Inflammation of one lung. Pneumonia in adults - first signs, causes and treatment

Infectious diseases of the respiratory tract are still among the leaders among all infectious diseases. Although modern medicine is successfully combating their spread and occurrence, people still continue to get sick. Pneumonia is a serious illness that affects both adults and children, accompanied by a cough and a number of other symptoms. The disease must be treated immediately before it leads to disastrous consequences.

What is pneumonia

Pathology is based infectious nature, arising under the influence of a number of physical or chemical factors. It should be understood that pneumonia and inflammation are one and the same disease, combining a wide group of diseases that are characterized by a certain clinical picture, signs, treatment regimen. During the development of the disease, inflammatory processes in the lungs are diagnosed, which are characterized by damage to the alveoli and interstitial tissue.

Experts distinguish primary pneumonia of the lungs, which begins as independent disease, and secondary, the cause of which is decreased immunity due to the course of a disease, for example, ARVI. Inflammation is transmitted by airborne droplets: bacterial infection enters the lungs healthy person, starting to progress there. There are other methods of infection, but they are not as widespread.

Symptoms of pneumonia in adults

There are several types of disease that are characterized by different signs. Croupous inflammation is considered the most dangerous, especially for elderly patients, since it is characterized by damage to the lobe of the lung, and this can be either unilateral or bilateral inflammation. The main symptom of this type of disease is pain in the side, which begins to intensify when coughing or inhaling.

In addition, body temperature rises and shortness of breath develops. The cough increases gradually, the side of the neck turns red diseased lung, blue lips and widening of the nasolabial triangle may be noted. With phlegm, mucus may be discharged Brown interspersed with blood from the lungs. In advanced stages, there are signs of intoxication of the body, when the patient may begin to become delirious and lose consciousness.

With atypical pneumonia, symptoms may differ depending on the pathogen that caused the inflammation. Microplasma infection is characterized by a dry cough, fever and sore throat. Muscle pain, inflammation of the lymph nodes, and nosebleeds may occur. Chlamydial infection is accompanied by a sharp increase in temperature, rhinitis and enlarged lymph nodes. In the process, allergic reactions and dermatitis may appear. The Legionella type of inflammation provokes fever with chills, cough, headache with a temperature within 40 degrees.

Chronic inflammation is a consequence of previously untreated pneumonia. It is characterized heavy breathing, wet cough with periodic discharge of purulent sputum. The nasopharynx and oral cavity become inflamed, appetite decreases, polyhypovitaminosis develops, and the immune system becomes weakened. Sweating and weight loss are noted. As the heart works harder due to lack of oxygen in the blood, there is a rapid heartbeat, which can lead to heart failure.

In children

The development of inflammation in a child often occurs as a consequence of other diseases: such as severe colds, acute bronchitis, complications of influenza and others. viral diseases. Lung disease begins with malaise, after which the body weakens. The temperature during pneumonia rises and is accompanied by rapid breathing - more than 50 breaths per minute. After the flu, pneumonia is characterized by temperature fluctuations; the baby’s shortness of breath does not go away even in the absence of a cough. One of the symptoms of pulmonary inflammation can also be called pale skin.

First signs

Characteristic symptoms of pneumonia are chest pain, cough, shortness of breath and dry wheezing. Noted increased sweating and fever. The temperature is not constantly elevated - it is characterized by abrupt values. The consequence of intoxication of the body due to inflammation is headache bad feeling. Later, abdominal pain may occur, stool upset, and flatulence may develop.

Can you have pneumonia without fever?

The first signs of pneumonia, such as fever and cough, do not always appear in the patient. This is extremely dangerous, since the disease can only be identified through certain diagnostics. This happens due to the fact that the patient’s immunity is weakened due to indiscriminate use of antibiotics and cough suppressants. medicines.

In this case, it is necessary to pay attention to other signs of pneumonia in an adult that characterize the disease: wheezing, pale facial skin with an unusual blush. Even with small loads, inflammation causes rapid breathing and an increased pulse. When turning the body, pain similar to muscle pain occurs, appetite decreases and an unquenchable feeling of thirst appears.

Causes

The disease develops for a number of reasons. In this regard, viral and fungal pneumonia are distinguished. Among the main infectious agents inflammations can be called pneumococci, streptococci, mycoplasmas, staphylococci, influenza viruses and respiratory infections, Candida mushrooms. In addition, pneumonia occurs due to diseases of the upper respiratory tract. The catalyst for the development of the disease is reduced immunity, colds, exposure to poisonous gases or inhalation of substances that irritate the upper respiratory tract.

Types of pneumonia

Most patients die due to infection with streptococcal pneumonia. The reason for this is hypothermia and weakened immunity. Enterobacteriaceae causes inflammation of the kidneys. Chlamydia is characterized by the development of the disease inside cells, therefore it is very difficult to treat, very often turning into chronic stage.

Mycoplasma is often combined with diseases of the genitourinary organs, occurring in a mild form. Predominantly affects middle-aged adults. Not often, but such cases are observed; legionella bacteria can cause illness, and such incidents are more likely to end in death. Against the background of the development of destruction, pneumonia of the lungs, provoked by Haemophilus influenzae, is isolated. This disease affects smokers.

Stages

In medicine, there are 4 stages of inflammation development:

high tide stage (from 12 hours to 3 days). There is a sharp filling of the pulmonary vessels with blood and fibrinous exudation in the alveoli;
stage of red hepatization (from 1 to 3 days). In case of defeat lung tissue thickens, the number of red blood cells in the alveolar exudate increases;
stage of gray hepatization (from 2 to 6 days). After the breakdown of red blood cells, a change in the blood is observed in the form of massive penetration of leukocytes into the alveoli;
resolution stage. Full recovery occurs after injury lung tissue.

Why is pneumonia dangerous?

