Description of the stages of development of pneumonia, four degrees of severity and criteria for their determination. Features of left-sided pneumonia of the lower lobe

Pneumonia in adults (pneumonia) is an inflammation of the lower respiratory tract of various etiologies, occurring with intraalveolar exudation and accompanied by characteristic clinical and radiological signs. The main cause of the development of the disease is a pulmonary infection that affects all structures of the lungs. There are many types of pneumonia, ranging in severity from mild to severe, or even those that can be fatal.

What is pneumonia?

Pneumonia is a predominantly acute pathological condition caused by an infectious and inflammatory lesion of the pulmonary parenchyma. In this disease, the lower respiratory tract (bronchi, bronchioles, alveoli) is involved in the process.

This is a fairly common disease, diagnosed in about 12-14 adults out of 1000, and in older people whose age has exceeded 50-55 years, the ratio is 17:1000. In terms of the frequency of deaths, pneumonia ranks first among all infectious diseases.

• ICD-10 code: J12, J13, J14, J15, J16, J17, J18, P23

The duration of the disease depends on the effectiveness of the prescribed treatment and the reactivity of the organism. Before the advent of antibiotics, the high temperature dropped by 7-9 days.

The degree of contagiousness directly depends on the form and type of pneumonia. But one thing is for sure - yes, almost all types of pneumonia are contagious. Most often, the disease is transmitted by airborne droplets. Thus, being in poorly ventilated rooms with a carrier of the pneumonia virus (collective), a person is easily susceptible to infection.

Causes

Treatment of pneumonia

General practitioners, pediatricians, family physicians, and general practitioners can treat uncomplicated forms of pneumonia.

For non-severe pneumonia in adults, inpatient treatment is performed. It consists of the following measures:

1. taking drugs that dilate the bronchi for sputum discharge;
2. taking antibiotics, antiviral drugs to fight the causative agent of pneumonia;
3. undergoing a course of physiotherapy;
4. performance of physiotherapy exercises;
5. diet, drinking plenty of water.

Moderate and severe course requires hospitalization in a therapeutic or pulmonological department. Uncomplicated mild pneumonia can be treated on an outpatient basis under the supervision of a local therapist or a pulmonologist visiting the patient at home.

It is preferable to treat in a hospital in the following situations:

• patient over 60 years of age;
• the presence of chronic lung disease, diabetes, malignant tumors, severe heart or kidney failure, low body weight, alcoholism or drug addiction;
• failure of initial antibiotic therapy;
• pregnancy;
• desire of the patient or his relatives.

Antibiotics

In pneumonia of the lungs, it is advisable to use antibiotics in adults after the disease has been confirmed by at least one diagnostic method.

• With a mild course, preference is given to protected penicillins, macrolides, cephalosporins.
• Severe forms require a combination of several antibiotics: macrolides, fluoroquinolones, cephalosporins.
• Efficiency is evaluated after 2-3 days. If the condition has not improved, this is a direct indication to change the group of drugs.

Other drugs

In addition to antibiotic therapy, antipyretic therapy is also prescribed. Antipyretics are prescribed when the temperature rises from 38.5 degrees:

• ibuprofen;
• Paracetamol;
• Ibuklin;
• Aspirin.

Mucolytics are used to thin sputum:

• Ambrohexal;
• Lazolvan;
• Ambrobene;
• Fluimucil;
• Fluditec.

Physiotherapy treatment of pneumonia in adults

There are a number of procedures that are used in the treatment of pathology, the most effective are:

• ultrasonic aerosol inhalation using mucolytics and antibiotics;
• electrophoresis with the use of antibiotics and expectorants;
• decimeter wave treatment of lungs;
• UHF therapy;
• magnetophoresis;
• UV radiation;
• chest massage.

Therapeutic measures are carried out until the patient's recovery, which is confirmed objective methods– auscultation, normalization of indicators of laboratory and radiological studies.

The prognosis for pneumonia in an adult directly depends on the degree of virulence and pathogenicity of the pathogen, the presence of a background disease, as well as the normal functioning of the human immune apparatus. In most situations, pneumonia proceeds favorably and ends with a complete clinical and laboratory recovery of the patient.

Compliance with the regime

1. During the entire period of illness, the patient must comply with bed rest.
2. You need a nutritious diet rich in vitamins. If there are no signs of heart failure, it is useful to drink plenty of fluids up to 3 liters per day.
3. The room should have fresh air, light, temperature +18C. When cleaning the room, you should exclude products containing chlorine, do not use heaters with an open coil, as they dry the air a lot.

During the period of resorption of the inflammatory focus, physiotherapy is prescribed:

• inductothermy;
• microwave therapy;
• electrophoresis of lidase, heparin, calcium chloride;
• thermal procedures (paraffin compresses).

Diet and nutrition

Diet for pneumonia during an exacerbation:

• lean meat, chicken, meat and chicken broth;
• lean fish;
• milk and dairy products;
• vegetables (cabbage, carrots, potatoes, herbs, onions, garlic);
• fresh fruits (apples, pears, citrus fruits, grapes, watermelon), dried fruits (raisins, dried apricots);
• fruit, berry and vegetable juices, fruit drinks;
• cereals and pasta;
• tea, rosehip broth;
• honey, jam.

Avoid foods such as: alcohol, smoked foods, fried, spicy and fatty foods, sausages, marinades, canned food, store-bought sweets, foods with carcinogens.

Recovery and rehabilitation

After pneumonia, a very important point is rehabilitation, which is aimed at bringing all the functions and systems of the body back to normal. Rehabilitation after pneumonia also has a beneficial effect on overall health in the future, which minimizes the risk of developing and recurring not only pneumonia, but also other diseases.

Recovery implies taking medications, physiotherapy, diet, tempering procedures. This stage can last up to 3-6 months, depending on the severity of the disease.

Prevention

The most the best prevention is leading a rational lifestyle:

1. Proper nutrition (fruits, vegetables, juices), walks on fresh air, avoid stress.
2. In winter and spring, to avoid a decrease in immunity, you can take a multivitamin complex, for example, Vitrum.
3. To give up smoking.
4. Treatment of chronic diseases, moderate alcohol consumption.

Pneumonia is a dangerous and unpleasant disease of the respiratory tract, which is accompanied by the manifestation specific signs. It is worth paying attention to these symptoms in order to maintain good health and maintain the health of the body.

