Pneumonia – what it is, causes, signs,symptoms in adults and treatment of pneumonia

Pneumonia in adults (pneumonia) – inflammation of the lower
respiratory tract of various etiologies occurring with
intraalveolar exudation and accompanied by characteristic
clinical and radiological signs. The main reason for the development
заболевания — это легочная инфекция, поражающая все структуры
lungs. There are many types of pneumonia that differ in
degrees of severity from mild to severe, or even those that may
be fatal.

What is pneumonia?

Пневмония у взрослых

Pneumonia (pneumonia) is predominantly acute.
pathological condition due to infectious-inflammatory
defeat of the pulmonary parenchyma. With this disease
the lower airways are involved in the process (bronchi, bronchioles,
alveoli).

This is a fairly common disease diagnosed
approximately 12–14 adults out of 1000, and older people whose
age has passed for 50–55 years, the ratio is
17: 1000 In terms of death rate, pneumonia is on
the first among all infectious diseases place.

  • Код МКБ-10: J12, J13, J14, J15, J16, J17, J18, P23

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

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

The reasons

Чаще всего воспаление легких вызывают бактерии
(пневмококки, гемофильная палочка, реже — микоплазмы,
chlamydia), but the likelihood of having pneumonia increases in
periods of outbreaks and epidemics of acute respiratory viral
infections.

In old age, pneumonia is most often caused by
pneumococci, streptococci, mycoplasma, their combinations. To exclude
errors in the diagnosis is radiographic
research of lungs in several projections.

Among the causes of pneumonia in adults, in the first place
worth a bacterial infection. Most common pathogens
are:

  • Gram-positive microorganisms: pneumococci (40 to 60%),
    стафилококки (от 2 до 5%), стрептококки(2,5%);
  • Gram-negative microorganisms: Friedlander wand (from 3 to
    8%), hemophilus bacillus (7%), enterobacteria (6%), proteus,
    E. coli, Legionella, etc. (from 1.5 to 4.5%);
  • микоплазмы (6%);
  • вирусные инфекции (вирусы герпеса, гриппа и
    parainfluenza, adenoviruses, etc.);
  • fungal infections.

Risk factors for the development of pneumonia in adults:

  • Constant stress that depletes the body.
  • Inadequate nutrition. Insufficient use of fruit,
    vegetables, fresh fish, lean meat.
  • Weakened immunity. Leads to lower barrier functions.
    organism.
  • Frequent catarrhal diseases leading to the formation
    chronic foci of infection.
  • Smoking. When smoking the walls of the bronchi and alveoli are covered
    various harmful substances, not giving surfactant and other
    light structures work normally.
  • Abuse of alcoholic beverages.
  • Chronic diseases. Especially pyelonephritis, heart
    failure, coronary heart disease.

Classification

  1. Внебольничная пневмония – самый распространенный вид
    diseases.
  2. Butзокомиальная или госпитальная пневмония. To this form
    include the disease that developed when the patient is in
    hospital for more than 72 hours.
  3. Atypical pneumonia. The type of disease caused by
    atypical microflora (chlamydia, mycoplasmas, legionella and
    etc.).
  4. Аспирационная пневмония – инфекционно-токсическое
    damage to the lung parenchyma due to exposure
    in the lower respiratory tract of the contents of the mouth, nasopharynx,
    stomach.

Depending on the etiology of pneumonia is:

  • viral;
  • fungal;
  • bacterial;
  • mycoplasma;
  • mixed

Depending on the nature of the disease:

  • acute;
  • acute protracted;
  • chronic;
  • atypical.

Type of pneumonia by localization

  • left sided;
  • right;
  • unilateral: one lung affected;
  • bilateral: both lungs are affected;

The severity of the inflammatory process:

  • easy;
  • moderate severity;
  • heavy

First signs

By what signs can you determine pneumonia in the home?
conditions? The initial signs of the disease is not easy to recognize. Their
may not be at all, rarely or weakly manifested. Everything
depends on the type of pathogen. therefore очень важно обратить внимание
on changes occurring in the body.

