How to distinguish pneumonia from SARS. Signs of the onset of pneumonia How to distinguish orvi from pneumonia in children

The phrase "pneumonia" is very scary for parents. At the same time, it does not matter at all how old or months the child is, this disease among mothers and fathers is considered one of the most dangerous. Is this really so, how to recognize pneumonia and how to properly treat it, says the well-known pediatrician, author of books and articles on children's health Evgeny Komarovsky.

About the disease

Pneumonia (this is how doctors call what is popularly called pneumonia) is a very common disease, inflammation of the lung tissue. Under one concept, doctors mean several ailments at once. If the inflammation is not infectious, the doctor will write "pneumonitis" on the card. If the alveoli are affected, the diagnosis will sound different - “alveolitis”, if the lung mucosa is affected - “pleurisy”.

The inflammatory process in the lung tissue is caused by fungi, viruses and bacteria. There are mixed inflammations - viral-bacterial, for example.

Ailments included in the concept of "pneumonia" are all medical reference books are classified as quite dangerous, since out of 450 million people from all over the world who fall ill with them per year, about 7 million die due to incorrect diagnosis, incorrect or delayed treatment, as well as from the swiftness and severity of the course of the disease. Among the dead, about 30% are children under 3 years old.

According to the location of the focus of inflammation, all pneumonias are divided into:

• Focal;
• Segmental;
• Equity;
• Drain;
• Total.

Also, inflammation can be bilateral or unilateral if only one lung or part of it is affected. Quite rarely, pneumonia is an independent disease, more often it is a complication of another disease - viral or bacterial.

The most dangerous pneumonia is considered for children under 5 years of age and the elderly, among such cases the consequences are unpredictable. According to statistics, they have the highest mortality rate.

Yevgeny Komarovsky claims that the respiratory organs are generally the most vulnerable to various infections. It is through the upper respiratory tract (nose, oropharynx, larynx) that most microbes and viruses enter the child's body.

If the baby's immunity is weakened, if the environmental conditions in the area where he lives are unfavorable, if the microbe or virus is very aggressive, then the inflammation does not linger only in the nose or larynx, but falls lower - into the bronchi. This disease is called bronchitis. If it cannot be stopped, the infection spreads even lower - to the lungs. Pneumonia occurs.

However, the airborne route of infection is not the only one. If we take into account that the lungs, in addition to gas exchange, perform several other important functions, it becomes clear why sometimes the disease appears in the absence of a viral infection. Nature has entrusted the human lungs with the mission of moistening and warming the inhaled air, purifying it of various harmful impurities (the lungs act as a filter), and similarly filter the circulating blood, releasing many harmful substances from it and neutralizing them.

If the baby underwent surgery, broke his leg, ate something wrong and got severe food poisoning, burned himself, cut himself, one or another amount of toxins, blood clots, etc. gets into the blood in various concentrations. by a defense mechanism - coughing. However, unlike household filters, which can be cleaned, washed or thrown away, lungs cannot be washed or replaced. And if one day some part of this “filter” fails, becomes clogged, the very disease begins, which parents call pneumonia.

Pneumonia can be caused by a wide variety of bacteria and viruses.. If a child falls ill while in the hospital with another illness, then in a huge degree of probability he will have bacterial pneumonia, which is also called hospital or hospital pneumonia. This is the most severe of pneumonias, because in conditions of hospital sterility, the use of antiseptics and antibiotics, only the strongest and most aggressive microbes survive, which are not so easy to destroy.

Most often, pneumonia occurs in children, which arose as a complication of a viral infection (ARVI, influenza, etc.). Such cases of inflammation of the lungs account for about 90% of the relevant childhood diagnoses. This is not even due to the fact that viral infections are “terrible”, but to the fact that they are extremely widespread, and some children get sick with them up to 10 times a year or even more.

Symptoms

To understand how pneumonia begins to develop, you need to have a good idea of ​​\u200b\u200bhow the respiratory system works in general. The bronchi constantly secrete mucus, the task of which is to block dust particles, microbes, viruses and other unwanted objects that enter the respiratory system. Bronchial mucus has certain characteristics, such as viscosity, for example. If it loses some of its properties, then instead of fighting the invasion of alien particles, it itself begins to deliver a lot of "trouble".

For example, too thick mucus, if the child breathes dry air, clogs the bronchi, interferes with normal ventilation of the lungs. This, in turn, leads to congestion in some areas of the lungs - pneumonia develops.

Often pneumonia occurs when the child's body is rapidly losing fluid reserves, bronchial mucus thickens. Dehydration of varying degrees can occur with prolonged diarrhea in a child, with repeated vomiting, high fever, fever, with insufficient fluid intake, especially against the background of the previously mentioned problems.