The incidence of pneumonia in children of the first year of life is 15-20 per 1000 children, older than 3 years 5-6 per 1000, in adults 10-13 per 1000 of the adult population. The high frequency of pneumonia in young children is associated with the anatomical and physiological characteristics of the respiratory system.

Anatomy and physiology of the lungs

The lungs are in chest cavity. Each lung is divided into parts (segments), the right lung consists of three segments, the left lung of two, as it is adjacent to the heart, therefore the volume of the left lung is less than that of the right by about 10%.

The lung consists of the bronchial tree and alveoli. The bronchial tree, in turn, consists of the bronchi. Bronchi are of various sizes (caliber). The branching of the bronchi from a large caliber to smaller bronchi, up to the terminal bronchioles, is the so-called bronchial tree. It serves to conduct air during inhalation and exhalation.

Bronchioles decrease in diameter, pass into respiratory bronchioles and eventually end in alveolar sacs. The walls of the alveoli are very well supplied with blood, which allows gas exchange.

The alveoli are covered from the inside with a special substance (surfactant). It serves to protect against microbes, prevents the collapse of the lung, is involved in the removal of microbes and microscopic dust.

Features of the respiratory system in young children

2. In newborns horizontal position ribs and underdeveloped intercostal muscles. Children at this age are in a horizontal position for a long time, which leads to stagnation of blood circulation.

3. Imperfect nervous regulation of the respiratory muscles, which leads to respiratory failure.

The main forms of pneumonia

Causes of pneumonia

According to many scientists, in 50% of all patients with pneumonia, the cause remains unknown.

The causative agents of pneumonia in early childhood are most often staphylococcus aureus, mycoplasma, microviruses, adenoviruses.

The most dangerous is a mixed viral-microbial infection. Viruses infect the respiratory mucosa and open access to the microbial flora, which aggravates the manifestations of pneumonia.
I would like to note other causes of pneumonia

Symptoms of pneumonia (manifestations)

The onset of the disease can be either gradual or sudden.

Signs of intoxication.
1. An increase in body temperature from 37.5 to 39.5 degrees Celsius.
2. Headache of varying intensity.
3. Deterioration of well-being in the form of lethargy or anxiety, decreased interest in the environment, sleep disturbances, night sweats.

From " pulmonary symptoms» Cough may be noted. His character is dry at the beginning, and after a while (3-4 days) becomes wet with copious sputum. Usually the sputum is rusty in color due to the presence of red blood cells in it.

In children, cough with rusty sputum occurs mainly at an older age. Cough occurs as a result of inflammation of the bronchial and tracheal mucosa under the action of inflammatory mediators, or mechanical (phlegm) irritation.
Edema interferes with the normal functioning of the lung and therefore, with the help of a cough, the body tries to clear it. When the cough lasts 3-4 days, there is a persistent increase in pressure in all structures of the lung, so red blood cells pass from the vessels into the lumen of the bronchi, forming, together with mucus, rusty sputum.

In addition to coughing, chest pain appears on the side of the damaged lung. The pain usually worsens with inspiration.

To the signs lung failure includes such symptoms as: shortness of breath, cyanosis (blue) of the skin, especially the nasolabial triangle.
Shortness of breath appears more often with extensive pneumonia (bilateral), breathing is especially difficult. This symptom appears due to the shutdown of the affected part of the lung from the function, which leads to insufficient saturation of the tissues with oxygen. The larger the focus of inflammation, the stronger the shortness of breath.

Rapid breathing, such as in children older than a year(more than 40 per minute) is one of the main signs of pneumonia. The blueness of the nasolabial triangle is especially noticeable in young children (during breastfeeding), but adults are no exception. The cause of cyanosis is again a lack of oxygen.

Course of pneumonia: the duration of the disease depends on the effectiveness of the prescribed treatment and the reactivity of the organism. Before the advent of antibiotics, the high temperature dropped by 7-9 days.

When treated with antibiotics, a drop in temperature can be in the early stages. Gradually, the patient's condition improves, the cough becomes wetter.
If the infection is mixed (viral-microbial), the disease is accompanied by damage to the cardiovascular system, liver, kidneys.

Diagnosis of pneumonia

What is waiting for you at the doctor?

In children, radiological changes characteristic of pneumonia may develop before the onset of symptoms of pneumonia (wheezing, decreased breathing). In children with damage to the lower lobe of the lung, it is necessary to differentiate pneumonia even with appendicitis (children complain of pain in the abdomen).

picture of pneumonia

Effective treatmentpneumonia

Hygiene, regimen and nutrition for pneumonia

2. Balanced diet: increase in fluid intake 1.5-2.0 liters per day, preferably warm. You can use fruit drinks, juices, tea with lemon. Do not eat fatty foods (pork, goose, duck), confectionery(cakes, pastries). Sweet enhances inflammatory and allergic processes.

3. Clearing the respiratory tract of phlegm by expectoration.
In children under one year old, the airways are cleansed of mucus and sputum at home by the mother (the oral cavity is cleaned with a napkin). In the department, suction of mucus and sputum is performed with an electric suction oral cavity and nasopharynx.

4. Regular ventilation and wet cleaning in the room when there is no patient in the room.
When the air temperature outside is more than 20 degrees in the room, the window should always be open. At a lower temperature outside, the room is ventilated at least 4 times a day, so that in 20-30 minutes the temperature in the room drops by 2 degrees.
In winter, in order to avoid rapid cooling of the room, the window is covered with gauze.

What medicines are used for pneumonia?

Broad-spectrum antibiotics are more commonly used. The choice of a group of antibiotics and the route of their administration (by mouth, intramuscularly, intravenously) depends on the severity of pneumonia.

In mild form of pneumonia, as a rule, antibiotics are used in tablet form and in the form intramuscular injections. Such drugs are used as: Amoxicillin 1.0-3.0 grams per day in 3 divided doses (orally), cefotaxime 1-2 grams every 6 hours intramuscularly.

Treatment of pneumonia in mild form possible at home, but under the obligatory supervision of a doctor.

Severe forms of pneumonia are treated in the hospital in the pulmonology department. Antibiotics in the hospital are administered either intramuscularly or intravenously.

The duration of antibiotic use should be at least 7 days (at the discretion of the attending physician)
The frequency of administration and dosage are also selected individually. As an example, we present standard schemes the use of drugs.

Cefazolin 0.5-1.0 grams intravenously 3-4 times a day.