The disease is dangerous because it can cause complications in the human body, which have different directions. This is a recurrence of the disease, a lung abscess or chlamydial inflammation. With pneumonia, lesions of the pleura (pleurisy) often occur, and with purulent inflammation lung destruction with sepsis may develop. During Taken measures will allow to avoid pulmonary edema or gangrene.

Deadly or not

A fatal outcome cannot be excluded as the most terrible consequence inflammation. Nowadays, this rarely happens, since medicine has stepped forward and mastered new ways of fighting, but if treatment is delayed, such a development of the situation is possible. For complications of acute forms of pneumonia and during accession secondary diseases it is extremely important to apply for timely medical care.

Diagnostics

If pneumonia is suspected, two types of diagnostics must be performed to make a diagnosis: instrumental and laboratory. The first type includes an x-ray performed in two projections to detect inflammatory foci (fluid) in different parts of the lung and determine the extent of damage to areas of lung tissue, fibrobronchoscopy (the bronchial mucosa is examined and a biopsy is taken), and computed tomography.

If a person experiences shortness of breath, a method of examining external respiration is used. Spirometry helps detect broncho-obstructive syndrome and respiratory failure. In case of rapid heartbeat, which is characteristic of the patient even with light loads, he will definitely be sent to an electrocardiogram, which helps to identify sinus tachycardia.

TO laboratory research inflammation is referred to as a blood test to detect large number leukocytes and sputum examination. The latter option is less informative, since the mucus mixes with bacteria from the mouth, some microorganisms may die even before the examination begins, and some cannot be detected at all. Bacterioscopy is used after special staining and seeding of the material. For sputum analysis, it is preferable to take samples during deep coughing, especially if the presence of foci of inflammation is possible in the lower part of the lung.

Treatment of pneumonia

Pneumonia can be treated at home with mild degree. At home, as a rule, they take medications prescribed by the doctor. Therapy in a hospital is still preferable, since the patient is always under the supervision of specialists, especially since in severe cases and respiratory failure artificial ventilation may be required.

In addition, it is recommended to go to the hospital for focal pneumonia in elderly patients with chronic diseases such as diabetes mellitus and heart disease. If treatment at home does not produce results within the first 3 days, it is strongly recommended to seek help in a hospital. This applies to taking medications: if improvement does not occur within the first 3 days, the treatment is reviewed.

Antibiotics

Antibiotics remain the medications used to treat pneumonia. Therapy antibacterial drugs is prescribed as early as possible, and the course itself lasts 7–10 days at an uncomplicated stage of the course. In case of complications and abscess, the course can be increased to 3 weeks. For pregnant women, doctors prescribe antibiotics such as macrolides, penicillins, and cephalosporin preparations, which are considered conditionally safe during pregnancy and pregnancy. breastfeeding.

Complications

In addition to the pulmonary complications that develop during the disease, other vital human organs suffer. First, it relates to the heart. Inflammation of the heart muscle and acute heart failure develop, associated with the work of the organ under heavy load. In addition, meningitis or severe septic shock may occur, which can be fatal. There is a high chance of developing sepsis, which can spread damage throughout the body through the blood.

Prevention

In order to combat pneumonia and relapses, you should be careful about your own health. First of all, this applies to strengthening the immune system, which can be done even at home. The main components are proper balanced nutrition, periodic physical activity, walks fresh air and taking vitamins.

Vaccination is of great importance, especially for those who belong to the so-called risk groups (the elderly and children). Don't forget to wash your hands with soap. Smokers should quit bad habit. Timely annual examination by a therapist, regular visits to the dentist, and in case of diseases of the nasopharynx, visits to the ENT specialist, identification and effective treatment of fungal infections - all this will help prevent the possibility of pneumonia affecting the lungs.

Video

When the respiratory system is normal, a person feels good. From this article you will learn everything about what pneumonia is, what are the symptoms and treatment of the pathology, what are the causes and first signs of the disease. If you quickly identify the disease, you can avoid unpleasant consequences and complications.

What is pneumonia

Pneumonia is an infectious and inflammatory disease. It affects the lower respiratory tract, including the alveoli, lung tissue, bronchi and bronchioles.

Important! The disease is considered dangerous because if left untreated, death can occur.

Despite advances in medicine, pathology is registered among thousands of patients every year. Pneumonia is diagnosed in both men and women. Cases among adults do not often result in fatalities, like children.

Causes of pneumonia

Pneumonia can develop as an independent pathology, or it can join an already existing inflammatory process. The etiology of this disease is varied, so only a doctor can make a diagnosis.

Pneumonia can be:

infectious;
non-infectious.

Infectious pneumonia develops under the influence of viral or bacterial pathogens. Most often in adult patients, pathology is caused by the following microorganisms:

Non-infectious pneumonia of the lungs occurs against the background of:

Often, suspicion of pneumonia arises after a cold or viral flu. Any bacterial infection can cause inflammation in the lungs.

What increases the risk

To avoid serious respiratory problems, it is important to know what factors increase your risk of pneumonia. For people of different ages their phenomena pose a danger.

For a child early age The appearance of pneumonia can be affected by:

During adolescence, the risk of developing pneumonia is influenced by:

smoking;
chronic diseases of the nasopharynx;
heart diseases;
carious teeth;
chronic runny nose;
frequent viral diseases;
decreased immune defense.

For adults, the risk factor may be:

By avoiding all of these risk factors, you can reduce your risk of contracting pneumonia.

Ways of contracting pneumonia

Many patients wonder whether they could have contracted the disease from another person. Pneumonia can be contagious if it is caused by an infection. If it arose against the background allergic reaction or a burn of the respiratory tract, then the sick person is not dangerous to others.

The routes of transmission and penetration into the lung parenchyma can be different. Highlight:

bronchogenic;
lymphogenous;
hematogenous.

With the bronchogenic route of infection, pathogenic microorganisms penetrate along with the inhaled air. This means that if there is a sick person nearby, the disease will be transmitted through airborne droplets. The likelihood that an infection will provoke a disease occurs when there is some kind of inflammatory process or swelling in the nasal or tracheal tract. In this case, the inhaled air is not filtered properly and infection occurs.