The main signs of pneumonia in adults are coughing (there are
exceptions) and chest pain which, depending on
the etiology of the disease and its type may be accompanied by
other symptoms.

First signs пневмонии, которые должны насторожить
person:

  • weakness of the limbs (feeling when “wadded feet”);
  • minor violations temperature conditions;
  • dry cough;
  • dyspnea;
  • periodic tides, which replaces the state of cold
    sweat.

A specific sign of pneumonia in an adult is
feeling of acute pain in the chest when making
respiratory movements and coughing process.

Body temperature can be very high up to 39-40 ° C, and
remain low-grade 37.1-37.5C ​​(with atypical form). therefore
even with a low body temperature, cough, weakness and other
signs of indisposition, should necessarily refer to
to the doctor.

Symptoms of pneumonia in adults

How pneumonia occurs in adults depends on the type
the causative agent, the severity of the disease, etc. Characteristic signs of inflammation
lung, acute development of the process, its vastness and probability
manifestations of complications with improper therapy – the main reasons
immediate treatment of patients to specialists.

Almost every type of pneumonia has its own characteristics.
currents due to the properties of the microbial agent, the severity
the course of the disease and the presence of complications.

The main symptoms of pneumonia in adults:

  • increased body temperature;
  • кашель, вначале заболевания сухой, по мере развития —
    с обильной мокротой;
  • dyspnea;
  • increased fatigue, weakness;
  • fear caused by lack of air;
  • боль в грудной клетке.

In addition, the following minor symptoms may occur.
pneumonia:

  • headache;
  • cyanotic (blue) lips and nails;
  • muscle pain;
  • быстрая утомляемость, dyspnea;
  • heat.

If bilateral pneumonia progresses, the symptoms are atypical,
detailed below:

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  • blue lips, fingertips;
  • heavy, confused breathing;
  • continuous dry cough with sputum;
  • shortness of breath, weakness in the whole body;
  • lack of appetite.

Sometimes pneumonia has an erased course – without increasing
temperature Only weakness attracts attention;
appetite, rapid breathing, intermittent cough. In this case
the diagnosis is confirmed only radiologically.

Focal pneumonia
  • high temperature;
  • weakness;
  • cough (First, cough is dry, then pus is expectorated
    branches with streaks of blood);
  • pain in the chest, under the shoulder blades, of the head.
 Hidden form
  • Onset of shortness of breath and cough;
  • pain in the joints and muscles;
  • absence of bronchial obstruction;
  • pulmonary hypertension;
  • drastic weight loss;
  • lack of temperature and sputum with blood.
Croup
  •  повышение температуры тела до 40 С
    Celsius;
  • dyspnea;
  • cough;
  • confusion;
  • weakness;
  • �”Rusty” sputum;
  • боль в грудной клетке.

Complications

If patients go to specialists immediately after
fall ill and adhere to the prescribed treatment regimen,
complications, as a rule, do not develop. Manifestation of complications
may be associated directly with the disease, as well as with the reception
drugs.

Возможные осложнения pneumonia:

  • The development of acute respiratory failure.
  • Pleurisy is an inflammation of the lining of the lung.
  • Lung abscess – the formation of a cavity filled with purulent
    content.
  • Pulmonary edema.
  • Sepsis – the spread of infection throughout the body
    blood vessels.

Diagnostics

Objective signs of pneumonia, determined by the doctor when
the initial examination of the patient is the appearance of a local
shortening of percussion sound, increased bronchophony, change
the nature of the breathing as a weakened and the appearance of local
fine bubbling rales, limited crepitus.

Already in the first hours of the disease the patient with suspected pneumonia
should be subject to comprehensive both laboratory and
instrumental examination. In the diagnosis of pneumonia are solved
several tasks at once:

  • differential diagnosis of inflammation with other pulmonary
    by processes
  • clarification of the etiology and severity (complications).

Independent diagnosis of pneumonia is not only impossible, but also
extremely dangerous, because starting to treat the disease wrong, you can
accelerate its development or provoke the appearance of complications.