Cefepime 0.5-1.0 grams intravenously 2 times a day.

On the 3-4th day of taking antibiotics (or simultaneously with the start of taking antibacterial drugs) an antifungal drug (fluconazole 150 milligrams 1 tablet) is prescribed to prevent a fungal infection.

The antibiotic destroys not only pathogenic ( disease-causing) flora, but also the natural (protective) flora of the organism. Therefore, a fungal infection, or intestinal dysbacteriosis, may occur. Therefore, the manifestation of intestinal dysbacteriosis can be manifested by loose stools, bloating. This condition is treated with drugs such as bifiform, subtil after the end of the course of antibiotics.

When using antibiotics, it is also necessary to take vitamins C and group B in therapeutic doses. Expectorant and sputum thinning drugs are also prescribed.

When the temperature is normalized, physiotherapy (UHF) is prescribed to improve the resorption of the focus of inflammation. After the end of UHF, 10-15 sessions of electrophoresis with potassium iodide, platifilin, lidase are carried out.

Phytotherapy for pneumonia

These plants are mixed in equal parts, rubbed and 1 tablespoon of the collection is poured with 1 glass of boiling water, simmered for 10-20 minutes (boiling bath), infused for 1 hour, drink 1 tablespoon 4-5 times a day.

Physiotherapy an obligatory part of the treatment of patients with acute pneumonia. After normalization of body temperature, short-wave diathermy, UHF electric field can be prescribed. After the end of the UHF course, 10-15 sessions of electrophoresis with potassium iodine and lidase are carried out.

Adequate treatment of pneumonia is possible only under the supervision of the attending physician!

Therapeutic exercise for pneumonia

1. Strengthening general condition sick
2. Improvement of lymph and blood circulation
3. Prevention of the formation of pleural adhesions
4. Strengthening the heart muscle

In the initial position, lying 2-3 times a day, breathing exercises are performed with the simplest movements of the limbs. Then they include slow turns of the torso and inclinations of the torso. The duration of classes is no more than 12-15 minutes.

For kids before school age gymnastics is used partly according to the game method. For example, walking in various ways. Using the story "a walk in the forest" - a hunter, a bunny, a clubfoot bear. Breathing exercises (porridge boils, woodcutter, the ball burst). Drainage exercises - from a position, standing on all fours and lying on its side (the cat is angry and kind). Exercises for the muscles of the chest (mill, wings). Ends with walking with a gradual deceleration.

To finally convince you that treatment should be carried out under the supervision of a doctor, I will give several possible complications pneumonia.

Abscess (accumulation of pus in the lung), which, by the way, is treated with surgery.

Pulmonary edema - which, if not dealt with in time, can lead to death.

Sepsis (the entry of microbes into the blood) and, accordingly, the spread of infection throughout the body.

Prevention of pneumonia

• Proper nutrition (fruits, vegetables, juices), outdoor walks, avoiding stress.
• In winter and spring, to avoid a decrease in immunity, you can take a multivitamin complex, for example, Vitrum.
• To give up smoking .
• Treatment of chronic diseases, moderate alcohol consumption.
• For children, it is important to exclude passive smoking, consult an otolaryngologist if the child often has colds, timely treatment rickets, anemia.

Yoga breathing exercises for the prevention of diseases of the respiratory system

2. Stand up straight. Hands forward. Inhale: at exposure, wave your arms like a windmill. Energetic exhalation with an open mouth.

3. Stand up straight. Grab your shoulders with your fingertips. While holding the breath, connect the elbows on the chest and spread widely several times. Exhale forcefully with your mouth wide open.

4. Stand up straight. Inhale in three vigorous gradual breaths - steps. In the first third, stretch your arms forward, in the second to the sides, at shoulder level, in the third, up. Exhale forcefully, opening your mouth wide.

5. Stand up straight. Inhale as you rise up on your toes. Hold your breath while standing on your toes. Slowly exhale through the nose, lowering onto the heels.

6. Stand up straight. On an inhale, rise up on your toes. Exhaling, sit down. Then get up.

How does pneumonia manifest itself in children?

In most cases, pneumonia in children manifests itself in the form of three main syndromes.

The main syndromes of pneumonia in children are:

• general intoxication syndrome;
• specific inflammation syndrome lung tissue;
• respiratory distress syndrome.

Signs of a general intoxication syndrome are:

• increased body temperature;
• rapid pulse ( more than 110 - 120 beats per minute for preschool children, more than 90 beats per minute for children over 7 years old);
• fatigue;
• fast fatiguability;
• drowsiness;
• pallor of the skin;
• decreased appetite up to refusal to eat;
• rarely sweating ;
• rarely vomiting.

Syndrome of specific inflammation of the lung tissue
Most characteristic features pneumonia in children are signs indicating organic lung damage, infection and inflammation.

Signs of specific inflammation of the lung tissue in pneumonia are:

• cough;
• pain syndrome;
• auscultatory changes;
• radiological signs;
• abnormalities in the hemoleukogram ( general blood test).

Usually pneumonia in children goes away without pain. Pain in the form of aching pain in the abdomen may appear when the lower segments of the lungs are affected.
When the inflammatory process from the lungs passes to the pleura ( the lining of the lungs), children complain of chest pains when breathing. The pain is especially aggravated when trying to take a deep breath and when coughing.

On radiographs with pneumonia in children, darker areas of the lung tissue are noted, which correspond to the affected areas of the lungs. Plots can cover several segments or entire shares. AT general analysis blood in pneumonia is observed elevated level leukocytes at the expense of neutrophils ( leukocytes with granules) and an increase in ESR ( erythrocyte sedimentation rate).

Respiratory failure syndrome
As a result of damage to the lung tissue in pneumonia, the area of ​​\u200b\u200bthe "breathing" surface of the lungs decreases. As a result, children develop respiratory failure syndrome. How less baby the faster he develops respiratory failure. The severity of this syndrome is also affected by comorbidities. So, if the child is weak and often sick, then the symptoms of respiratory failure will increase rapidly.

Signs of respiratory failure in pneumonia are:

• dyspnea;
• tachypnea ( increase in breathing);
• difficult breathing;
• mobility of the wings of the nose during breathing;
• cyanosis ( bluish coloration) of the nasolabial triangle.