Parents can suspect pneumonia in a child by a number of signs:

• Cough has become the main symptom of the disease. The rest, who were present before, gradually pass, and the cough only intensifies.
• The child became worse after improvement. If the disease has already receded, and then suddenly the baby feels bad again, this may well indicate the development of complications.
• The child cannot take a deep breath. Each attempt to do so results in a violent fit of coughing. Breathing is accompanied by wheezing.
• Pneumonia can manifest itself through severe pallor skin against the background of the above symptoms.
• The child has shortness of breath and antipyretics, which had always helped quickly before, ceased to have an effect.

It is important not to engage in self-diagnosis, since one hundred percent way to establish the presence inflammation easy is not even the doctor himself, but an X-ray of the lungs and bacterial culture of sputum, which will give the doctor an accurate idea of ​​which pathogen caused the inflammatory process. A blood test will show the presence of antibodies to viruses if the inflammation is viral, and the Klebsiella found in the feces will suggest that pneumonia is caused by this particular dangerous pathogen. At home, the doctor will definitely listen and tap the area of ​​​​the lungs of a small patient, listen to the nature of wheezing during breathing and during coughing.

Is pneumonia contagious?

Whatever caused inflammation of the lungs, it is in almost all cases contagious to others. If these are viruses, they are easily transmitted to other family members through the air, if bacteria - by contact, and sometimes by airborne droplets. Therefore, a child with pneumonia should be provided with separate dishes, towels, bed linen.

Treatment according to Komarovsky

Once the diagnosis is established, the doctor will decide whether the child will be treated at home or in the hospital. This choice will depend on how old the child is and how severe the pneumonia is. Pediatricians try to hospitalize all children under 2 years of age, because their immunity is weak, and the treatment process should therefore be constantly monitored by medical personnel.

All cases of obstruction during pneumonia (pleurisy, bronchial obstruction) are grounds for hospitalization of children of any age, as this is an additional risk factor, and recovery from such pneumonia will not be easy. If the doctor says that you have uncomplicated pneumonia, then with a high degree of probability he will allow you to treat it at home.

Most often, pneumonia is treated with antibiotics, and it is not at all necessary that you will have to do a lot of sick and terrible injections.

Antibiotics, which can quickly and effectively help, the doctor will determine according to the results of a sputum analysis for bakposev.

Two-thirds of cases of pneumonia, according to Yevgeny Komarovsky, are perfectly treated with pills or syrups. In addition, expectorants are prescribed, which help the bronchi to clear accumulated mucus as soon as possible. At the final stage of the child's treatment, physiotherapy and massage are shown. Also, children who are undergoing rehabilitation are shown walking and taking vitamin complexes.

If the treatment takes place at home, then it is important that the child is not in a hot room, drinking enough fluids, vibration massage is useful, which helps to expel bronchial secretions.

Treatment of viral pneumonia will proceed in the same way, with the exception of antibiotics.

Prevention

If the child is sick (ARVI, diarrhea, vomiting and other problems), it is imperative to ensure that he consumes enough fluids. Drinking should be warm so that the liquid can be absorbed faster.

A sick baby should breathe clean, moist air. To do this, you need to ventilate the room, moisten the air with a special humidifier or with wet towels hung around the apartment. Do not allow the room to be hot.

The best settings for saving normal level mucus viscosities are as follows: air temperature 18-20 degrees, relative humidity - 50-70%.

Pneumonia is a very serious and dangerous disease, because. can lead to patient death. When pneumonia develops acute inflammation lung tissue. The concept of pneumonia combines a whole group of diseases that differ different symptoms, the course of the disease, and the causes of the appearance.

There are a number of diseases similar in symptoms to pneumonia, so the accurate diagnosis and separation of pneumonia from other respiratory diseases is of great importance in medicine.

Let us consider in more detail the definition of pneumonia, its symptoms, causes, and how to distinguish it from other similar diseases.

Inflammation of one or both lungs, accompanied by the accumulation of inflammatory fluid in the alveoli, is called pneumonia. Alveoli are involved in gas exchange, and fluid infiltration in them makes this process difficult. Pneumonia is divided into several types:

• By type of pathogen is divided into: viral, bacterial, fungal, mycoplasmal or mixed.
• Home or community is divided into: typical, atypical (occurs in people with reduced immunity), aspiration (presence foreign bodies in the lungs), and pneumonia caused by microorganisms and with symptoms of intestinal distress.
• Nosocomial pneumonia occurs in patients who are in the hospital for more than 2 days, or with mechanical ventilation, or in patients with reduced immunity.
• According to the degree of severity, it is divided into mild, moderate and severe forms.
• According to the volume of inflammation, it is divided into: unilateral (the right or left lung is affected), bilateral, segmental, lobar and total.
• Pneumonia can be acute or chronic.