The lymphogenous route of infection is the least common. To do this, the infection must first penetrate into lymphatic system, and only then get into the lung and bronchial tissues.

The hematogenous route of infection is the penetration of infection through the blood. This is possible in cases where the causative agent of the disease has entered the bloodstream, as, for example, during sepsis. This path infection is rare, but is quite possible with pneumonia.

Classification of pathology

All pneumonias are divided into:

out-of-hospital;
hospital.

Community-acquired forms develop at home or in groups and, as a rule, can be treated traditional methods treatment, as they can be completely eliminated with the help of antibiotics and other medicines. Hospital-acquired types of pneumonia mean those that develop within the walls of hospitals against the background of the penetration of various infections. The duration of treatment for these forms is usually longer, since these pathogens are resistant to many drugs.

The classification of pneumonia involves dividing the types of disease depending on:

type of pathogen;
morphological features;
the nature of the flow;
prevalence of the process;
development mechanism;
stages of severity;
presence of complications.

Only a specialist can determine pneumonia and what caused it after conducting clinical studies.

Pneumonia can be caused by a virus, bacteria, fungus, mycoplasma, or several pathogens at the same time. To cure pneumonia, it is important to determine which group of infections caused the disease. Otherwise, the use of drugs will be ineffective.

By morphological features pneumonia can be divided into the following types:

lobar;
parenchymal;
focal;
interstitial;
mixed.

The mechanism of development of pneumonia is distinguished:

primary;
repeated (arising against the background of other pathologies);
aspiration;
post-traumatic.

Atypical pneumonia can be difficult to recognize, since some symptoms are uncharacteristic for this group of diseases.

Depending on the prevalence of the pathological process, pneumonia occurs:

drain;
focal;
small-focal (usually sluggish);
segmental;
share;
middle lobe;
basal;
total;
subtotal;
one-sided;
bilateral.

Note! Double pneumonia is more severe and often requires hospital treatment.

Based on the nature of the disease, three stages of severity are distinguished. At mild form treatment at home is possible. If an exacerbation develops, a hospital is required.

Complications usually occur with untreated pneumonia and in the presence of tumor processes. For example, paracancrosis pneumonia can develop against the background of cancer tumors. Possible occurrence destructive changes, which leads to irreversible consequences.

Important! If pneumonia is not treated, pulmonitis can develop, a disease that affects the alveoli and leads to the formation of scar tissue, which ultimately leads to cancer.

Upon penetration bacterial infection purulent pneumonia may occur. Against the background of this condition, there is a high risk of developing the most dangerous form of the disease – septic. Cavities can form in the lung tissues and necrotic processes can begin. Of particular danger is hidden form, since the patient loses a lot of time while the pathology is diagnosed.

When the pathogen exhibits resistance to the drugs used, patients experience prolonged pneumonia. In order not to die from complications of the disease, it is necessary to know the symptoms of the pathology and respond promptly when they occur.

General symptoms

After incubation period the infection that has entered the body has expired, the patient begins to show signs of illness.

Rarely does pneumonia begin without a cough. Since the inflammatory process primarily affects the respiratory system, normal breathing is violated immediately. Initially, the patient will notice the following clinical picture:

dry cough;
weakened breathing;
lethargy;
respiratory symptoms.

Only when atypical course pneumonia, the disease passes without fever. In a sense, this is dangerous, since the person may not take the complaints seriously and will delay treatment.

Pneumonia is no different from pneumonia, but this pathology has distinctive features from a cold. None colds cannot last more than a week. After this period, symptoms should subside and the patient’s well-being should improve. If, a few days after the onset of the clinical picture, additional signs, and the condition has worsened, one may suspect the addition of an inflammatory process in the lung tissue.

For any pneumonia, symptoms can be divided into three groups.

Intoxication symptoms

Intoxication syndrome develops due to the fact that bacteria that have entered the body begin to secrete toxic substances. As a result, the patient notes the following intoxication phenomena:

temperature rise to 39.5 degrees;
dizziness;
headache;
increased sweating;
lethargy and drowsiness;
apathy;
insomnia.

In rare cases, severe pneumonia may cause nausea and vomiting.

Note! At a temperature caused by pneumonia, medications to eliminate fever are ineffective.

Pulmonary symptoms

The onset of pneumonia is most often associated with fever, but sputum may not be produced at first. The cough is dry but persistent.

Wet cough appears only on the fourth day after the onset of symptoms. The color of the sputum is rusty. This is usually due to the fact that a certain amount of red blood cells are released along with the mucus.

Pain in the back and chest may occur. The lung itself is devoid of pain receptors. However, when the pleura is involved in the process, the patient begins to experience discomfort in this area. This is especially acute when a person tries to take a deep breath.

In general, fever and sharp picture symptoms may last about 7-9 days.

Symptoms of pulmonary failure

Develops against the background of pneumonia pulmonary failure. It manifests itself with the following symptoms:

dyspnea;
cyanosis of the skin due to inadequate access to oxygen;
rapid breathing.

Pulmonary failure usually occurs with bilateral pneumonia. How big square the lung tissue is damaged, the stronger the symptoms.

The doctor must be able to distinguish pneumonia from other lung lesions. Diagnosis may include several measures. The doctor decides which methods are necessary.

First, the doctor will carefully listen to what the symptoms are, what preceded their appearance and how long the patient has been observing this clinical karting. After this, the specialist will ask the patient to undress to the waist to examine the chest.

Note! During the process of breathing, the inflamed areas may lag behind in the intensity of translational movements, which allows the doctor to more specifically determine the localization of the pathology.

auscultation;
percussion;
general blood analysis;
sputum analysis;
X-ray;
bronchoscopy;
Ultrasound of the lungs.

Auscultation is carried out by a therapist or pulmonologist using a special device - a stethoscope. It consists of several tubes that amplify the sound and allows the doctor to clearly hear the sounds of the lung. A healthy person will simply breathe normally. With inflammation you can hear hard breathing in the lungs and wheezing.