With pneumonia in children, difficult, irregular breathing is noted. Attempts to take a deep breath are accompanied by great efforts involving all chest muscle groups. During breathing in children, you can see the retraction of the skin in the hypochondrium or supraclavicular region, as well as in the spaces between the ribs.
During inhalation, the wings of the nose move. The child seems to be trying to inhale more air by inflating the wings of the nose. This is another hallmark that indicates respiratory failure.

What are the features of pneumonia in newborns?

Another feature of pneumonia in newborns is the predominance of symptoms of general intoxication. So, if in adults pneumonia is more manifested by pulmonary symptoms ( cough, shortness of breath), then newborns are dominated by intoxication syndrome ( refusal to feed, convulsions, vomiting).

Pneumonia in newborns may have the following manifestations:

• refusal to breastfeed;
• frequent regurgitation and vomiting;
• shortness of breath or groaning breath;
• convulsions;
• loss of consciousness.

The first thing the mother pays attention to is that the child refuses to eat. He whimpers, restless, throws up his chest. In this case, a high temperature may not be observed, which will make it difficult to diagnose the disease. A slight increase in temperature or its decrease, as a rule, is observed in premature babies. High temperature is typical for children born in normal terms.

Newborns immediately show signs of respiratory failure. In this condition, an insufficient amount of oxygen enters the child's body, and the tissues of the body begin to experience oxygen starvation. Therefore, the skin of the child becomes bluish. The skin of the face begins to turn blue first. Breathing becomes shallow, intermittent and frequent. The frequency of respiratory excursions reaches 80 - 100 per minute at a rate of 40 - 60 per minute. At the same time, the children seem to groan. The rhythm of breathing is also interrupted, and foamy saliva often appears on the lips of children. Against the background of temperature, convulsions occur in more than half of the cases. The so-called febrile convulsions occur at high temperatures and are clonic or tonic in nature. The consciousness of children at such moments is rarely preserved. Often it is confused, while the children are sleepy and lethargic.

Another difference between pneumonia in newborns is the presence of so-called intrauterine pneumonia. Intrauterine pneumonia is the one that developed in a child when he was still in the womb. The reason for this may be various infections that a woman suffered during pregnancy. Also intrauterine pneumonia is typical for premature babies. This pneumonia appears immediately after the birth of the child and is characterized by a number of symptoms.

Intrauterine pneumonia in a newborn baby may have the following features:

• the first cry of the child is weak or completely absent;
• the skin of the baby is bluish;
• breathing is noisy, with multiple moist rales;
• decrease in all reflexes, the child reacts poorly to stimuli;
• the child does not take the breast;
• possible swelling of the extremities.

Intrauterine pneumonia in newborns is most often caused by bacterial flora. These can be peptostreptococci, bacteroids, E. coli, but most often they are group B streptococci. In children after six months, pneumonia develops against a background of a viral infection. So, first a viral infection develops ( like the flu), to which bacteria subsequently attach.

The most common causative agents of pneumonia in children of the first year of life

For newborns, the following forms of pneumonia are characteristic:

• small focal pneumonia- on the X-ray pictures small areas of darkening ( looks white on film.);
• segmental pneumonia- the focus of inflammation occupies one or more segments of the lung;
• interstitial pneumonia- not the alveoli themselves are affected, but the interstitial tissue between them.

What temperature can be with pneumonia?

The nature of the temperature depends on the form of pneumonia, on the degree of reactivity of the body and, of course, on the age of the patient.

How does pneumonia caused by Klebsiella proceed?

The main syndromes that dominate the clinical picture of pneumonia caused by Klebsiella are intoxication syndrome and lung tissue damage syndrome.

Intoxication syndrome
One of important features Klebsiella pneumonia is an acute, sudden onset due to the action of microbial toxins on the human body.

The main manifestations of intoxication syndrome are:

• temperature;
• chills;
• general weakness;
• increased sweating;
• dizziness;
• headache;
• delirium;
• prostration.

Lung Tissue Syndrome
Klebsiella are quite aggressive towards lung tissue, causing destruction ( destruction) lung parenchyma. For this reason, the course of Klebsiella pneumonia is especially severe.

Symptoms of lung tissue damage in pneumonia caused by Klebsiella are:

• cough;
• sputum;
• pain syndrome;
• dyspnea;
• cyanosis ( bluish coloration).

Sputum
Sputum with Klebsiella pneumonia contains particles of destroyed lung tissue, so it has a reddish color. It can be compared with currant jelly. Sometimes there are streaks of blood in the sputum. Also, sputum has a sharp specific smell, reminiscent of burnt meat. On the 5th - 6th day from the onset of the disease, bloody sputum is secreted in in large numbers.

Pain syndrome
First, there are constant pains in the throat and in the retrosternal region due to a persistent cough. Secondly, there are pleural pains. The inflammatory process from the lungs quickly spreads to the pleural sheets ( membranes of the lungs) that have large quantity nerve endings. Any irritation of the pleura causes severe pain in the chest, especially in the lower sections. The pain is aggravated by coughing, walking, bending over.

Dyspnea
Due to the destruction of lung tissue by Klebsiella, the area of ​​\u200b\u200bthe alveoli involved in the breathing process decreases. For this reason, shortness of breath appears. With the defeat of several lobes of the lungs, shortness of breath becomes pronounced even at rest.

Cyanosis
Severe respiratory failure leads to the appearance of a cyanotic color of the nasolabial triangle ( area covering the nose and lips). This is especially pronounced on the lips and tongue. The rest of the face becomes paler with a grayish tinge. There is also a bluish discoloration of the skin under the nails.

In a particularly severe course of Klebsiella pneumonia with a pronounced intoxication syndrome, other organs and systems are often affected. With untimely treatment in 30 - 35 percent of cases, the disease ends in death.

What are the features of the course of croupous pneumonia?

The main features of the course of croupous pneumonia

What is the difference between viral pneumonia and bacterial pneumonia?

Differences between viral and bacterial pneumonia

What is nosocomial pneumonia?

The term "hospitalized" means that pneumonia is caused by bacteria living within the walls of hospitals. These bacteria are particularly resistant and have multiresistance ( resistant to several drugs at once). Also, nosocomial pneumonia in most cases is caused not by a single microbe, but by a microbial association ( multiple pathogens). Conditionally allocate early nosocomial pneumonia and late. Early pneumonia develops within the first 5 days from the moment of hospitalization. Late nosocomial pneumonia develops no earlier than the sixth day from the moment the patient enters the hospital.

