplasma, legionella,
Enterobacteria - Klebsiella, Escherichia, Proteus,
Anaerobes - actinomycetes, fusobacteria.

Viral infection often precedes the development of bacterial pneumonia. Influenza, herpes viruses, respiratory syncytial virus, cytomegalovirus, as well as, and weaken the body's immune defenses and create favorable conditions for the reproduction of bacteria and their manifestation of virulent properties.

Pathogenic fungi - causative agents of histoplasmosis, coccidioidomycosis, blastomycosis, candidiasis.

The causative factors of non-infectious pneumonia are injuries, radiation, exposure to certain toxins and allergens.

Etiological signs

Staphylococcal pneumonia is characterized by the development of necrotic foci in the lung, surrounded by neutrophils. In this case, the alveoli are filled with fibro-purulent exudate, in which there are no bacteria. In severe cases, staphylococcal pneumonia ends with the destruction of lung tissue.
Pneumonia caused by pneumococci is rarely complicated by abscess formation. Commonplace inflammation usually develops in the lung tissue.

Streptococci cause necrotic damage to the lung tissue with a hemorrhagic component and lymphogenous dissemination.
Pseudomonas aeruginosa can lead to the appearance of grayish-red foci of doughy consistency in the lung tissue, as well as pinpoint hemorrhages.
Klebsiella pneumonia is characterized by the defeat of the entire lobe of the lung, the formation of mucous exudate and extensive areas of necrosis.
Mycoplasma and viral pneumonias are characterized by inflammation of the interstitium of the lung - its edema and infiltration. There are no pathological changes in the alveoli.

Provoking factors:

Pathogenesis

The upper respiratory tract is most exposed to pathogenic biological agents that can cause a number of pathologies in humans.

Upper respiratory protection factors:

Lower respiratory protection factors:

cough reflex,
mucociliary clearance,
The functioning of the ciliated epithelium,
Special structure of the respiratory tract,
Lung surfactant,
Immunoglobulins A and G,
Macrophage link of phagocytosis,
T-cell immunity.

These specific and non-specific factors prevent the development of infectious pathology.

There are a number of conditions in which protective mechanisms are violated, the composition of the normal microflora of the respiratory organs changes, and the activity of saprophytic microorganisms decreases.

These states include:

Irrational nutrition,
systemic pathology,
prolonged hospitalization,
Stay in a nursing home
Irrational or prolonged antibiotic therapy,
Smoking,
Nasogastric or endotracheal intubation
exhaustion
Nervous tension.

Infection with pneumonia occurs by hematogenous, lymphogenous and bronchogenic routes.

Bronchogenic pathway the spread of infection is the main one. Large particles with a diameter of more than 10 microns immediately settle on the nasal mucosa and upper respiratory tract. Particles with a diameter of up to 5 microns are in the air for a long time, and then enter the human body. This fine aerosol easily and quickly overcomes the host's defenses. Small particles settle on the mucous membrane of the bronchioles and alveoli, causing the development of the disease. The following pathogens of pneumonia penetrate by inhalation: mycobacterium, influenza virus, legionella and many others.

By hematogenous route the infection penetrates from extrapulmonary foci. So, Staphylococcus aureus with blood flow penetrates into the lung tissue with bacterial endocarditis, bronchitis.

Microbes penetrate into the alveoli of the lungs through the protective bronchopulmonary barrier with a decrease in the overall resistance of the organism. Infectious inflammation develops. The exudate formed in the alveoli disrupts the processes of gas exchange in the lungs, which leads to hypoxia, the development of respiratory and heart failure.

Pathomorphology

The leading pathomorphological sign of pneumonia is limited exudative inflammation of the respiratory section of the lungs.

Lobar pneumonia- inflammation of the lobe of the lung.

Bronchopneumonia- a disease in which inflammation is limited to the alveoli and adjacent bronchi.

Drain pneumonia is the fusion of small foci of inflammation into large ones.
Necrotic pneumonia characterized by the appearance of areas of dead lung tissue, the formation of small cavities in it and lung abscess formation.
- inflammation of the interstitial lung tissue.