Causes of the disease

Pneumonia can develop due to many reasons, the most common of which are microorganisms: pneumococci, staphylococci, streptococci, E. coli, enterobacteria, viruses, mycoplasmas, fungal pathogens. There are a number of causes of pneumonia and non-infectious nature: exposure to toxins and allergens, trauma to the sternum, exposure to radiation.

Factors favoring the development of pneumonia are:

1. Reduced immunity, immunodeficiency and a weakened state of the body, for example, in old age.
2. Smoking and frequent drinking.
3. Chronic diseases of the respiratory tract.
4. Heart failure and disorders in the work of the heart.
5. Prolonged bed rest.
6. Hypothermia.
7. Endocrine diseases.
8. Birth trauma, asphyxia (pneumonia of newborns).

Symptoms of pneumonia

Since pneumonia has many forms and types, it can manifest itself in different ways.

Symptoms of acute pneumonia:

• Severe intoxication.
• Temperature 39-40 ° - fever.
• Clouding of consciousness and delusional state.
• Increased heart rate over 100 beats per minute.
• Strong shortness of breath.
• X-ray shows signs of severe infiltration in the lungs.

The average form of pneumonia is more mildly expressed:

• The person is conscious but feels weak.
• Elevated temperature up to 39 ° and sweating.
• There is no shortness of breath at rest.
• Pulse up to 90 beats per minute.
• X-ray indicates visible infiltration.

The mild form of pneumonia is not pronounced, the symptoms increase gradually and can be similar to any other disease: influenza and SARS, intestinal upset, bronchitis and others:

• Weakness.
• Loss of appetite.
• Sweating is increased.
• Muscles ache, as with a "cold."
• Headache.
• Sometimes there is pain in the chest.
• Violent dry cough, which in a few days turns into a cough with clear or purulent sputum.
• Increasing dyspnea.
• With pneumonia caused coli, intestinal disorders appear (vomiting, diarrhea, abdominal pain).
• With viral pneumonia caused by herpes, rashes appear.

In order for pneumonia to be correctly diagnosed, it must be distinguished from other diseases with similar symptoms.

How to distinguish pneumonia from other diseases?

Very often people are interested in how to distinguish pneumonia from pneumonia. There is no such diagnosis as pneumonia in medicine., is a more colloquial term for pneumonia. Any inflammatory process in the lungs is pneumonia, therefore Inflammation of the lungs and pneumonia are exactly the same.

How to differentiate between pneumonia and bronchitis? Bronchitis is also characterized by inflammation of the airways: the lungs and bronchi. However, if pneumonia in most cases is caused by a bacterial infection, then bronchitis is viral. With bronchitis, the patient does not have much elevated temperature, on the respiratory tract swelling and scars appear, breathing is noisy, whistling when listening. On x-rays pathological changes can not see.

How to distinguish influenza and SARS from pneumonia? Influenza, as a rule, begins with a sharp increase in temperature, a person feels a sharply rolling weakness, muscle aches, chills, dizziness. Symptoms of pneumonia increase more gradually. If we talk about SARS, then in this case, the hallmark will be perspiration and swelling in the throat, at the beginning of the disease, then the throat starts to hurt badly and a runny nose joins, which does not happen with pneumonia. Sore throat is replaced by a dry cough or cough with sputum, which is a clear mucus.

The difference between pneumonia and tuberculosis. Tuberculosis does not always have an acute onset, more often, the development is very slow, the patient has a cough that lasts 3 or 4 months. A person with tuberculosis, as a rule, had previously had contacts with carriers of this infection. For an accurate diagnosis of tuberculosis, X-ray examination, which shows extensive damage to lung tissue, not as significant as with pneumonia. People with tuberculosis suffer from loss of appetite and marked weight loss. one more hallmark is an unhealthy blush on the face.

In the spring, when it gets warm outside, the sun warms up, people lose their “vigilance”, which is why they often “earn” pneumonia. But the disease is very insidious, because. at the initial stages of the disease, signs are very often confused with acute respiratory infections - slight temperature, a slight cough, and if you do not do a fluorography, then it is difficult to identify the danger. Because of this, the disease is started and the treatment of pneumonia is started at a stage when the disease is already strongly progressing. The finale may turn out to be very sad, because. the later treatment is started, the more likely it is to die. This is especially true for children and the elderly, because this group is among the most “unprotected”.

Therefore, everyone should know how to distinguish pneumonia from the common cold in time and about these 4 important features and we'll talk.