Thus, the course of nosocomial pneumonia is complicated by the polymorphism of bacteria and their particular resistance to medications.

The most common causative agents of nosocomial pneumonia

Risk factors for the development of nosocomial pneumonia are:

• advanced age ( over 60 years);
• smoking;
• previous infections, including respiratory system;
• chronic diseases (chronic obstructive pulmonary disease is of particular importance);
• unconsciousness with a high risk of aspiration;
• food through a probe;
• long horizontal position when the patient is in a supine position for a long time);
• connecting the patient to the ventilator.

Clinically, nosocomial pneumonia is very difficult and with numerous consequences.

Symptoms of nosocomial pneumonia are:

• temperature over 38.5 degrees;
• cough with phlegm;
• purulent sputum;
• frequent shallow breathing;
• interruptions in breathing;
• changes in the blood - can be observed as an increase in the number of leukocytes ( over 9x 10 9) and their decrease ( less than 4x 10 9);
• decrease in oxygen levels in the blood oxygenation) less than 97 percent;
• new foci of inflammation are visible on the x-ray.

What is SARS?

Symptoms of SARS are:

• high fever - more than 38 degrees, and with pneumonia caused by legionella - 40 degrees;
• symptoms of general intoxication predominate, such as excruciating headaches, muscle pain;
• erased pulmonary symptoms - moderate, unproductive ( no sputum) cough, and if sputum appears, then its amount is insignificant;
• Availability extrapulmonary symptoms, characteristic of the pathogen ( e.g. rashes);
• mild changes in the blood - there is no leukocytosis, which is characteristic of pneumococcal pneumonia.
• on the radiograph, an atypical picture - there are no pronounced foci of blackout;
• there is no reaction to sulfa drugs.

A feature of this atypical pneumonia is also erased pulmonary symptoms and a pronounced intoxication syndrome. Also, with pneumonia caused by a coronavirus, multiple changes in the internal organs are noted. This happens because, penetrating the body, the virus spreads very quickly to the kidneys, lungs, and liver.

The features of SARS or SARS are:

• adults from 25 to 65 years old are predominantly ill, isolated cases were noted among children;
• the incubation period lasts from 2 to 10 days;
• the route of infection transmission is airborne and fecal-oral;
• pulmonary symptoms appear on day 5, and before that symptoms of viral intoxication appear - chills, muscle pain, nausea, vomiting, and sometimes diarrhea ( such a course of the disease can mimic an intestinal infection);
• on the part of the blood, there is a decrease in the number of both lymphocytes and platelets ( which often provokes hemorrhagic syndrome);
• in a biochemical blood test, an increase in liver enzymes is noted, which reflects the damage to the liver by the virus.
• complications such as distress syndrome, toxic shock, acute respiratory failure develop rapidly.

What are the stages of development of pneumonia?

The stages of development of pneumonia are:

• start stage;
• heat stage;
• permission stage.

Stage of onset of pneumonia
The beginning of the inflammatory process in the lungs is characterized by a sharp, sudden deterioration the general condition of the patient against the background of complete health. Sudden changes in the body are explained by its hyperergic ( excessive) reaction to the causative agent of pneumonia and its toxins.

The first symptom of the disease is subfebrile body temperature ( 37 - 37.5 degrees). In the first 24 hours, it quickly increases to levels of 38 - 39 degrees and more. High body temperature is accompanied by a number of symptoms caused by general intoxication of the body with toxins of the pathogen.

Symptoms of general intoxication of the body are:

• headaches and dizziness;
• general fatigue;
• fast fatiguability;
• rapid heartbeat ( more than 90 - 95 beats per minute);
• a sharp decrease in performance;
• loss of appetite;
• the appearance of a blush on the cheeks;
• cyanosis of the nose and lips;
• herpetic eruptions on the mucous membranes of the lips and nose;
• increased sweating.

stage of pneumonia
In the stage of peak, there is an increase in the symptoms of general intoxication of the body, and signs of inflammation of the lung tissue also appear. The body temperature is kept at a high level and is difficult to treat with antipyretic drugs.

Symptoms of pneumonia in the stage of peak are:

• severe chest pain;
• quickening of breathing;
• cough;
• expectoration;
• dyspnea.

In the stage of heat, a constant cough persists. Due to the constant irritation of the pleural sheets, the cough intensifies and becomes painful. At the height of the disease with a cough, thick mucopurulent sputum begins to stand out. Initially, the color of sputum is gray-yellow or yellow-green. Gradually, streaks of blood and particles of destroyed lungs appear in the secretions. This gives the sputum a bloody-rusty color. During the peak of the disease, sputum is excreted in large quantities.

As a result of inflammation of the respiratory surface of the lungs, respiratory failure occurs, which is characterized by severe shortness of breath. In the first two days of the peak of the disease, shortness of breath appears during movement and normal physical exertion. Gradually, shortness of breath appears when performing minimal physical exertion and even at rest. Sometimes it can be accompanied by dizziness and severe fatigue.

Resolution stage
In the stage of resolution of the disease, all the symptoms of pneumonia go into decline.
Signs of general intoxication of the body disappear, and body temperature returns to normal.
The cough gradually subsides, and the sputum becomes less viscous, as a result of which it is easily separated. Its volume is decreasing. Pain in the chest appears only with sudden movements or a strong cough. Breathing gradually normalizes, but shortness of breath persists during normal physical exertion. Visually, there is a slight lag of half of the chest.

What complications can pneumonia cause?

Pulmonary complications of pneumonia are:

• development of an obstructive syndrome;

With pleurisy, symptoms of respiratory failure quickly increase. Skin at the same time they quickly become cyanotic, there are interruptions in the work of the heart.

empyema
Empyema, or purulent pleurisy, is also a formidable complication of pneumonia. With empyema, pus does not accumulate in the pleural cavity. The symptoms of empyema are similar. exudative pleurisy, but are much more pronounced. The main symptom is a high temperature ( 39 - 40 degrees) of a hectic nature. For the fever of this type daily fluctuations of temperature from 2 to 3 degrees are characteristic. So, the temperature from 40 degrees can drop sharply to 36.6. Sharp rises and falls in temperature are accompanied by chills and cold sweat. Also affected by empyema the cardiovascular system. The heart rate rises to 120 beats per minute or more.

lung abscess
An abscess forms a cavity in the lung or multiple cavities) in which purulent contents accumulate. An abscess is a destructive process, therefore, in its place, the lung tissue is destroyed. The symptomatology of this condition is characterized by severe intoxication. Until a certain time, the abscess remains closed. But then he breaks out. It can break through into the bronchial cavity or into the pleural cavity. In the first case, there is a copious discharge of purulent contents. Pus from the lung cavity exits through the bronchus to the outside. The patient has offensive, copious sputum. At the same time, the patient's condition improves with the breakthrough of the abscess, the temperature drops.
If the abscess breaks into the pleural cavity, then pleural empyema develops.