Stages of development of pneumonia:

high tide- lasts three days and is accompanied by the formation of fibrinous exudate in the alveoli.
red hepatization- lasts three days and is characterized by compaction of the lung tissue. The lungs in structure become like the liver. Blood cells appear in the exudate.
gray hepatization- lasts about six days. In the exudate, the breakdown of erythrocytes occurs, leukocytes massively penetrate into the alveoli.
Permission- restoration of the normal structure of the lung.

Classification of pneumonia

On an epidemiological basis Pneumonias are classified into: community-acquired, nosocomial, caused by immunodeficiency, aspiration.
Origin inflammation of the lungs can be: bacterial, viral, mycoplasmal, fungal, caused by protozoa, caused by helminths, non-infectious, mixed.
pathogenetically pneumoniae are divided into the following types: Independent pathologies - primary, arising against the background of concomitant diseases - secondary, developing after a chest injury - post-traumatic, postoperative.
By localization pathological focus: unilateral - right-sided or left-sided, bilateral.
With the flow: sharp, lingering.

Symptoms

Focal pneumonia- complication, or. The disease begins gradually: the temperature becomes subfebrile, fluctuates, then appears with hard-to-separate mucous or, sweating, acrocyanosis.
Patients complain of pain in the chest during coughing.

The characteristic symptoms of pneumonia found on physical examination are:

Weakening of percussion sound over the area of inflammation,
hard breathing,
Various wheezing,
Crepitus is a high-frequency pathological breath noise detected during auscultation.

If the lesions merge, then the patient's condition deteriorates sharply - shortness of breath and cyanosis appear.

Croupous pneumonia proceeds much more severely than focal and is manifested by more pronounced symptoms. This is due to inflammation of the whole lobe of the lung and part of the pleura.

Pathology develops rapidly: fever, symptoms of intoxication, shortness of breath and chest pain appear. The main clinical sign of the disease is, which eventually becomes productive with the discharge of "rusty" sputum. High fever and cough with sputum persist for 10 days.

In severe cases, the skin turns red, cyanosis and herpetic eruptions appear in the nose, lips and chin. Breathing becomes rapid and shallow, the wings of the nose swell, blood pressure drops, heart sounds are muffled. Auscultation revealed moist rales and crepitus.

Given the risk of complications and the severity of the symptoms of pneumonia, it should be treated in a pulmonology department.

A whole group of diffuse lung diseases, in which there is a steady progression of inflammatory changes in the interstitial tissue. In this case, the parenchyma of the organ is affected - the endothelium of the pulmonary vessels, alveolar septa. The connective interstitial tissue becomes inflamed and swells, gas exchange is disrupted, and the lung elements stick together irreversibly.

The disease develops slowly, often over several years. Shortness of breath is the main symptom of pneumonia in an adult. It is often accompanied by a rise in temperature, a cough with scanty sputum and streaks of blood. Patients have weight loss, rhinitis, conjunctivitis, headache. Auscultation reveals harsh breathing without wheezing.

Interstitial pneumonia usually develops in individuals with congenital and acquired immunodeficiency.

Occult or asymptomatic pneumonia usually develops in weakened and emaciated individuals against the background of a decrease in the overall resistance of the body. Immune cells are in a suppressed, inactive state and become non-aggressive against pathogenic microorganisms. Patients complain only of mild malaise and increased sweating. These signs are the only symptoms of the disease associated with a high level of intoxication of the body. Bacterial toxins circulate in the blood for a long time, are not inactivated and are not completely eliminated by the liver and kidneys. This is how the internal organs are damaged - the brain, heart, blood vessels. Pneumonia without fever, cough, headache and myalgia is a life-threatening disease.

Features of pneumonia in children

The upper respiratory tract of the child is not sufficiently developed: they cannot "keep" the viruses that quickly descend into the bronchi and lungs. A banal runny nose and a slight cough can lead to the development of tracheitis, bronchitis and even pneumonia. That is why it is necessary to eliminate the infection in the child's body as soon as possible and relieve inflammation. At home, you can give the child a massage, rub the chest and back, give a freshly prepared decoction of medicinal herbs or herbal tea.