Sign #1. When using antipyretic drugs, the desired effect cannot be achieved.
Often, with pneumonia, a person holds on to the body, i.e. not high. It goes astray with the help of drugs, but then rises again. Therefore, if within 3-5 days the temperature, despite the effect of the drugs, still remains, then this is already a signal.

Sign #2. Cough that produces mucus
In the early stages of the disease, a cough may not appear, but in the future it may appear. Color can be yellowish, brownish and greenish. This is also a reason to call a doctor to the patient.

Sign #3. Blueness of the skin around the mouth.
In later stages, symptoms of circulatory disorders appear. Inflammation occurs at the level of the alvioli (gas exchange occurs there) because of this, the lungs are poorly ventilated. The blood is saturated with oxygen worse, the body simply does not have enough of it, as a result of which the lips and skin around the mouth acquire a bluish tint.

Sign number 4. Shortness of breath and rapid pulse.
If a person during an illness did not go to the doctor on time, then this is already the fourth symptom. Respiratory functions are disturbed more strongly, the body is deficient in oxygen. To compensate for the shortage, the heart and lungs have to work harder.

Remember that self-medication is very dangerous, the fact is that the disease can occur not only due to pathogenic bacteria when antibiotics are used. It can also be caused by fungi, this may be a consequence viral diseases, exposure to atypical pathogens and in each case, treatment should be strictly defined.

If at least one of these symptoms you experienced during the so-called. colds, seek immediate medical attention medical care, because if this is not done, then as a result respiratory failure you can simply suffocate.

Editor

Doctor, forensic expert

The most common diseases of the respiratory system are acute respiratory viral infections (they also include influenza) and pneumonia (pneumonia). These diseases are completely different in terms of, but not always distinguishable in terms of clinical manifestations.

is an inflammatory process in the lung tissue with a primary lesion of the respiratory sections of the lung. Acute respiratory viral infections (ARVI) are a group of diseases that have a similar morphological and clinical picture, with lesions of the upper respiratory tract of the catarrhal type.

In this article, we will delve deeper into the fundamental differences between these diseases.

The mechanism of the development of the common cold

A cold is a general hypothermia of the body, after which a disease develops (most often SARS). In medical practice, the term "cold" means the usual hypothermia, however, in everyday life it is used as a designation for the disease itself.

Attention! The cold itself is not the cause of the development of the disease, it only creates the prerequisites for its development.

So how can a decrease in body temperature lead to the development of the disease? The organism in this case includes a protective mechanism, which is aimed at heating the “core”. All are last internal organs, in them the temperature is always higher and is about 37 ° C. There is a spasm of the peripheral vessels of the skin, oral cavity, which in turn prevents the entry of immune cells with the blood stream.

This leads to a weakening of the body's defenses and is manifested by increased susceptibility to infections. In addition, due to temperature stress, cortisone levels increase, which inhibits activity. immune system organism.

A constant temperature is necessary to ensure all chemical and biological reactions occurring in the body.

At its normal values immune cells capture the infectious agent and die with it, preventing its spread. During hypothermia, these processes are disrupted.

Temperature is also important for bacteria and viruses themselves. It has been proven that when low temperatures their outer shell hardens, which contributes to their stability in environment and better distribution.

It should always be remembered that diseases are caused by bacteria and viruses, not the common cold, and if they do not enter the body during cooling, then the disease will not occur.

Most often, a cold becomes the cause of the development of the disease in the autumn-winter period. This also has a rationale: people spend more time at home and in other poorly ventilated areas where there is a high concentration of microorganisms. Another significant factor is low air humidity, which causes dryness of the nasal mucosa, which reduces the protective properties.

SARS

As mentioned earlier, ARVI is not a specific disease, but includes a group of similar pathologies. They cannot be distinguished without special laboratory tests, and since they all have the same course and treatment, this is not necessary. Therefore, they were united in a group.

ARVI ranks first in the structure of the global incidence. All people suffered from these diseases at least once in their lives, and many suffer them several times a year. Due to their non-severe course, many people do not seek medical help and are treated on their own, for this reason it is impossible to fully calculate the incidence. Children of the first year of life practically do not suffer from these diseases, this is due to their passive immunization with mother's milk. But children from one to seven years old get sick most often (up to 10 times a year).

You can get infected from a sick person at the end of the incubation and the entire febrile period. The most common route of infection is airborne. Sometimes it can be transmitted by contact, directly by direct contact (kiss, handshake) or through household items.

The cause of the development of the disease is microorganisms. Basically, these are viruses that have a very high contagiousness (infectivity) index. These include:

• rhinoviruses;
• adenoviruses;
• influenza and parainfluenza;
• reoviruses and many others.

Clinical manifestations may resemble the initial stage of the course of pneumonia. ARVI is characterized by a pronounced catarrhal syndrome:

• temperature rise to subfebrile numbers (37 ° C);
• headache;
• weakness;
• Pain in the eyes;
• cough;
• sore throat;
• runny nose;
• sneeze.