The development of obstructive syndrome
Symptoms of the obstructive syndrome are shortness of breath and periodic attacks suffocation. This is due to the fact that the lung tissue at the site of the former pneumonia loses its functionality. In its place, connective tissue develops, which replaces not only lung tissue, but also its vessels.

Pulmonary edema
Edema is the most formidable complication of pneumonia, the lethality of which is very high. In this case, water from the vessels penetrates first into the interstitium of the lungs, and then into the alveoli themselves. Thus, the alveoli, which are normally filled with air, are filled with water.

In this state, a person begins to quickly suffocate and becomes agitated. A cough appears, which is accompanied by the release of foamy sputum. The pulse rises to 200 beats per minute, the skin is covered with a cold sticky sweat. This condition requires resuscitation.

Extrapulmonary complications of pneumonia are:

• toxic shock;
• toxic myocarditis;

toxic shock
Toxic shock is a condition in which toxins from bacteria and viruses enter the patient's bloodstream. This is an emergency condition in which multiple organ failure is observed. Multiple organ failure means that pathological process more than 3 organs and systems are involved. Most often, the cardiovascular, renal, digestive and nervous systems suffer. The main symptoms are fever, low blood pressure and a polymorphic rash on the body.

Toxic myocarditis
Myocarditis is a lesion of the heart muscle, as a result of which its function is lost. The highest cardiotropism ( selectivity for the heart muscle) have viruses. Therefore, viral pneumonia is most often complicated by toxic myocarditis. Bacteria such as mycoplasma and chlamydia also specifically affect the heart tissue.
The main symptoms are heart rhythm disturbances, weakness of cardiac activity, shortness of breath.

Pericarditis
Pericarditis is an inflammation of the serous membrane that surrounds the heart. Pericarditis may develop on its own or precede myocarditis. At the same time, inflammatory fluid accumulates in the pericardial cavity, which subsequently presses on the heart and compresses it. As a result, the main symptom of pericarditis develops - shortness of breath. In addition to shortness of breath, a patient suffering from pericarditis complains of weakness, pain in the heart, dry cough.

Meningitis
Meningitis ( inflammation of the meningeal membranes of the brain) develops due to the penetration of pathogenic microorganisms into the central nervous system. Meningitis can also be bacterial or viral, depending on the etiology of the pneumonia.
The main symptoms of meningitis are nausea, vomiting, photophobia, and stiff neck.

Hepatitis
Is very frequent complication atypical pneumonia. With hepatitis, the liver tissue is affected, as a result of which the liver ceases to perform its functions. Since the liver plays the role of a filter in the body, when it is damaged, all metabolic products are not excreted from the body, but remain in it. With hepatitis, a large amount of bilirubin enters the blood from destroyed liver cells, which leads to the development of jaundice. The patient also complains of nausea, vomiting, dull pain in the right hypochondrium.

What antibiotics are used in the treatment of pneumonia?

Drugs that are used in the treatment of typical pneumonia

Also, having studied in detail the patient's medical history, he can assume what kind of disease this is. If the patient has recently been hospitalized, then most likely it is nosocomial ( hospital) pneumonia. If the clinical picture is dominated by symptoms of general intoxication, and pneumonia is more like measles or mumps, then most likely it is atypical pneumonia. If it is intrauterine pneumonia of a newborn child, then perhaps its cause is gram-negative bacilli or Staphylococcus aureus.

Once pneumonia has been diagnosed, antibiotics are prescribed ( if it's bacterial pneumonia).

Drugs used in the treatment of SARS

It is important to note that although antibiotic therapy is the mainstay of treatment, other drugs are used in the treatment of pneumonia. Without fail, antibiotic therapy is carried out in parallel with the appointment of antifungal drugs ( for the prevention of candidiasis) and other drugs, in order to eliminate the main symptoms of pneumonia ( for example, antipyretics to lower the temperature).

Is there a vaccine for pneumonia?

The Prevenar vaccine is one of the most modern and most expensive. The vaccine is given in three doses one month apart. It is believed that immunity after vaccination is developed after a month. The Synflorix vaccine is given on the same schedule as Prevenar. Pneumo-23 is the oldest vaccine currently in existence. It is set once, and its validity period is about 5 years. A significant disadvantage of this vaccination is that it can be given only after reaching the age of two. It is known that newborn children are the most vulnerable category in terms of the development of pneumonia.

It should be noted right away that vaccination against pneumonia does not mean at all that a child or an adult will not get sick again. Firstly, you can get pneumonia of another origin, for example, staphylococcal. And secondly, even from pneumococcal pneumonia, immunity is not formed for life. Vaccine manufacturers warn that it is possible to get sick again after vaccination, but the patient will endure the disease much more easily.

In addition to the pneumococcal vaccine, there is a vaccine against Haemophilus influenzae. Haemophilus influenzae, or influenza bacillus, is also a common causative agent of pneumonia. The following three vaccines are registered in Russia - Act-HIB, Hiberix and Pentaxim. They are given at the same time as the polio and hepatitis B vaccines.

With regard to vaccination against viral pneumonia, it is a little more complicated. It is known that viruses are able to mutate, that is, to change. Therefore, it is very difficult to model a vaccine against a particular virus. As soon as science invents one vaccine against a known virus, it changes and the vaccine becomes ineffective.

How does aspiration pneumonia develop?

Aspiration pneumonia can develop under the following conditions:

• alcohol intoxication;
• drug intoxication;
• the use of certain drugs;
• unconscious state;
• severe, uncontrollable vomiting;
• early childhood.

In children, aspiration pneumonia can develop when food particles enter the bronchi. This happens when complementary foods are introduced into the baby's diet. Porridge, for example, buckwheat, has the greatest danger. Even one grain of buckwheat, once in the lungs, causes local inflammation.