Classification of pneumonia in children by etiology:

The causative agents of pneumonia in newborns are usually group B beta-hemolytic streptococcus, gram-negative rods, cytomegalovirus and pathogenic listeria.
In children from 3 weeks to 3 months - influenza viruses, RSV, pneumococcus, Staphylococcus aureus, bordetella, chlamydia.
In children from 3 months to 4 years - group A streptococci, pneumococci, influenza virus, adenovirus, RSV, mycoplasma.
In children from 4 to 15 years old - pneumococci, mycoplasmas, chlamydia.

Pneumonia caused by, pneumococcus, and Pseudomonas aeruginosa, the most dangerous for newborns and infants.

Symptoms of pneumonia in children are in many ways similar to the clinical manifestations of the disease in adults. Shortness of breath and respiratory rate are the main signs of pneumonia, which must be paid special attention when examining a sick child. Shortness of breath against the background of SARS and a respiratory rate of more than 40 per minute are symptoms that threaten the child's life.

Among children, the most common pneumonia caused by "atypical" pathogens - mycoplasmas, chlamydia and legionella. Treatment of such diseases should be carried out with macrolide antibiotics.

Children with pneumonia should only be treated in a hospital to avoid such dangerous complications as acute respiratory and cardiovascular failure.

Severity

For pneumonia mild degree characterized by mild intoxication syndrome, subfebrile temperature, shortness of breath after exercise. X-ray signs - a small focus of inflammation.
At medium degree symptoms of intoxication appear - fever, chills, weakness, fatigue, irritability, lowering blood pressure, tachypnea, shortness of breath at rest. The radiograph clearly shows lung infiltration.
Severe degree pneumonia is manifested by pronounced signs of intoxication, fever, impaired consciousness, a sharp drop in blood pressure, the appearance of symptoms, and the development of complications.

Complications of pneumonia

Pulmonary complications

Extrapulmonary complications

- a complication of pneumonia on the part of the cardiovascular system, the occurrence of which is associated with circulatory disorders in the pulmonary circulation. Stagnation in the lung tissue leads to the fact that the lungs fill with fluid, and the patient suffocates.
Inflammation of various parts of the heart - myocarditis, endocarditis, pericarditis.
Sepsis and toxic shock lead to dysfunction of internal organs and are associated with the penetration of microbes into the bloodstream. If urgent treatment is not started, intravascular coagulation will develop, and the patient will die.

Diagnosis of pneumonia

Diagnosis of pneumonia is based on the study of the patient's complaints, anamnesis of life and disease, as well as on the data of additional research methods - instrumental and laboratory.

Clinical signs that make it possible to suspect the disease are fever, intoxication, cough.

On physical examination, a dullness of percussion sound is found, which indicates an existing seal in the lung. On auscultation, specialists note fine bubbling and crepitus.

Instrumental diagnostic methods

Among the additional instrumental methods, the leading ones are:

Radiography of the lungs in two projections,
X-ray,
CT scan,
electrocardiography,
echocardiography,
Ultrasound examination of the organs of the chest cavity.

X-ray of the lungs allows you to make the correct diagnosis and determine the localization of the lesion. Usually the pathological process is located in the lower lobes of the lung.

Pneumonia

Radiographic signs of pneumonia:

Changes in the parenchyma of the organ - focal or diffuse shadows,
Interstitial changes - increased lung pattern, perivascular and peribronchial infiltration.

A more accurate method for examining patients with suspected pneumonia is computed tomography of the lungs. It is used in the following cases:

If the x-ray examination does not reveal the lesion, and the patient has characteristic symptoms of pathology,
With a recurrent course of pneumonia with the location of the focus of inflammation in the same lobe of the lung,
If the clinic and X-ray diagnostic data do not correspond to each other.

Laboratory diagnostics

Treatment of pneumonia

Treatment of patients with severe pneumonia, as well as in the presence of complications, is carried out in a hospital - in the pulmonology department.

Uncomplicated forms of the disease do not require hospitalization. Treatment of pneumonia of mild and moderate severity is carried out on an outpatient basis by general practitioners, therapists, pediatricians, family doctors.

Treatment of pneumonia at home is possible subject to all medical recommendations. Patients are shown bed rest, plenty of fluids, a complete, balanced diet containing a sufficient amount of proteins, carbohydrates and vitamins.