Attention! Treatment with antibiotics is absolutely meaningless, since it does not act on viruses.

You can use interferon preparations that have a detrimental effect on the pathogen. But most often only symptomatic therapy is used. It includes combined preparations analgesics and antipyretics, which relieve fever and pain.

Flu

The flu is acute inflammatory disease upper respiratory tract, which is caused by the influenza virus. It belongs to the group of acute respiratory viral infections and occupies a special place in it.

The flu virus is incredibly contagious, in connection with which it spreads very quickly and causes pandemics. This pathogen affects all age groups without exception.

Once in the body, the virus penetrates the cells of the mucous membrane, destroying them, which in turn leads to the formation of reactions such as coughing, sneezing, nasal congestion. Further, the virus enters the bloodstream and causes viremia, which has a toxic effect and is manifested by an intoxication syndrome. It leads to increased permeability vascular wall, this leads to the occurrence of edema, hemorrhages and other vascular phenomena.

Influenza occurs with a primary lesion of the trachea (tracheitis). A characteristic feature is a pronounced intoxication, which appears from the first days of the disease and continues throughout the acute period.

The disease begins gradually with an increase in temperature from subfebrile to hyperpyretic figures (37-40 ° C). It is accompanied by weakness, myalgia, headaches.

Catarrhal phenomena are weakly expressed, runny nose is not typical, dryness in the nose is more pronounced. There is a dry cough that causes pain in the chest.

With a favorable course, the symptoms begin to subside after 3-4 days. But the flu leads to a significant weakening of the body, which creates favorable conditions for secondary infection. Most often, bacterial pneumonia develops against its background.

Influenza is very difficult to differentiate from other acute respiratory viral infections, especially with an atypical course. This can be done only with a special virological study, which takes a lot of time. But to distinguish influenza from other acute respiratory viral infections is very important, since it has specific drugs for treatment (oseltamivir, rimantadine, zanamivir). Influenza vaccination significantly reduces the incidence and alleviates the course of the disease.

Vaccination must be carried out no later than 2 weeks before the expected epidemic, otherwise the effectiveness is controversial.

Pneumonia

Pneumonia is an inflammatory process of the lungs. The cause of its occurrence is most often bacteria, the leader of which is certainly pneumococcus. It accounts for about 95% of community-acquired pneumonia. In the structure, the first place belongs to Staphylococcus aureus.

The pathogenesis of pneumonia is based on damage to the hemato-alveolar barrier, which leads to increased vascular permeability and exudation of plasma and blood cells into the alveolar cavity. This process takes place in, which end in the purification of the lungs through the separation of sputum.

very similar to SARS especially when it is mild. Many people carry the disease “on their feet”, confusing it with SARS. In this case, pneumonia is diagnosed retrograde, with an X-ray examination for another reason. Classical pneumonia begins acutely and is accompanied by the following symptoms:

• severe fever (38-39 ° C);
• lethargy, fatigue, weakness;
• myalgia, headaches, dizziness;
• chest pain;
• dry cough, after 3-4 days it is replaced by a productive one.

Antibiotics are the etiotropic therapy for pneumonia., which kill the bacteria that caused the inflammation. In addition, it applies a large number of symptomatic agents (NSAIDs, immunostimulants, and other drugs).

How to distinguish diseases?

Despite all their similarities, these diseases have a number of hallmarks by which they can be identified. Consider the differences in a handy table:

Conclusion

ARVI is a very common disease, it not only looks like pneumonia in its course, but can also be complicated by it. Therefore, it is necessary to consult a doctor for high-quality diagnosis and treatment. To prevent the occurrence of these diseases, it is necessary to follow all recommendations and conduct healthy lifestyle life.

All parents know that pneumonia is dangerous disease. It often occurs as a complication of a cold or illness that has nothing to do with the lungs. It is necessary to know by what signs it can be suspected that a child has pneumonia, in which cases he needs to be hospitalized, and when it can be treated at home, how contagious the disease is. Antibiotics are effective remedy with pneumonia, but they only help with correct application when the diagnosis is precisely known and the type of infection is established.

Content:

How does pneumonia occur in children?

Pneumonia (inflammation of the lungs) is an infectious lesion of the lowest part of the respiratory system. Depending on the pathogen, it can be viral or bacterial in nature. Viruses and bacteria cause inflammation and swelling of the lung tissue, which makes it difficult for the absorption of oxygen and the removal of carbon dioxide, leading to oxygen starvation all organs.