Another risk group is people taking psychotropic drugs, such as antidepressants or hypnotics ( sleeping pills). These drugs weaken all the reactions of the body, including reflexes. People, especially those who take sleeping pills, are in a sleepy, somewhat slowed down state. Therefore, the obstruction in their airways is weakened, and food ( or drinks) easily enters the lungs.

Getting into the lung tissue, foreign bodies ( vomit, food) cause inflammation and pneumonia.

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– acute lesion lungs of an infectious-inflammatory nature, which involves all structural elements lung tissue, mainly alveoli and interstitial lung tissue. 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.

Among the extrapulmonary complications of pneumonia, acute cardiopulmonary failure, endocarditis, myocarditis, meningitis and meningoencephalitis, glomerulonephritis, toxic shock, anemia, psychosis, etc. often develop.

Diagnosis of pneumonia

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

On physical examination, lung tissue compaction is determined (based on percussion dullness of lung sound and increased bronchophony), a characteristic auscultatory picture - focal, moist, finely bubbling, sonorous rales or crepitus. With echocardiography and ultrasound of the pleural cavity, a pleural effusion is sometimes determined.

As a rule, the diagnosis of pneumonia is confirmed after a lung x-ray. 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 blackouts of various localization and extent);
• interstitial (pulmonary pattern is enhanced by perivascular and peribronchial infiltration).

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). 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.

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 treatment for pneumonia is antibiotic therapy. Antibiotics should be prescribed as early as possible, without waiting for the identification 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 (spiramycin, roxithromycin), cephalosporins (cefazolin, etc.) are more often prescribed. The choice of the method of administration of the antibiotic is determined by the severity of the course of pneumonia. For the treatment of nosocomial pneumonia, penicillins, cephalosporins, fluoroquinolones (ciprofloxacin, ofloxacin, etc.), carbapenems (imipenem), aminoglycosides (gentamicin) 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.

With pneumonia, detoxification therapy, immunostimulation, the appointment of antipyretic, expectorant and mucolytic, antihistamines are indicated. 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 condition and well-being, physical, radiological and laboratory parameters. With frequent repeated pneumonia of the same localization, the issue of surgical intervention is decided.

Pneumonia prognosis

In 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: their mortality rate is 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 of pneumonia

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 carry out respiratory and therapeutic gymnastics, massage, the appointment of antiplatelet agents (pentoxifylline, heparin).

Pneumonia or pneumonia refers to acute infectious diseases. The causative agents of pneumonia can be varieties of viruses, bacteria, fungi. There are also types such as aspiration pneumonia or paracancer inflammation of the lungs, which develops around the focus of a cancerous tumor in the tissues of the lung. At the first sign of pneumonia, you should immediately consult a doctor.

The inflammatory process in the lungs is a disease that can cause significant harm to health. Before the invention of antibiotics, mortality from pneumonia reached 80%. At the moment, in various regions, death rates due to the development of pneumonia range from 5 to 40%, and the elderly are mainly affected.
An uncomplicated form of the disease with timely diagnosis and therapy is cured in 10-14 days. Modern medicines help to avoid severe complications and cure almost any form of pneumonia without consequences. However, it must be remembered that for effective treatment and successful prevention of complications, therapy this disease should be handled by a specialist.

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What is pneumonia

Pneumonia is an inflammatory process with localization in the lung tissues. In most cases, the causative agent is an infectious agent. The ways the infection enters the body are different, most often it is airborne, less often it spreads through the bloodstream.

Some of the microorganisms responsible for the development of pneumonia are constantly present in the human body. With the proper level of immune defense, the body successfully copes with such infections, with a decrease in the level of protective forces (hypothermia, primary disease) develops an inflammatory process in the lungs.
Most often in the etiology of pneumonia there are diseases of the upper respiratory tract. In this case, against the background of symptoms of a cold, tracheitis, acute, chronic, or other focus of infection in the respiratory system, an inflammatory process develops in the lungs. The occurrence of the disease can also be a consequence of a previous illness of other organs and systems, a complication after surgical intervention, other situations that adversely affect the immune system.

Symptoms of pneumonia in adults and children

The symptomatology of the disease depends on the causes that caused it, the age of the patient, the state of his health. The disease is acute or develops in an erased form, may have classic symptoms or be asymptomatic, atypical pneumonia. The most severe course of the disease with severe pulmonary complications occurs in elderly patients, immunocompromised people and children with their imperfect immune systems.

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The clinical picture of pneumonia: symptoms in adults

The most common trigger of the inflammatory process in the lungs in the adult population is hypothermia. To characteristic symptoms inflammation of the lungs in such cases include the following manifestations that occur sequentially:

• suddenly developing hyperthermia of the body, a sharp rise in temperature to febrile levels;
• symptoms of intoxication of the body (fatigue, weakness,);
• on the 3-5th day appears, turning into wet, with sputum;
• pain in the chest from the side of lung tissue damage (with bilateral pneumonia on both sides) when coughing, breathing. Sometimes wheezing is clearly audible;
• the appearance of shortness of breath as a result of extensive lung lesions and onset of respiratory failure.

The picture of the disease may not correspond to the classical pattern of the development of the disease. Clinical manifestations and the severity of the disease largely depend on the type of causative agent of the inflammatory process. So, among atypical pathogens, H1N1 is known, the infectious agent of "swine flu", which causes a serious complication in the form of viral bilateral pneumonia, accompanied by significant lesions of the lung tissue with extensive foci of inflammation, acute respiratory failure.

With high frequency pneumonia develops against the background of acute respiratory infections, acute respiratory viral infections, accompanied by flu-like symptoms. The risk of pneumonia and the presence of other complications increases significantly with self-treatment, most often consisting in taking antipyretics. This contributes to the spread of infection down the respiratory tract and the formation of infectious foci in the lungs. Thus, the prevention of pneumonia in infectious diseases becomes a full course of treatment and timely diagnosis.

Symptoms of pneumonia in children

The incidence rate in children correlates with age: babies under three years old get sick 2-3 times more often (1.5-2 cases per 100 people) than children older than 3. Infants get pneumonia more often due to aspiration of gastric contents during regurgitation, ingestion of foreign bodies in the respiratory tract, birth injuries, malformations.
Symptoms of pneumonia in childhood also differ depending on the age period, etiology and spread of the inflammatory process.
At the age of one year, the following signs are distinguished:

• drowsiness, lethargy, general malaise, lack of appetite;
• irritability, frequent causeless crying;
• hyperthermia, often in subfebrile limits;
• increase in the rhythm of breathing;
• with a unilateral process - signs of insufficient filling of one of the lungs, lagging behind half of the chest during respiratory movements;
• symptoms of respiratory failure - cyanosis of the nasolabial triangle, fingertips especially during crying, feeding, increased arousal.