Traditional treatment

Etiotropic treatment - antibacterial:

Macrolides - "Azithromycin", "Sumamed",
Penicillins - "Amoxiclav", "Flemoxin",
Cephalosporins - Suprax, Cefataxime,
Fluoroquinolones - "Ciprofloxacin", "Ofloxacin",
Carbapenems - "Imipenem",
Aminoglycosides - "Streptomycin", "Gentamicin".

The choice of drug is determined by the result of microbiological analysis of sputum and determination of the sensitivity of the isolated microorganism to antibacterial agents. The duration of taking antibiotics is 7-10 days.

If the causative agent of pneumonia remains unknown, then a combination of 2 antibacterial drugs is prescribed, one of which can be replaced.

Antiviral treatment should be started as early as possible, preferably within the first 48 hours. To do this, use "Ribavirin", "Rimantadine", "Ingavirin", "Acyclovir". These drugs reduce the duration of the disease and the severity of symptoms. They are indicated to prevent unwanted outcomes of viral pneumonia.

Symptomatic treatment It is aimed at eliminating the main clinical manifestations of the disease and improving the patient's condition.

Expectorant and mucolytic agents are prescribed to patients who are tormented by a cough with sputum difficult to separate - ACC, Ambroxol, Bromhexin.
Bronchodilators are prescribed to patients with the development of shortness of breath - "Eufillin", "Berodual", "Salbutamol". These drugs are best taken by inhalation through a nebulizer.
Detoxification therapy consists in the drip administration of a glucose solution and saline solutions - physiological, "Disol", Ringer's solution.
Antihistamines - "Cetrin", "Diazolin", "Loratodin".
Immunomodulators - "Polyoxidonium", "Pyrogenal", "Bronchomunal".
Antipyretic drugs - "Ibuklin", "Nurofen".
Multivitamins - "Centrum", "Vitrum".

Video: antibiotic in the treatment of pneumonia, “Doctor Komarovsky”

Physiotherapy

After stabilization of the general condition of the patient and elimination of the symptoms of the acute period, they proceed to physiotherapeutic procedures.

Patients are prescribed:

Electrophoresis with antibiotics, bronchodilators,
UHF therapy,
massage and vibrotherapy,
corticosteroid inhalations,
infrared laser therapy,
ultrasound therapy,
oxygen therapy,
magnetotherapy,

Alternative therapy

Traditional medicine can only complement the traditional treatment of pneumonia, but not replace it completely.

Prevention

Effective preventive measures:

To give up smoking,
annual vaccination,
The use of antiviral drugs during epidemics,
hardening,
Increasing the overall resistance of the organism,
Sanitation of foci of chronic infection - treatment of carious teeth, tonsillitis, sinusitis,
Breathing and therapeutic exercises.

Forecast

Factors on which the outcome of the disease depends:

Pathogenicity and virulence of the pathogen,
resistance of microorganisms to antibiotics,
patient's age,
The presence of comorbidities
The state of the immune system
Timeliness and adequacy of treatment.

Pneumonia associated with immunodeficiency often has a poor prognosis.

If the treatment of pneumonia was timely and adequate, then the disease usually ends in recovery. Most often, the structure of the lungs is completely restored.

Risk factors for death:

Aspiration,
Old age - over 65 years old,
The child is less than a year old
The prevalence of the pathological process - the defeat of more than 1 lobe of the lung,
The number and nature of comorbidity,
severe immunosuppression,
Certain causative agents of infection are pneumococci,
The development of septic syndrome,
Damage to internal organs,
Exacerbation of concomitant diseases - cardiac and hepatic-renal failure.

Video: pneumonia, “Doctor Komarovsky”

- an acute lesion of the lungs of an infectious-inflammatory nature, which involves all the structural elements of the lung tissue, mainly the alveoli and interstitial tissue of the lungs. The clinic of pneumonia is characterized by fever, weakness, sweating, chest pain, shortness of breath, cough with sputum (mucous, purulent, "rusty"). Pneumonia is diagnosed on the basis of an auscultatory picture, X-ray data of the lungs. In the acute period, treatment includes antibiotic therapy, detoxification therapy, immunostimulation; taking mucolytics, expectorants, antihistamines; after the cessation of fever - physiotherapy, exercise therapy.