Percussion is tapping on the chest. Normally, when the organ is filled only with air, the sound is distinct, but with inflammation easy process filled with exudate, which creates a broken, dull and shortened sound.

The CBC allows the doctor to assess the presence of the inflammatory process and its intensity. Blood counts for pneumonia are as follows: increased ESR and leukocytes.

A biological study of secretions from the lungs is carried out to clarify the causative agent of pneumonia. Only in this case will the doctor be able to issue a prescription that will help quick release from illness.

In the image obtained after the x-ray, the doctor will assess the size and location of the inflammation. The affected areas are usually lighter than other healthy tissue (as can be seen in the photo). It will also determine the presence of peribronchial infiltration inside the organ.

Bronchoscopy and ultrasonography They are rarely performed, only in advanced and complicated forms of pneumonia. Whether such an examination is necessary or not will be determined by the doctor after X-rays and other studies.

Treatment of pneumonia

Self-medication and treatment folk remedies for pneumonia is prohibited. Any traditional methods can only be maintenance therapy in the stage of convalescence (recovery).

Indications for placing a patient in hospital treatment:

reduction in blood pressure to levels below 90/60;
tachycardia up to 125 beats per minute;
confusion;
rapid breathing (from 30 times per minute);
too low (up to 35.5) or high (40) temperature;
saturation less than 92%;
inflammation in several lobes of the lung;
sepsis;
concomitant pathologies of the heart, kidneys or liver.

It is very important to take care of creating suitable conditions for the patient:

full bed rest;
drinking plenty of water;
balanced diet;
regular ventilation in the patient’s room and wet cleaning.

Most often, first aid consists of the correct use of medications.

Drug treatment of pneumonia

Since the causative agent of pneumonia is most often bacteria, broad-spectrum antibiotics are prescribed to combat the disease. If a sputum analysis is performed and the infection is accurately determined, the patient can be transferred to another, more accurate, but gentle drug.

The duration of treatment with antibacterial agents is 7-10 days. In rare cases, therapy can be extended to two weeks.

Important! Antibiotics can only be prescribed by the attending physician, since a mistake can lead to serious complications.

Most often prescribed:

The dosage is determined only by the doctor, depending on the type of drugs and research results. Based on the severity of the patient’s condition and the presence of concomitant diseases, antibiotic therapy can be carried out in the form of:

oral administration of tablets;
injections;
IVs

To avoid recurrence of pneumonia, it is very important to complete treatment to the end. Stopping treatment due to a decrease in symptoms is very dangerous. The pathogen will not die, but will only acquire resistance to the antibiotics of the group used.

At wet cough you can use products like “ACC”, “Ambroxol” or “Lazolvan”. Absorbable mucolytics should not be taken with dry nonproductive cough, since the attacks will become more frequent, and the patient will experience severe suffering.

It is important to focus your energy on strengthening your immune system. To do this, it is important to ensure that the patient has a balanced diet and a sufficient amount of vitamins.

Acceptable auxiliary folk recipes include regular use of honey, garlic, onions, rosehip, linden and raspberry decoctions. All these methods are used exclusively along with the main treatment. It is important to take into account the absence of an allergic reaction, as this can aggravate the course of pneumonia.

Breathing exercises are also carried out under the supervision of a doctor. They may be contraindicated in some conditions. Strelnikova or Butenko gymnastics are recommended. To prevent congestion in the lungs, experts recommend inflating balloons.

Prevention

Good prevention against pneumonia:

maintaining an active lifestyle;
increasing immunity;
regular walks in the fresh air;
timely treatment of infectious diseases.

This way you can protect your body from pathology.

If a person is attentive to the symptoms that occur in the body, pneumonia can be detected at the initial stage. This will allow you to heal quickly and without complications.

Watch the video:

You are a fairly active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle, and your body will delight you throughout your life, and no bronchitis will bother you. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and strong emotional overload.

It's time to think about what you are doing wrong...

You are at risk, you should think about your lifestyle and start taking care of yourself. Physical education is required, or even better, start playing sports, choose the sport that you like most and turn it into a hobby (dancing, cycling, Gym or just try to walk more). Do not forget to treat colds and flu promptly, they can lead to complications in the lungs. Be sure to work on your immunity, strengthen yourself, and be in nature and fresh air as often as possible. Do not forget to undergo scheduled annual examinations, treat lung diseases initial stages much simpler than in a neglected state. Avoid emotional and physical overload; if possible, eliminate or minimize smoking or contact with smokers.

It's time to sound the alarm! In your case, the likelihood of getting pneumonia is huge!

You are completely irresponsible about your health, thereby destroying the functioning of your lungs and bronchi, have pity on them! If you want to live a long time, you need to radically change your entire attitude towards your body. First of all, get examined by such specialists as a therapist and pulmonologist, you need to take radical measures otherwise everything may end badly for you. Follow all the doctors’ recommendations, radically change your life, perhaps you should change your job or even your place of residence, completely eliminate smoking and alcohol from your life, and reduce contact with people who have such bad habits to a minimum, toughen up, strengthen your immunity as much as possible spend more time in the fresh air. Avoid emotional and physical overload. Completely eliminate everything from everyday use aggressive means, replace with natural ones, natural remedies. Do not forget to do wet cleaning and ventilation of the room at home.

Pneumonia in most cases refers to infectious diseases and is caused by various pathogens (pneumococci, staphylococci, streptococci, mycoplasma, legionella, chlamydia, anaerobic microorganisms, klebsiella, E. coli, viruses, etc.). The characteristic symptoms of the disease make it possible to successfully diagnose and treat this disease. Although in recent decades, thanks to the success of antibacterial therapy, mortality from pneumonia has decreased significantly.

The high prevalence of the disease, the severity of development and severity of symptoms in the initial period of the disease, and the possibility of serious complications make pneumonia a frequent reason for seeking emergency care. There are lobar (lobar) and focal (bronchopneumonia) inflammations. Every person who values owl health should know how to determine pneumonia.

