Clinical signs and treatment of pneumonia in children and adults
Diseases of the respiratory system are one of the most frequent reasons for visiting a doctor. Usually everything starts with a banal acute respiratory infection, but in some situations the infection breaks through the protective barriers and penetrates into the lower parts of the respiratory system - the bronchi and lungs. When the latter are affected, various types of pneumonia develop.
Classification
There are many classifications of this disease, but each of them separately does not reflect all the details of the process that the doctor needs. Basically, such a division is used, which takes into account the conditions of the infectious process, the immunological state of the body and the causes of the appearance of pneumonia. According to these principles, the disease is divided into:
- out-of-hospital (that arose outside the walls of a medical institution);
- nosocomial (which appeared as a result of infection that occurred inside the hospital);
- aspiration (caused by inhalation of any liquid or solid bodies that should not enter the respiratory tract under normal conditions);
- pneumonia that arose against the background of immunodeficiency conditions (HIV, congenital immunodeficiencies, suppression of immunity during medical manipulations).
Microorganisms are directly "to blame" for the development of pneumonia, and usually these are the microbes that under normal conditions are in the upper respiratory tract of every person. It is most often caused by pneumococci or Haemophilus bacillus (up to 60% of all diseases), less often by mycoplasma, legionella and chlamydia (up to 30%), rather rarely by staphylococcus aureus and microbes from the enterobacteria group.
Symptoms of pneumonia
The appearance of this disease should be suspected in all cases of fever, which is combined with shortness of breath, cough, discharge of sputum and chest pain (the last symptom is not always present). After studying the anamnesis, which often reveals factors that can lead to the development of pneumonia, the patient is listened to and tapped. At the same time, characteristic signs are revealed:
- a special sound (boxy) over the lesion;
- local appearance of bronchial breathing where it should not be;
- wheezing and crepitation;
- intensification of bronchophony, transmission of voice sound to the surface of the chest above the lesion.
In some cases, it is possible to have pneumonia without fever (it happens more often in children and the elderly) and without other outwardly noticeable symptoms. In such situations, an x-ray examination of the chest is mandatory. It is made in two projections, focal shadows of different sizes and locations are revealed in the picture. Sometimes in them, the phenomena of the destruction of lung tissue are noted, which indicates a possible staphylococcal, enterobacterial lesion of the lungs. It should be noted that all patients with suspected pneumonia are now sent "for X-rays".
In addition to these data, other studies are conducted:
- general and biochemical blood tests;
- blood gas analysis in patients with respiratory failure;
- microbiological examination of sputum (carried out before taking antibiotics);
- fibrobronchoscopy.
As a result, the doctor receives complete information about the causative agent of the disease, the involvement of other organs in the process, and can make a forecast of the outcome.
Treatment of pneumonia in adults and children
Mild forms of the disease are treated on an outpatient basis, but sometimes patients need hospitalization. A patient is admitted to a hospital when:
- high fever (> 40ºС) or hypothermia (<35.5ºС);
- low blood pressure - systolic less than 95, diastolic less than 60 mm Hg. article;
- increased pulse up to 125 beats per minute or more;
- consciousness disorders;
- presence in laboratory analyzes of signs of a severe course of the process;
- development of complications.
A pulmonologist directs his efforts to completely remove the causative agent of pneumonia from the lungs, eliminate the symptoms of the disease, return to normal laboratory parameters and restore respiratory function, and prevent complications. For this, the method of choice is antibiotic therapy.
Antibiotics for pneumonia are used in mild cases in the form of tablets or capsules, in severe cases, injectable forms of drugs are used. Treatment with them should be started in the first 8 hours from the onset of the disease. With a later start of antibiotic therapy, the prognosis for recovery progressively decreases. A wide variety of drugs are used for treatment, starting with simple amoxicillin and ending with fluoroquinolones of the latest generation. The site https://dobrobut.com/ categorically does not recommend trying to treat pneumonia on your own. Schemes of correct treatment are known only to the doctor, and only he will be able to control the dynamics of the process.
Antibiotic therapy is the only scientifically proven method of combating the infectious process in the lungs. However, other groups of drugs are also prescribed for pneumonia, which by themselves do not destroy microbes, but, as many doctors believe, help the body cope with the disease and prevent the development of complications. These include antihistamines, vitamins, biostimulants, and immunomodulators.
Such appointments contradict the principles of evidence-based medicine, but it will be extremely difficult for patients to refuse them. There is a strong traditionalism in medicine and these drugs are prescribed more out of habit. The only group of drugs, the appointment of which is justified and scientifically substantiated for pneumonia, along with antibiotics, are antipyretic analgesics. But they should be used for a limited period of time, until the temperature drops to stable values and until the pain subsides to a tolerable level.
Pneumonia is a serious disease, with a mortality rate of 1-3% in young healthy people and 15-30% in elderly patients, especially in the presence of other diseases. Therefore, its treatment should be carried out exclusively by specialists.
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