General information

Pneumonia is an inflammation of the lower respiratory tract of various etiologies, occurring with intraalveolar exudation and accompanied by characteristic clinical and radiological signs. Acute pneumonia occurs in 10-14 people out of 1000, in the age group over 50 years old - in 17 people out of 1000. The urgency of the problem of the incidence of acute pneumonia remains, despite the introduction of new antimicrobial drugs, as well as a high percentage of complications and mortality (up to 9% ) from pneumonia.

Among the causes of death of the population, pneumonia is in 4th place after diseases of the heart and blood vessels, malignant neoplasms, traumatism and poisoning. Pneumonia can develop in debilitated patients, joining the course of heart failure, oncological diseases, cerebrovascular accidents, and complicates the outcome of the latter. In AIDS patients, pneumonia is the leading direct cause of death.

Causes and mechanism of development of pneumonia

Among the etiological factors that cause pneumonia, bacterial infection is in the first place. The most common causative agents of pneumonia are:

gram-positive microorganisms: pneumococci (from 40 to 60%), staphylococci (from 2 to 5%), streptococci (2.5%);
Gram-negative microorganisms: Friedlander's bacillus (from 3 to 8%), Haemophilus influenzae (7%), Enterobacteriaceae (6%), Proteus, Escherichia coli, Legionella, etc. (from 1.5 to 4.5%);
viral infections (herpes, influenza and parainfluenza viruses, adenoviruses, etc.);

Also, pneumonia can develop as a result of exposure to non-infectious factors: chest injuries, ionizing radiation, toxic substances, allergic agents.

Risk factors

The risk group for the development of pneumonia includes patients with congestive heart failure, chronic bronchitis, chronic nasopharyngeal infection, congenital malformations of the lungs, with severe immunodeficiency, debilitated and malnourished patients, patients who are on bed rest for a long time, as well as elderly and senile people .

People who smoke and abuse alcohol are especially susceptible to the development of pneumonia. Nicotine and alcohol vapor damage the bronchial mucosa and inhibit the protective factors of the bronchopulmonary system, creating a favorable environment for the introduction and reproduction of infection.

Pathogenesis

Infectious pathogens of pneumonia penetrate the lungs through bronchogenic, hematogenous or lymphogenous routes. With the existing decrease in the protective bronchopulmonary barrier in the alveoli, infectious inflammation develops, which spreads through the permeable interalveolar septa to other parts of the lung tissue. In the alveoli, exudate is formed, which prevents the gas exchange of oxygen between the lung tissue and blood vessels. Oxygen and respiratory insufficiency develops, and with a complicated course of pneumonia - heart failure.

There are 4 stages in the development of pneumonia:

the stage of the tide (from 12 hours to 3 days) - is characterized by a sharp blood filling of the vessels of the lungs and fibrinous exudation in the alveoli;
stage of red hepatization (from 1 to 3 days) - lung tissue is compacted, resembling a liver in structure. In the alveolar exudate, erythrocytes are found in large numbers;
the stage of gray hepatization - (from 2 to 6 days) - is characterized by the breakdown of erythrocytes and a massive release of leukocytes into the alveoli;
resolution stage - the normal structure of the lung tissue is restored.

Classification

1. Based on epidemiological data, pneumonia is distinguished:

out-of-hospital (out-of-hospital)
nosocomial (hospital)
caused by immunodeficiency conditions

2. According to the etiological factor, with the specification of the pathogen, pneumonia can be:

mycoplasma
fungal
mixed.

3. According to the mechanism of development, pneumonia is isolated:

primary, developing as an independent pathology
secondary, developing as a complication of concomitant diseases (for example, congestive pneumonia)
aspiration, developing when foreign bodies enter the bronchi (food particles, vomit, etc.)
post-traumatic
postoperative
pneumonia infarctiondeveloping as a result of thromboembolism of small vascular branches of the pulmonary artery.

4. According to the degree of interest of the lung tissue, pneumonia occurs:

unilateral (with damage to the right or left lung)
bilateral
total, lobar, segmental, sublobular, basal (central).