Pneumonia can occur as an independent disease (primary), as well as a complication of diseases of the upper respiratory tract (secondary). In children under 7 years of age, most often it occurs after acute respiratory infections. However, it can accompany diseases that have nothing to do with the lungs. For example, it occurs against the background of an infectious lesion of the intestine, food poisoning, a burn, or after surgical operations. The reason is that a decrease in the child's physical activity leads to a deterioration in lung ventilation, the accumulation of microbes in them, and a weakened immune system increases the body's susceptibility to infection.

Inflammation of the lungs is unilateral and bilateral.

Is pneumonia contagious?

The causative agents of pneumonia can be viruses, bacteria, fungi and other microorganisms. There are several types of pneumonia:

1. Typical (the symptoms of pneumonia in a child appeared as a result of hypothermia, SARS).
2. Aspiration (microbes enter the lungs along with mucus, vomit).
3. Atypical. The causative agents are unusual forms of bacteria that live in the air of closed rooms with artificial ventilation. Depending on the type of pathogen, mycoplasma, chlamydial and other types of pneumonia are distinguished. They are difficult to diagnose with x-rays. The type of disease is determined only with the help of instrumental methods analysis.
4. Hospital, which occurs 2-3 days after the child's admission to the hospital, and he initially has no pulmonary infection. Often seen after surgery abdominal cavity, in the area of chest in patients with mechanical ventilation. The causative agents of such pneumonia are not sensitive to the action of antibiotics.

Transmission of infection in pneumonia occurs mainly by airborne droplets. Viruses and bacteria from a sick child, when coughing and sneezing, enter the respiratory organs of people around them, causing the appearance of influenza or SARS. But whether they then turn into pneumonia depends on the state of immunity, the timeliness and correctness of the treatment of these diseases. The risk of infection is especially high in asymptomatic pneumonia or in incubation period when there are no manifestations. The most contagious and dangerous are atypical and nosocomial pneumonia, especially caseous (tuberculosis).

Note: After the baby shows signs of illness, it makes no sense to separate him from the rest of the family members who have been in contact with him before, since the infection has already entered their body. It is necessary to take measures (use vitamins, treat the throat, eat garlic, lemons). It is better for the baby to refrain from contact with strangers until the runny nose and cough pass.

The incubation period is 3-10 days. Acute stage disease lasts up to 6 weeks.

Video: Dr. E. Komarovsky about the causes, symptoms and treatment of pneumonia

Causes of the disease

The main cause of pneumonia is infection. Contributing factors are the common cold, chronic diseases lungs, weak immunity, structural features respiratory organs in children.

Due to the fact that the respiratory system in babies is underdeveloped, air exchange in the lungs is not as good as in adults, due to the lesser porosity of the tissue. The volume of the lungs is smaller, the respiratory passages are narrower. The mucous membranes are thinner, swelling occurs faster. Sputum is excreted worse. All this creates conditions for the accumulation and development of pathogens.

Especially high is the risk of infection in the lungs of children who are in a smoky room (passive smoking). Infection can enter the lungs not only through the bronchi, but also through the blood and lymph. This usually occurs with secondary pneumonia, when there are chronic inflammatory processes in other organs.

The cause of pneumonia may be improper treatment of influenza or acute respiratory infections. Inflammation of the lungs also occurs as a result of vapors entering the organ. chemical substances, allergens.

Causes of pneumonia in newborns

In newborns, even a small cold quickly turns into pneumonia, especially if the child was born prematurely or weakened. Cause inflammation of the lungs any kind of infection from which an adult is protected.

The baby can become infected while still in the womb (congenital pneumonia). The infection enters the lungs during childbirth, if it swallows amniotic fluid, if the mother has infection(for example, the herpes or chlamydia virus enters the lungs of a newborn through the respiratory tract).

Signs of pneumonia in a child

If pneumonia in a child occurs after a cold or flu, parents should notice changes in his condition and consult a doctor in a timely manner. There are early warning signs to look out for Special attention. Manifestations of pneumonia give increased cough and worsening of the child's condition after the illness has lasted more than 7 days, and recently he felt better.

If a child has shortness of breath, with a deep breath, he begins to cough, the temperature does not drop even after taking an antipyretic, this also indicates the development of pneumonia. The lack of oxygen during inflammation of the lungs affects the work of the heart, the blood supply to the organs worsens. The child becomes pale, blue circles appear under the eyes.

Types of pneumonia, characteristic symptoms

With inflammation of the lungs, the child shows signs of respiratory failure, as well as poisoning with substances that, in the course of their life, produce pathogens. Therefore, the most characteristic symptoms are such as heat(40°-41°), cough, dizziness, vomiting, headache, shortness of breath, chest pain.