Symptoms and signs of different forms of pneumonia

Symptoms of lobar pneumonia

The clinical picture of lobar pneumonia is characterized by an acute onset with a sharp increase in temperature to 39-40 ° C, combined with chills and sweating.

At the same time, the symptoms of pneumonia are accompanied by headache, significant weakness, and lethargy.

With severe hyperthermia and intoxication, cerebral symptoms may be observed - severe headache, vomiting, stupor of the patient or confusion, and even meningeal symptoms.

Very early in chest pain occurs on the side of inflammation. Often with pneumonia, the pleural reaction is so severe that chest pain is the main complaint and requires emergency care.

Distinctive feature pleural pain in pneumonia - its connection with breathing and coughing: a sharp increase in inhalation and coughing. In the first days, a cough may appear with the release of sputum rusty from the admixture of red blood cells, and sometimes mild hemoptysis.

During examination, one often notices the forced position of the patient: more often he lies on the side of inflammation. The face is usually hyperemic, sometimes a feverish blush is more pronounced on the cheek, corresponding to the side of the lesion. A characteristic symptom pneumonia is shortness of breath up to 30-40 breaths per minute, combined with cyanosis of the lips, swelling of the wings of the nose. Often in early period disease, blistering rashes appear on the lips (herpes labialis). Examination of the chest usually reveals a delay in breathing on the affected side. Due to severe pleural pain, the patient seems to spare the side of inflammation. Over the zone of inflammation, upon percussion of the lungs, a shortening of the percussion sound is determined, breathing acquires a bronchial hue, and fine-bubbly moist crepitating rales appear early. Characterized by tachycardia up to 100 beats per minute and a slight decrease in blood pressure. A pronounced pleural reaction is sometimes combined with reflex pain in the corresponding half of the abdomen, pain on palpation in its upper parts. Icterus of the skin and mucous membranes may appear due to the destruction of red blood cells in the affected lobe of the lung and, possibly, the formation of focal necrosis in the liver.

How to determine focal pneumonia?

For focal pneumonia, which often occurs in patients with chronic inflammation upper respiratory tract and bronchi or with heart failure and other serious diseases, symptoms are usually less pronounced: fever up to 38-38.5 ° C, dry cough or with mucopurulent sputum, possible pain when coughing and deep breathing , symptoms of inflammation of the lung tissue are objectively revealed, expressed to varying degrees depending on the extent and location (deep or superficial) of the inflammation, most often the focus of crepitant rales is revealed.

How to identify symptoms of pneumonia in older people?

The prognosis is especially unfavorable when acute vascular insufficiency is combined with increasing cardiac weakness, leading to pulmonary edema. In the origin of pulmonary edema during pneumonia, in addition to heart failure, it is important toxic damage pulmonary capillaries with increased vascular permeability.

The threat of developing pulmonary edema is indicated by the appearance of dry and especially moist rales over a healthy lung against the background of increased shortness of breath and deterioration of the patient’s condition.

The development of pneumonia in elderly people with concomitant diseases of cardio-vascular system, emphysema, pneumosclerosis often requires emergency care, but recognizing pneumonia in early dates the illness in these patients is often complicated due to the absence of an acute onset, a mild pleural reaction with chest pain when breathing, slight increase temperature.

The thought of pneumonia in the elderly and weakened patients should arise in cases where, for no apparent reason, the patient’s activity significantly decreases, weakness increases, he stops moving, lies down all the time, becomes indifferent, often drowsy, and refuses to eat.

A careful examination sometimes reveals a one-sided flush of the cheek, a dry tongue, and always significant shortness of breath and tachycardia.

Auscultation of the lungs usually reveals a focus of sonorous moist rales.

Manifestations of pneumonia in people with alcohol dependence

The acute form of pneumonia is very dangerous in patients suffering from chronic alcoholism and generally abusing alcohol. Usually their pneumonia is severe, with severe intoxication and is often complicated by the development alcoholic psychosis- “delirium tremens”. Psychosis is accompanied by visual and auditory hallucinations, mental and motor agitation, abnormal behavior, disorientation in time and space. Often patients try to escape and even throw themselves out of the window and do not allow themselves to be examined or given injections. Meanwhile, very often pneumonia in patients in a state of “delirium tremens” is complicated by the development of severe shock.

Signs and symptoms of complications of pneumonia

Signs of pneumonia life threatening both in the case of lobar and focal forms, may be due to the development of complications - septic shock, pulmonary edema, psychosis. Typically, shock and pulmonary edema are observed when pneumonia develops in elderly, weakened patients with severe concomitant cardiac pathology and often circulatory failure. A harbinger of shock due to pneumonia should be considered the appearance of persistent tachycardia, especially over 120 beats per minute with low pulse filling. The development of shock is accompanied by a significant deterioration in the condition, the appearance of severe weakness, and sometimes a decrease in temperature. The skin takes on a gray tint, facial features become sharper, cyanosis increases, shortness of breath increases significantly, the pulse becomes frequent and small, blood pressure drops below 90/60 mmHg. Art., urination stops.

How to identify pulmonary complications pneumonia?

Pulmonary complications of pneumonia (exudative pleurisy, abscess formation and especially breakthrough of the abscess in pleural cavity with the development of pyopneumothorax) also require emergency care for the patient. Exudative pleurisy is manifested by a lag in the lower part of the chest on the affected side when breathing, severe dullness and weakening of breathing on the affected side. You should think about abscess formation when intoxication increases, profuse night sweats appear, and the temperature becomes hectic in nature with daily variations of up to 2 °C or more.