5. By the nature of the course of pneumonia can be:

sharp
acute lingering
chronic

6. Taking into account the development of functional disorders of pneumonia, the following occur:

with the presence of functional disorders (indicating their characteristics and severity)
with no functional impairment.

7. Taking into account the development of complications of pneumonia, there are:

uncomplicated course
complicated course (pleurisy, abscess, bacterial toxic shock, myocarditis, endocarditis, etc.).

8. On the basis of clinical and morphological features, pneumonia is distinguished:

parenchymal (croupous or lobar)
focal (bronchopneumonia, lobular pneumonia)
interstitial (more often with mycoplasmal lesions).

9. Depending on the severity of the course of pneumonia, they are divided into:

mild degree- characterized by mild intoxication (clear consciousness, body temperature up to 38 ° C, blood pressure is normal, tachycardia is not more than 90 beats per minute), there is no shortness of breath at rest, a small focus of inflammation is determined radiographically.
medium degree- signs of moderate intoxication (clear consciousness, sweating, severe weakness, body temperature up to 39 ° C, blood pressure moderately reduced, tachycardia about 100 beats per minute), respiratory rate - up to 30 per minute. at rest, the expressed infiltration is defined radiologically.
severe- characterized by severe intoxication (fever 39-40 ° C, clouding of the creation, weakness, delirium, tachycardia over 100 beats per minute, collapse), shortness of breath up to 40 beats per minute. at rest, cyanosis, radiographically determined extensive infiltration, the development of complications of pneumonia.

Symptoms of pneumonia

Croupous pneumonia

Characterized by an acute onset with fever over 39 ° C, chills, chest pain, shortness of breath, weakness. Worried about the cough: at first dry, unproductive, then, for 3-4 days - with "rusty" sputum. Body temperature is constantly high. With lobar pneumonia, fever, cough and sputum discharge last up to 10 days.

In severe cases of croupous pneumonia, hyperemia of the skin and cyanosis of the nasolabial triangle are determined. Herpetic eruptions are visible on the lips, cheeks, chin, wings of the nose. The patient's condition is serious. Breathing is shallow, rapid, with swelling of the wings of the nose. Crepitus and moist small bubbling rales are auscultated. Pulse, frequent, often arrhythmic, blood pressure is reduced, heart sounds are muffled.

Focal pneumonia

It is characterized by a gradual, inconspicuous onset, more often after acute respiratory viral infections or acute tracheobronchitis. The body temperature is febrile (38-38.5 ° C) with daily fluctuations, cough is accompanied by discharge of mucopurulent sputum, sweating, weakness are noted, when breathing - pain in the chest on inspiration and coughing, acrocyanosis. With focal confluent pneumonia, the patient's condition worsens: severe shortness of breath, cyanosis appear. During auscultation, hard breathing is heard, the exhalation is lengthened, dry small and medium bubbling rales, crepitus over the focus of inflammation.

Complications of pneumonia

Features of the course of pneumonia are due to the severity, the properties of the pathogen and the presence of complications. The course of pneumonia is considered complicated, accompanied by the development in the bronchopulmonary system and other organs of inflammatory and reactive processes caused directly by inflammation of the lungs. The course and outcome of pneumonia largely depends on the presence of complications. Complications of pneumonia can be pulmonary and extrapulmonary.

Pulmonary complications of pneumonia can include:

obstructive syndrome
abscess, gangrene of the lung
parapneumonic exudative pleurisy.

Among the extrapulmonary complications of pneumonia often develop:

acute cardiopulmonary failure
endocarditis, myocarditis
meningitis and meningoencephalitis
infectious-toxic shock
anemia
psychoses, etc.

Diagnostics

When diagnosing pneumonia, several tasks are solved at once: differential diagnosis of inflammation with other pulmonary processes, clarification of the etiology and severity (complications) of pneumonia. Pneumonia in a patient should be suspected on the basis of symptomatic signs: the rapid development of fever and intoxication, cough.