Depending on the way the infection enters the lungs and the volume of inflammation sites, the following types of pneumonia are distinguished:

• segmental (inflammation of one or more segments of the lung occurs) occurs when an infection enters the lungs through the blood;
• lobar (inflammation of the lung lobe, pleura and bronchi);
• total (inflammation of the entire lung) can be either unilateral or bilateral;
• interstitial (inflammation of the connective tissue of the lung).

Segmental pneumonia

With this form, the child's temperature rises sharply, chills, shortness of breath, chest pain, vomiting, and bloating occur. In the first 3 days, the cough is dry, rare. Then it intensifies.

Lobar pneumonia

Characterized by an increase in temperature to 39.5 ° -40 °, signs of intoxication and damage to the lung tissue. There are two forms of lobar pneumonia: pleuropneumonia (croupous pneumonia) and bronchopneumonia (or focal).

The disease develops in 4 stages (from the stage of "tide" to the stage of "resolution"). At the first stage, there is a cough with copious sputum, wheezing and wheezing in the lungs and bronchi. If pleurisy occurs (the pleura becomes inflamed, fluid accumulates in it), children develop sharp pains when turning the body, sneezing and coughing. The pain radiates to the shoulder, under the ribs. The child cannot take a full breath, breathing heavily. His pulse quickens.

Then the face swells and turns red, the cough becomes more frequent, the temperature drops sharply, wheezing intensifies. The disease becomes chronic.

total pneumonia

This is an extremely dangerous form in which one or both lungs are completely affected. There is acute respiratory failure, frequent coughing, high fever and all other signs of severe pneumonia. The child has blue nails on the hands and feet, lips and the area of ​​​​the face above upper lip and around the nose. There may be a lethal outcome.

Interstitial pneumonia

Such inflammation of the lungs is most often observed in newborns, premature babies, as well as in dystrophy. It occurs when viruses, mycoplasmas, pneumococci, staphylococci, fungi, allergens enter the lungs. The connective tissue in the region of the alveoli and blood vessels becomes inflamed. This disrupts the supply of oxygen to the tissues of the lung, which leads to gluing of its individual elements.

The most characteristic manifestations of this disease are shortness of breath, dry cough with a small amount of mucus. Perhaps the appearance of pus impurities in it.

How to distinguish pneumonia from SARS and bronchitis

Symptoms of these diseases (cough, fever) are similar. It is often possible to establish the exact nature of the disease only with the help of x-rays.

Signs of viral diseases (ARVI)

They are characterized by an increase in temperature up to 38 °, which lasts for 2-3 days in children. If the temperature rises above, then antipyretics help bring it down. There are also weakness, headache, snot, cough, sneezing, sore throat. The doctor, when listening, can detect wheezing in the upper respiratory tract. The illness lasts for 5-7 days. Antibiotics do not affect recovery in any way. Only cough, cold and fever remedies are used.

Signs of acute bronchitis

With this disease, the temperature does not rise above 38 °. First, there is a dry cough, which after 2 days turns into a wet one. Unlike pneumonia, there is no shortness of breath. But the cough becomes hard, hacking. In the bronchi appears hoarseness and wheezing. X-ray shows that the lungs are clean, there are no changes in their structure.

Symptoms of pneumonia in children of different ages

The severity and nature of the manifestations depends both on the type of pathogens of pneumonia and on the age of the child. The younger the child, the lower his resistance to infections and the worse he tolerates the consequences of inflammation of the respiratory organs.

Under the age of 2 years

Most often suffer from pneumonia in a segmental, croupous or interstitial form. Inflammation occurs in the form of several small foci in one or both lungs. At the same time, the bronchi are affected. Duration acute illness 3-6 weeks. Possibly even longer lingering course. When listening, characteristic wheezing is detected, especially noticeable when the child cries.

The appearance of the disease can be detected by a change in behavior. The baby becomes lethargic, cries a lot, refuses to breast (or other food), wants to sleep, but wakes up quickly. Him liquid stool possibly vomiting or frequent regurgitation.

At this age, the temperature usually does not rise above 37.5 °, but it is not brought down by antipyretics. There is a runny nose and cough, the attacks of which are aggravated during crying or feeding. At wet cough sputum has a yellow-green color due to impurities of pus.

The child breathes more often than normal (the norm is: for a child of 1-2 months - 50 breaths per minute, 2-12 months - 40, for children from 1 to 3 years - 30, at the age of 4-6 years - 25) . Shortness of breath in a baby is indicated by nodding the head to the beat of breathing with simultaneous puffing of the cheeks and stretching of the lips.

You can notice the retraction of the skin between the ribs during inspiration, and it occurs unequally on the right and left. Periodically, breathing stops, its rhythm and depth are disturbed. With unilateral inflammation, the child tends to lie on a healthy side.