Breakthrough of an abscess into the bronchus during pneumonia and discharge large quantity purulent, foul-smelling sputum makes the diagnosis of lung abscess obvious. A sharp deterioration in the condition, increased pain in the side when breathing, a significant, rapid increase in shortness of breath, tachycardia, and a drop in blood pressure may indicate a breakthrough of the abscess into the pleural cavity and the complication of pneumonia by the development of pyopneumothorax. The condition of patients with pyopneumothorax is always severe. Usually, due to pain, they are forced to take a semi-sitting position. Breathing, coughing and movement sharply increase the pain. Shortness of breath is characteristic (over 40 per 1 min). Breathing over the sore side is weakened. Percussion reveals a boxy sound above the upper and dullness above lower sections lung Pulse is frequent and small. BP is low. Such a menacing picture of pleural shock requires emergency assistance.

Diagnostic symptoms and signs of pneumonia

Usually, pneumonia is successfully recognized on the basis of the characteristic clinical picture of the disease - a combination of pulmonary and extrapulmonary manifestations and an x-ray picture. Symptoms of pneumonia that allow diagnosis at the prehospital stage:

Pulmonary symptoms - shortness of breath, cough, sputum production (mucous, mucopurulent, etc.), pain when breathing, local clinical signs (dullness of percussion sound, bronchial breathing, crepitating rales, pleural friction noise).

Extrapulmonary symptoms of pneumonia - fever, chills and sweating, myalgia, headache, cyanosis, tachycardia, herpes labialis, skin rash, damage to the mucous membranes (conjunctivitis), confusion, diarrhea, jaundice, toxic changes peripheral blood.

Some features of the pneumonia clinic allow for etiological diagnosis of pneumonia before receiving the results microbiological research. The most common causative agents of “domestic” pneumonia in people under 60 years of age without severe concomitant pathology are pneumococci; in the appropriate epidemiological situation, mycoplasmas and viruses (Table 7). Elderly patients with severe somatic diseases and chronic alcoholism are especially susceptible to pneumonia caused by gram-negative microorganisms (Klebsiella, coli, Proteus, Enterobacter), with frequent development destruction of lung tissue and the formation of lung abscesses.

Diagnostic signs of pneumonia in old age

In elderly patients suffering from severe somatic diseases or severe immunodeficiency, pneumonia can occur atypically. Such patients often have no fever, and extrapulmonary symptoms predominate (disorders of the central nervous system etc.), physical signs of pulmonary inflammation are weak or absent, identification of the causative agent of pneumonia is difficult.

The most important method, confirming the diagnosis of pneumonia and clarifying the localization of the source of inflammation, is X-ray examination chest organs. X-ray signs pneumonia appears later than clinical pneumonia, which, along with the characteristics of the pathogen and the localization of the process, causes cases of “X-ray negative” pneumonia.

Differential symptoms of pneumonia

The spread of pain to the upper abdomen, their combination with pain on palpation, especially in the right upper quadrant of the abdomen, and increased pain when tapping along the right costal arch often complicate the diagnosis of pneumonia. All these symptoms of pneumonia are caused by the involvement of the pleura in the inflammatory process and irritation of the endings of the right phrenic and lower intercostal nerves embedded in it, which are also involved in the innervation of the upper parts of the anterior abdominal wall and organs abdominal cavity. This explains frequent occurrence various symptoms from the abdomen (abdominal) in acute diseases of the chest organs.

Severity of abdominal pain combined with other gastrointestinal disorders, often causes misdiagnosis acute diseases abdominal organs in patients lobar pneumonia, as well as pleurisy, pericarditis, myocardial infarction. Often these patients are sent to surgical departments with a diagnosis of acute cholecystitis, appendicitis, perforated ulcer stomach; There are known cases when they were subjected to surgical intervention. In such cases, the diagnosis of pneumonia is helped by the absence of tension in most patients abdominal muscles and symptoms of peritoneal irritation, although this sign is not absolute.

Treatment of incipient pneumonia

Emergency care for pneumonia

The scope of emergency care for pneumonia depends, naturally, on the prevailing symptoms. In the presence of severe respiratory failure, oxygen therapy is indicated, in case of persistent debilitating cough - antitussive drugs, in case of pleural pain - non-narcotic analgesics, in case of severe intoxication - detoxification therapy, in case of infectious-toxic shock - anti-shock therapy.

The development of mental disorders in alcoholics with pneumonia requires the use of psychotropic drugs: Seduxen (10 mg intravenously or intramuscularly, the drug is contraindicated in chronic obstructive pulmonary diseases), Haloperidol (1-2 ml of 0.5% solution), Aminazine (2 ml of 2.5% solution). Should be considered hypotensive effect Aminazine, therefore its use in arterial hypotension contraindicated. In addition, the use of psychotropic drugs is contraindicated in patients with acute alcohol intoxication.

Hospitalization for pneumonia

Establishing a diagnosis of pneumonia entails the need to hospitalize the patient in the therapeutic department of the hospital, because only in a hospital setting can a clinical examination be completed and sufficient intensive care. Treatment of pneumonia at home is justified only in cases of its mild, uncomplicated course, in the absence of any doubt about the diagnosis.

In case of pneumonia, complicated by cardiac and vascular failure, the development of an abscess or pyopneumothorax, immediate hospitalization of the patient is required. Patients with abnormal behavior, mental and motor agitation should be under the constant supervision of medical personnel.

Inpatient treatment for pneumonia

In a hospital setting, empirical antibacterial therapy is carried out until the sensitivity of the pathogen to antibiotics is established. At severe course pneumonia with pronounced physical signs of pulmonary inflammation, pneumonia is regarded as pneumococcal and penicillin is used intramuscularly or intravenously from 6 to 30 million units per day. In patients with chronic nonspecific lung diseases, Ampicillin is preferable in a daily dose of 4-8 g. In patients with chronic alcoholism and severe somatic diseases, as well as in elderly patients, therapy begins with 2nd generation cephalosporins or with a combination of Ampicillin with betalactamase inhibitors. For bilobar (bilobar) pneumonia, severe cases with severe symptoms of intoxication and an unknown pathogen, a combination of antibiotics is used (semi-synthetic Penicillins or Cephalosporins with Aminoglycoside - Gentamicin or Netromycin), Fluoroquinolones, Carbapenems are used.