The doctor will prescribe:

  • stethoscope listening;
  • body temperature measurement;
  • рентгенография органов грудной клетки;
  • bronchoscopy, sputum analysis;
  • общий и биохимический анализ крови.

Незаменимым для  постановки точного диагноза пневмонии
is a chest x-ray. It is held in a straight line, and
if necessary and in lateral projection and allows not only
establish the diagnosis of acute pneumonia and identify possible complications,
but also to evaluate the effectiveness of treatment.

снимок легких при пневмонии

In some cases, additional methods are needed.
Research: computed tomography of the chest,
bronchoscopy, examination of the pleural fluid (to exclude
lung cancer, pulmonary tuberculosis).

Pneumonia treatment

Doctors may be able to treat uncomplicated pneumonia.
broad profile: general practitioners, pediatricians, family doctors and general practitioners
practice.

При не тяжелой пневмонии у взрослых проводится
hospital treatment. Оно состоит в комплексе следующих
measures:

  1. taking drugs that expand the bronchi for the discharge
    sputum;
  2. antibiotics, antiviral drugs to combat
    с возбудителем пневмонии;
  3. passing a course of physiotherapy;
  4. performance physiotherapy exercises;
  5. diet, drink plenty of water.

The moderate and severe course requires hospitalization in
therapeutic or pulmonary department. Uncomplicated
mild pneumonia can be treated on an outpatient basis under control
district therapist or pulmonologist visiting the patient
at home.

It is preferable to conduct inpatient treatment in the following
situations:

  • a patient over 60;
  • наличие хронических болезней легких, диабета,
    malignant tumors, severe heart or kidney
    deficiency, low body weight, alcoholism or
    addiction;
  • the ineffectiveness of initial antibiotic therapy;
  • pregnancy;
  • the desire of the patient or his relatives.

Antibiotics

При пневмонии легких антибиотики у взрослых целесообразно
apply after the disease has been confirmed by at least one
diagnostic method.

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

Other drugs

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

  • Ibuprofen;
  • Paracetamol;
  • Ibuklin;
  • Aspirin.

To dilute sputum mucolytics are used:

  • Ambrohexal;
  • Lasolvan;
  • Ambrobene;
  • ACC;
  • Fluimucil;
  • Fluditec.

Physiotherapy treatment of pneumonia in adults

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

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

Treatment activities are held until the patient recovers
which is confirmed by objective methods – auscultation,
normalization of laboratory and radiological indicators
research.

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

Compliance with the regime

  1. During the entire period of the disease the patient must
    comply with bed rest.
  2. You need a nutritious diet rich in vitamins. If a
    there are no signs of heart failure, copious benefits
    drink up to 3 liters per day.
  3. The room should be fresh air, light, temperature + 18C.
    When cleaning the room should exclude products containing chlorine, not
    use open coil heaters as they are strongly
    dry the air.

In the period of resorption of the inflammatory focus is assigned
physiotherapy:

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

After recovery, the patient is recommended sanatorium
treatment in local forest resorts or places with warm and humid
climate, at sea. It will be useful to undergo a course of reflexology,
massage, aero ionization sessions.

Diet and nutrition

Diet for pneumonia during the exacerbation:

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

Exclude products such as: alcohol, smoked products,
fried, spicy and fatty dishes, sausages, marinades, canned goods,
store sweets, products with carcinogens.

Recovery and Rehabilitation

After pneumonia, a very important point is rehabilitation,
which aims to bring all the functions and systems of the body into
normal condition. Rehabilitation after pneumonia also
a beneficial effect on overall health and in
further, which minimizes the risk of development and recurrence, not only
pneumonia, but also other diseases.

Recovery involves taking medication,
physiotherapy, diet, tempering procedures. This stage may
last up to 3-6 months, depending on the severity of the disease

Prevention

The best prevention is to maintain a rational image.
life:

  1. Proper nutrition (fruits, vegetables, juices), walks in the fresh
    air, avoid stress.
  2. In winter and springtime to avoid a decrease in immunity.
    You can take a complex of multivitamins, for example, Vitrum.
  3. Отказ от курения.
  4. Treatment of chronic diseases, moderate use
    of alcohol.

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

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