Physical research. The compaction of the lung tissue is determined (based on percussion dullness of the pulmonary sound and increased bronchophony), a characteristic auscultatory picture - focal, moist, finely bubbling, sonorous rales or crepitus.
Laboratory diagnostics. Changes in the general blood test in pneumonia are characterized by leukocytosis from 15 to 30 109 / l, a stab shift of the leukocyte formula from 6 to 30%, an increase in ESR to 30-50 mm / h. In the general analysis of urine, proteinuria can be determined, less often microhematuria. A sputum bacteriological analysis for pneumonia allows you to identify the pathogen and determine its sensitivity to antibiotics.
Radiography of the lungs. X-rays for pneumonia are usually taken at the onset of the disease and after 3-4 weeks to monitor the resolution of inflammation and exclude other pathology (often bronchogenic lung cancer). With any type of pneumonia, the process often captures the lower lobes of the lung. On radiographs with pneumonia, the following changes can be detected: parenchymal (focal or diffuse darkening of various localization and extent); interstitial (pulmonary pattern is enhanced by perivascular and peribronchial infiltration).
ultrasound. According to echocardiography and ultrasound of the pleural cavity, pleural effusion is sometimes determined.

Treatment of pneumonia

Patients with pneumonia are usually hospitalized in a general therapeutic department or a pulmonology department. For the period of fever and intoxication, bed rest, plentiful warm drink, high-calorie, vitamin-rich food are prescribed. With severe symptoms of respiratory failure, patients with pneumonia are prescribed oxygen inhalations. The main directions of therapy:

Antibiotic therapy. The main treatment for pneumonia is antibiotic therapy. Antibiotics should be prescribed as early as possible, without waiting for the definition of the pathogen. The selection of an antibiotic is carried out by a doctor, no self-treatment is unacceptable! With community-acquired pneumonia, penicillins (amoxicillin with clavulanic acid, ampicillin, etc.), macrolides, cephalosporins are more often prescribed. The choice of the method of antibiotic administration is determined by the severity of the course of pneumonia. For the treatment of nosocomial pneumonia, penicillins, cephalosporins, fluoroquinolones (ciprofloxacin, ofloxacin, etc.), carbapenems, aminoglycosides are used. With an unknown pathogen, a combined antibiotic therapy of 2-3 drugs is prescribed. The course of treatment can last from 7-10 to 14 days, it is possible to change the antibiotic.
Symptomatic therapy. With pneumonia, detoxification therapy, immunostimulation, the appointment of antipyretic, expectorant and mucolytic, antihistamines are indicated.
Physiotherapy. After the cessation of fever and intoxication, the regimen is expanded and physiotherapy is prescribed (electrophoresis with calcium chloride, potassium iodide, hyaluronidase, UHF, massage, inhalation) and exercise therapy to stimulate the resolution of the inflammatory focus.

Treatment of pneumonia is carried out until the patient's complete recovery, which is determined by the normalization of the state and well-being, physical, radiological and laboratory parameters. With frequent repeated pneumonia of the same localization, the issue of surgical intervention is decided.

Forecast

With pneumonia, the prognosis is determined by a number of factors: the virulence of the pathogen, the age of the patient, background diseases, immune reactivity, and the adequacy of treatment. Complicated variants of the course of pneumonia, immunodeficiency states, resistance of pathogens to antibiotic therapy are unfavorable in relation to the prognosis. Especially dangerous is pneumonia in children under 1 year old, caused by staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella: mortality in them ranges from 10 to 30%.

With timely and adequate therapeutic measures, pneumonia ends in recovery. According to the variants of changes in the lung tissue, the following outcomes of pneumonia can be observed:

complete restoration of the lung tissue structure - 70%;
formation of a site of local pneumosclerosis - 20%;
formation of a local carnification site – 7%;
decrease in segment or share in size - 2%;
wrinkling of a segment or share - 1%.

Prevention

Measures to prevent the development of pneumonia are to harden the body, maintain immunity, eliminate the hypothermia factor, sanitize chronic infectious foci of the nasopharynx, combat dust, stop smoking and alcohol abuse. In debilitated bedridden patients, in order to prevent pneumonia, it is advisable to conduct respiratory and therapeutic exercises, massage, and prescribe antiplatelet agents (pentoxifylline, heparin).