Along with pneumonia, inflammatory processes are observed, the characteristic feature of which is focal infectious destruction of all elements of the lung tissue - either limited (single or multiple abscesses) or without clear boundaries (pulmonary gangrene).

Many types of pneumonia, as well as abscess and gangrene of the lungs, develop as a result of microaspiration of microflora from the oropharynx - aspiration pneumonia. The term was introduced to refer to a disease associated with aspiration into the lungs of not only the contents of the oropharynx, but also the contents of the stomach by patients who are unconscious at the time of vomiting. The primary reaction of the lungs to aspiration is not of an infectious nature, but is an inflammatory process in the bronchi in response to irritant effect hydrochloric acid of gastric juice. This reaction creates favorable conditions for the subsequent development of infection, aspirated along with the contents of the oropharynx and stomach. Mucus from the oropharynx and gastric juice contain only a small amount of microflora, which is normally present wide range anaerobic and aerobic bacteria. Anaerobes, the number of which significantly exceeds the number of aerobes (10:1 ratio), interact with each other as a mixed infection that can induce not only inflammation of the lung parenchyma, but also necrosis of the lung tissue with subsequent abscess formation.

Complications after treatment for pneumonia

Causes of destruction of lung tissue after inflammation

Typically, the causative agents of infectious destruction of lung tissue are necrotizing infections:

pyogenic bacteria (Staphylococcus aureus, Klebsiella, group A streptococci, bacteroides, fusobacteria, anaerobic streptococci, etc.);

mycobacteria (tuberculosis, etc.);

fungi (aspergillus, Histoplasma, Coccidioides);

Causes of abscess and gangrene after pneumonia

Abscess and gangrene of the lung characterized by such signs of pneumonia as necrosis of lung tissue that occurs in the central part inflammatory infiltrate, almost identical to the infiltrate observed with pneumonia, infarction pneumonia or aspiration pneumonia. The dead tissue undergoes purulent melting with the subsequent formation of purulent cavities.

Several factors contribute to the development of necrosis:

violation of bronchial obstruction (narrowing of the lumen of small bronchi due to swelling of the mucous membrane);

thrombosis small vessels with subsequent disruption of microcirculation;

necrotizing mixed anaerobic and aerobic infection.

Necrotic lung tissue favors the rapid development of pathogenic microflora, the progression of a purulent or putrefactive process, and the melting of lung tissue with the formation of purulent cavities.

Abscess and gangrene have a common origin and the same type of initial phase of the development of the disease, identical to that after pneumonia. Some authors do not agree with this and tend to consider abscess and gangrene as qualitatively different pathological processes.

Pneumonia is an infectious disease that can be caused by viruses, bacteria or fungi. The type and severity of the disease depends on the pathogen, provoking factors, protective functions of the body and timely diagnosis.

Causes of the disease

The reason for the development of the disease is always the same - the penetration and reproduction of an infectious agent; only the factors under which this occurs differ:

untreated viral, bacterial or fungal diseases;
complications after illnesses;
damage to the respiratory system by various chemical reagents or vapors when inhaled;
increased level of radiation with the addition of infection;
allergies that affect the respiratory system;
colds due to hypothermia;
thermal burns of the lungs in a fire;
penetration foreign body into the respiratory tract.

Any condition that creates a favorable environment for the proliferation of microbes and the development of pneumonia can be considered the cause of the disease. Therefore, doctors divide pneumonia into hospital-acquired and community-acquired forms.

In addition, pneumonia is divided into types depending on the pathogen; the severity of the disease and the clinical picture also depend on this:

streptococci are the most common pathogens; the disease is always severe and often causes death;
mycobacteria – children and young people are often infected;
chlamydia infection often occurs among the younger generation and middle-aged people, mainly in facilities equipped with artificial ventilation;
Haemophilus influenzae usually affects the respiratory system of smokers and patients with chronic diseases of the lungs and bronchi;
Infection with enterobacteriaceae occurs rarely; as a rule, this occurs in patients diabetes mellitus and those suffering from heart, kidney and liver diseases;
staphylococcal pneumonia develops more often in older people who have had the flu;
There are pneumonias caused by unknown or rare fungi and bacteria.

Causes of the disease

When making a diagnosis and prescribing treatment, it is necessary to take into account the etiology of pneumonia, the causative agent, medical history and the presence of third-party diseases. Pneumonia is often treated on an outpatient basis; in severe cases, the patient is hospitalized.

The first signs of pneumonia in adults

Previously, there was a fairly high mortality rate among patients with pneumonia. Today's medicine in the treatment of the disease gives a positive prognosis, subject to timely treatment. Therefore, it is necessary to know how they manifest themselves:

sudden increase in body temperature, chills;
cough, the first days may be dry, then wet;
runny nose;
general malaise;
hard breath.

It must be remembered that the incubation period for pneumonia is very short, only 2-3 days, then the disease begins to progress rapidly, and if treatment is not carried out on time, the patient may die. Therefore, it is important to contact a medical facility at the first signs of pneumonia.

The onset of the disease always has acute form, but symptoms depend on age, immune system and individual characteristics of the body. The first signs of pneumonia in different people may differ significantly. Some people may not have a fever or cough, especially if the person was previously treated with antibiotics for another illness.

Additional symptoms appear later in adult patients:

purulent sputum begins to separate;
chest pain;
respiratory failure;
cyanosis of the skin, especially on the face, this occurs due to oxygen starvation;
tachycardia, low blood pressure.

One of the first signs of pneumonia is a cough of varying intensity. At first it may be infrequent and dry, then, if treatment has not been started, it becomes wet. Purulent greenish sputum appears.

Chest pain

If a person falls ill with ARVI, then his condition should improve in a week; if this does not happen, and the condition worsens, pneumonia can be suspected. In this case, the temperature is usually very high, only atypical pneumonia is accompanied low-grade fever. It often happens that the patient begins to experience relief, but there is a sharp increase in temperature and the condition worsens. As a rule, antipyretic drugs have no effect. This is a signal for an urgent visit to the doctor.