The child has a blue nasolabial triangle.

Children 2-3 years and older

The child is pale, lethargic, capricious, he has no appetite, he falls asleep badly and often wakes up. Antipyretics do not help bring down the temperature. This state lasts for more than a week. There is a cough, shortness of breath, rapid breathing, chest pains radiating to the shoulder and back.

Symptoms of SARS in children

Most often, children have such types of atypical pneumonia as chlamydial and mycoplasma. You can become infected with them during your stay at the airport, store or other places with a large crowd of people.

Such a disease begins with a sharp rise in temperature to 39.5°, soon it drops to 37.2°-37.5° and stays within these limits. Runny nose, sneezing, sore throat. Then a debilitating dry cough is added. Shortness of breath appears and disappears, which is atypical for pneumonia, more typical for bronchitis. This can be disorienting for the doctor.

Weak wheezing without typical signs is observed. On X-ray, changes in the lungs are poorly visible. As a rule, the disease takes a protracted character. Antibiotics of only a certain type help (macrolides - azithromycin, clarithromycin).

Video: Features of SARS in children, complications

In what cases is hospitalization

Children are hospitalized if they show signs of respiratory failure, loss of consciousness, a fall blood pressure, heart failure. Hospitalization is made if the baby has extensive lobar pneumonia with pleurisy. The child is treated in the hospital also if he lives in poor living conditions, if it is impossible to fulfill the doctor's prescriptions.

Treatment of children infancy are carried out in the hospital, since they can very quickly stop breathing, urgent mechanical ventilation will be required. Regardless of age, a child is referred to a hospital for treatment if, in addition to pneumonia, he has any chronic diseases.

Complications of pneumonia

Occur both during the course of the disease and subsequently. Typical complications are:

• pleurisy (accumulation of fluid and pus in the lungs);
• blood poisoning (penetration of bacteria into the blood, with which they enter other organs, causing meningitis, peritonitis, inflammation of the heart muscle, joints);
• heart failure;
• stop breathing (apnea).

Chronic diseases of the respiratory system occur or worsen ( bronchial asthma and others), calcification occurs in the lungs. In addition, there are consequences long-term treatment antibiotics (allergy, dysbacteriosis, fungal diseases).

Diagnostic methods

The doctor makes a diagnosis and prescribes treatment, based on the manifestations of the disease, the nature of coughing, breathing and wheezing in the lungs of the baby. The main diagnostic method is x-ray, which determines the presence and extent of areas of inflammation.

General and biochemical analyzes blood can detect deviations in its composition, characteristic of pneumonia.

A bacteriological culture of mucus from the nose and throat, as well as sputum, is done to identify the type of bacteria and the effect of antibiotics on them.

ELISA and PCR methods can accurately determine the type of infection.

In more complex cases, CT of the lungs is used for examination, as well as fiberoptic bronchoscopy.

Treatment

In the case of viral pneumonia, antibiotic treatment is not carried out, since they do not act on viruses. Only relief is carried out with the help of antipyretic drugs (paracetamol, panadol), mucolytic agents that thin sputum (bromhexine, ACC 100), bronchodilators that relieve spasms (ephedrine, eufillin), antihistamines (zyrtec, suprastin).

The main treatment for bacterial pneumonia in children is antibiotic therapy. It must be carried out for at least 10 days. If this type of antibiotic is ineffective within 2 days, then it is changed to another.

In severe cases, treatment in the intensive care unit and assistance to the child with the help of a ventilator is required.

If there are no complications, then recovery occurs in 2-4 weeks.

Vaccination for pneumonia

The most common cause of pneumonia in children is the bacterium pneumococcus. There are vaccines (Pneumo-23 and others) that are recommended to be administered to weakened children for prevention. Vaccination allows several times to reduce the risk of morbidity with colds, pneumonia, otitis and bronchitis.

Video: Why pneumonia occurs in children. Prevention

When treating pneumonia at home, doctors advise you to follow certain rules:

1. Antipyretics should not be given to children when the temperature does not exceed 38 °. If the baby has ever had convulsions, then such remedies should be given at a temperature of 37.5 °.
2. Food should be easily digestible, without chemical additives and fats, to ease the load on the liver. You can not force a child to eat when he does not want to.
3. He needs to drink a lot of fluids (natural juices, tea with raspberries, rosehip broth).
4. The room should be clean and cool air, every day you need to do wet cleaning.
5. Without a doctor's prescription, children should not be given allergy medications, synthetic vitamins, immunomodulators. They can aggravate the condition of the baby with their side effects complicate treatment.

Under a complete ban is self-medication, the consequences can be unpredictable. Treatment folk remedies(expectorant, antipyretic, anti-inflammatory) can only be carried out after consultation with the doctor.