In older children with pneumonia, the symptoms are similar to those of pneumonia in adults: fever, weakness, drowsiness, increased sweating, decreased appetite, loss of interest in favorite activities, severe general malaise, respiratory failure may develop if large areas of the lungs are involved in the inflammatory process or individual features child.

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Classification of pneumonia

The classification of forms of pneumonia as a well-studied disease is based on several factors, which allows more accurate diagnosis and more effective treatment of pneumonia in patients.

Classification according to the condition of occurrence

Allocate community-acquired pneumonia and nosocomial, nosocomial pneumonia. Nosocomial is considered a form that develops in a hospital, clinic 48 hours after the patient's hospitalization for other indications. This type of pneumonia is distinguished due to the characteristics of the course and treatment, since strains of infectious pathogens that are resistant to antibiotic therapy often develop in hospitals and hospitals.

Aspiration form, which develops as a result of entry into the lower respiratory tract of the contents of the oral cavity, nasopharynx or stomach, as well as in the form of solid bodies. Bacterial pathogens found in aspiration masses or objects develop and cause a severe type of inflammation with purulent complications: the production of purulent sputum, difficulty in transporting it, and significant damage to lung tissues.

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Classification according to the volume of lung damage

Depending on the prevalence of the inflammatory process, the volume of involved lung tissues, several types of the disease are distinguished.

Symptoms of focal pneumonia

The focal form is characterized by a clear localization of the inflammatory process. Most often, this variety develops as a complication of a viral disease. There is a dry cough with a transition to a wet form, high body temperature, soreness when coughing, the presence of sputum with purulent inclusions.

Unilateral form of the disease

The process captures only the right or only the left lung, and can spread to a small segment or involve all parts of the organ. Symptoms depend on the extent of the lesion, the pathogen, the general condition of the patient, and may be pronounced or asymptomatic.

Bilateral pneumonia

Localization of foci of inflammation is noted both in the right and in the left lung. In this case, the inflammatory process can be segmental, lobar or completely involve the entire organ. The main difference is that both sides of the lung are affected, regardless of the extent of the lesion.

Croupous pneumonia

With this form, pneumonia is characterized by one of the most pronounced clinical pictures. Distinctive external symptoms of the croupous form are a sharp increase in body temperature to extreme levels (40 ° C and above), a pronounced pain syndrome, a characteristic yellow-orange tint of sputum.
The causative agent of croupous pneumonia is most often pneumococci, and the timely administration of antibacterial drugs (most often antibiotics of the penicillin series are prescribed) brings recovery in both croupous and other forms of pneumococcal pneumonia.

Lobar inflammation of the lungs

The lung is an organ consisting of conditional lobes: there are three of them in the right lung, and two in the left. If one lobe of the organ is affected, then this is the lobar form, localization in two lobes means the bidol form, unilateral or bilateral. With the defeat of two lobes of the left lung, they speak of total pneumonia, two lobes of the right lung - a subtotal form.
Types of inflammation characterize the extent of the process and the severity of tissue damage. The more segments and lobes involved, the more pronounced the symptoms of the disease.

Classification of pneumonia due to disease

Diagnosis of the disease by the pathogen largely dictates the methods of therapy and the choice of drugs. Depending on the causes and type of infectious agent, several types of the disease are distinguished.

Inflammation of the lungs of viral etiology

Infectious pneumonia caused by viruses can be a complication of influenza, parainfluenza or SARS (adenoviral form) or have a primary etiology. Due to the imperfection of diagnostic methods, it is not always possible to identify which virus is responsible for the onset of the disease, so treatment is most often carried out using antiviral drugs. broad action and is symptomatic.
If the viral form is prescribed antibacterial agents, this means that there are symptoms or the likelihood of a bacterial infection.

Bacterial infections in the etiology of pneumonia

Bacterial pneumonia is one of the most common types of pneumonia. There are several groups of bacteria that can cause inflammation of the lower respiratory tract. Among them, the most common causative agent of pneumonia are pneumococci, streptococci, staphylococci, mycoplasma, chlamydia, Pseudomonas aeruginosa and others.
Subject to the correct identification of the pathogen and selection effective drug bacterial form successfully treated with antibiotics. However, it is important to remember the need to select therapy according to the sensitivity of bacteria to drugs of a particular group.

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Features of staphylococcal pneumonia

The staphylococcal form is most often a complication after SARS. The disease is characterized by symptoms of significant intoxication of the body, scarlet sputum, weakness, dizziness.

The causative agent of mycoplasma pneumonia

Mycoplasma form of pneumonia develops when specific bacteria, mycoplasmas, enter the tissues of the lungs. Most often this form of the disease affects children and adolescents.
The disease does not have severe symptoms, which makes it difficult to diagnose, it is treated successfully, although the therapy process itself is quite lengthy due to the characteristics of mycoplasma as a pathogen.

Chlamydial infection in the etiology of pneumonia

The cause of chlamydial pneumonia is the entry into the respiratory tract and lungs of chlamydia, bacteria that normally cause bacterial chlamydia of the vagina. The most common route of infection is from mother to child through birth canal if prenatal sanitation of the vagina has not been performed and there is a harmful flora containing chlamydia.
This type is more common among children, especially infants, and adolescents, and on initial stage has an unexpressed clinical picture, similar to ARI. Therapy for this form of the disease is selected individually, taking into account the age and characteristics of the patient.
Together with mycoplasmal infections, these two forms fall under the category of atypical pneumonia, also characterized by damage to the alveoli and interstitial tissues. Character interstitial pneumonia most often protracted, with the transition to a chronic form.

Fungal infections

Various can also cause inflammation in the lungs. However, the diagnosis requires a thorough examination, since clinical picture not expressed, the symptoms for a long time can be quite "blurred", do not correspond to the classical manifestations of the disease of bacterial etiology. Long-term treatment, with the use of antimycotic drugs.
Any types and stages of pneumonia are considered a serious disease, dangerous complications and negatively affecting the body as a whole. A course of properly selected therapy allows you to cure patients with high efficiency, provided timely treatment for diagnosis and compliance with specialist appointments.