Often the sick person feels pain in the chest when coughing or breathing, this alarming symptom indicates that the pleura is involved in the inflammatory process. The person becomes pale, has difficulty breathing, sweating increases, fever, delirium and other symptoms of intoxication of the body appear.

All these manifestations can be considered the first signs of pneumonia, which requires immediate examination. It should be noted that the first signs of pneumonia in women are no different from men, the only difference is that due to smoking, men are more likely to expose themselves to this disease than women.

First signs in children

With pneumonia, the first signs in children differ significantly from adults. Parents are advised to pay attention to the slightest changes in the child’s well-being. The first symptoms of pulmonary inflammatory processes can be considered:

high, persistent temperature, usually above 39 0 C, which is not reduced even by antipyretics;
the child becomes lethargic, refuses to eat, and cries constantly;
sweating increases;
it is necessary to take into account that infants the thermoregulation function is not yet fully regulated and the temperature may not be high;
In babies, the rhythm of breathing is disturbed, it becomes frequent; if you pay attention to the child’s chest, one side will be delayed when breathing. In newborns, foam may be released from the nose or mouth; the child may puff out his cheeks due to shortness of breath;
if atypical pneumonia develops, the symptoms may be similar to ARVI, but shortness of breath and fever are alarming factors;
The cough usually develops, first coughing occurs, then a dry cough, turning into a wet one;
infants may suffer from diarrhea and vomiting;
The baby is capricious, refuses to breastfeed, cries often, and sleeps poorly.

If these symptoms occur, you should immediately call a doctor if timely treatment pneumonia usually has a positive prognosis and resolves without complications.

Forms of pneumonia

Based on the localization of the process and the severity of the disease, pneumonia is divided into four forms, which have different first signs:

An acute form of inflammation does not pose a danger if treated in a timely manner. Complications may occur if left untreated. Develops due to the penetration of an infectious agent, may be a consequence past diseases. The first sign is heat and cough.
A chronic form of pneumonia, the causative agent of which is constantly present in the tissues and mucous membranes of the respiratory tract. This form of the disease has phases of exacerbation and remission, develops in rare cases, but is dangerous due to its protracted course and vague symptoms. The very first sign of this form of the disease is a weakened immune system, and if the patient is not treated in time, the inflammation may develop into pleurisy and result in death.
Lobar pneumonia is characterized by damage to a larger lobe of the lung and is considered the most dangerous form. Treatment is carried out in a hospital setting under the supervision of doctors. This form of the disease is usually a continuation of acute or chronic forms of pneumonia and the first sign is difficulty breathing and high temperature.
Focal pneumonia develops in a certain segment of the lungs and is not dangerous, but timely treatment is necessary, otherwise acute or chronic form with all the ensuing consequences.

In order to determine the form of pneumonia, it is necessary to conduct a series of blood tests and take a chest x-ray.

To understand the seriousness of the disease, it is enough to pay attention to the first signs and additional symptoms, the brighter the clinical picture, the more dangerous pneumonia is for human life.

What to do at the first signs of pneumonia?

It is important to maintain bed rest

Knowing how the first signs of pneumonia appear, you can consult a doctor in time and begin treatment. Some forms of the disease are almost asymptomatic, which makes their diagnosis difficult. If we are talking about children or the elderly, therapy is required immediately when characteristic features pneumonia.

First of all, it is necessary to provide the patient with bed rest and rest. If your body temperature is very high, you need to take an antipyretic. You can give tea with lemon.

Antibacterial therapy should be prescribed by a doctor after examining sputum and identifying the pathogen. Antiviral therapy may be required in parallel.

You can drink it at home Herb tea, badger fat and honey Under no circumstances should warming procedures be performed on the chest. At the first signs of pneumonia, you should immediately consult a doctor; the measures that will be aimed at treating the disease in the first 7-9 hours determine the duration and prognosis of treatment.

Complications caused by pneumonia

Complications from pneumonia are very dangerous

Inflammatory processes in the respiratory system can lead to serious complications. This is due to the fact that blood washes the lungs and can spread the infection throughout the body, thereby provoking:

blood poisoning, sepsis;
inflammation of the brain, meningitis;
inflammation of the heart muscle, endocarditis, pericarditis.

If pneumonia develops in an older person after surgical treatment, this poses a double threat. Inflammation of the lungs during pregnancy can provoke infection of the fetus with staphylococcus or pneumococcus, which will lead to miscarriage or premature birth. If a pregnant woman has breathing problems, she should immediately contact the clinic.

You cannot self-medicate, pneumonia cannot be cured traditional methods. Treatment at home can muffle the symptoms and give a misleading picture of improvement, while the inflammatory process will gradually increase.

Treatment

Treatment is usually done with medications and antiviral drugs

Treatment should be comprehensive, including various measures. First of all, this is drug therapy:

antibiotics to combat the causative agent of the disease, if they are used for more than a week, it is advisable to replace them with another drug in order to avoid the development of bacterial resistance to the drug;
if necessary, antiviral or antifungal agents are prescribed;
anti-inflammatory drugs, antipyretics (used at temperatures above 38 0 C);
mucolytic and bronchodilator drugs for thinning mucus and removing it from the respiratory tract, the use of these drugs is mandatory, accumulated mucus can cause inflammation in a new circle;
Doctors often prescribe inhalations using essential oils eucalyptus, pine and cedar;
taken to eliminate toxins antihistamines and blood purification drugs;
At the same time, it is necessary to strengthen the immune system;
in cases where complications concern the heart and blood vessels, cardiac medications are prescribed.

Treatment cannot be stopped on your own; in the absence of symptoms, the inflammatory process can continue and worsen over time, only in a severe form. During the recovery period, it is recommended to perform breathing exercises, watch your diet and take walks in the fresh air.