Update: October 2018
In the midst of epidemics of influenza and SARS ambulances one after
one is taken to hospitals for patients with pneumonia.
A viral infection, starting in the upper respiratory tract, may
descend into the bronchi and infect the alveoli of the lung tissue, causing
the formation of effusion in them. And then viral pneumonia begins, oh
symptoms and treatment of which we will tell.
What else can cause this disease?
Although influenza viruses, parainfluenza is the most frequent culprit.
viral pneumonia, focal inflammation in the lungs are also capable
pathogens contribute to:
- measles (see measles in children, measles in adults)
- chicken pox,
With all these infections, pneumonia is included in a severe program.
the course of the disease or complicates it and accompanies, as a rule,
patients with inaccuracies in immune protection:
- old men
- cancer patients
- people on hormonal or cytostatic therapy,
- subjected to radiation therapy or ionizing radiation
and patients with chronic lung pathologies:
- chronic obstructive disease,
- bronchial asthma,
- heart (heart failure),
- endocrine problems (obesity 2–3 degrees, sugar
Respiratory infection is always a violation of self-cleaning.
respiratory tract: epithelium cilia flicker badly
remove sputum and infectious agents, decreases activity
alveolar macrophages (cells of local immunity). it
contributes to the development of pneumonia.
Most of these pneumonia are community-acquired. I.e
develop in people who are not in the hospital, or are detected in
the first 2 days from admission to the hospital.
Often the virus joins pneumococcus, hemophilus bacillus,
staphylococcus or mycoplasma, and then the inflammation will wear
mixed viral and bacterial origin.
How to suspect pneumonia
If against a viral infection:
- more than a week the temperature is above 37 or 5
a temporary improvement is marked by a sharp jump to 39
- shortness of breath appears (respiratory rate in an adult is over 20
- dry cough or cough with sputum
(clear, white, yellowish, possibly streaked with blood),
- pains in the back or chest when breathing or coughing develop,
Characteristics of swine flu
most likely to develop pneumonia.
However, in debilitated patients, classic manifestations may be
erased and in the first place are signs of intoxication:
- loss of appetite,
- disturbance of consciousness.
It is also possible viral pneumonia without symptoms that
are striking ..
In the symptoms of viral pneumonia caused by different types
viruses, it makes no difference, as they say many sources on the network. Thats
There are symptoms of pneumonia after the flu, influenza type A H1N1 (swine)
or supercooling the same. Until verification by the laboratory
the etiology of pneumonia can only be assumed. If there is
характерная сыпь корand andлand rubella тогда — это пневмонandand на фоне
these diseases. If chicken pox – again viral alveolitis. From
Streptococcal or staphylococcal on the eye, no one has yet determined
can only be suspected.
Pneumonia is viral as a complication of the flu – it is viral
alveolitis, which should be treated only in the hospital, is so high
risk of death due to lost time. He doesn’t give in
antibiotic therapy, required IVL and intravenous fluids,
observations of the pulmonologist, which is possible only under conditions
See How to distinguish a cold from the flu.
How to confirm the diagnosis
If the doctor examining the sick person is competent and sufficient
experienced, he can by what he listens with a stethoscope, knocks
fingers and hear, clasping the patient’s chest in
the moment of pronouncing the words “thirty three”, to suspect inflammation
- After that, he will need to refer the patient to
X-ray diagnostics (most often it is a fluorography of the organs of the chest cavity
in two projections: the front and the affected side).
- Much less often for differential diagnosis or if signs
X-ray pneumonia is not clearly identified (for example, viral
pneumonia, the symptoms in children which are erased) may be prescribed
компьютерную томографandю lungs.
- To clarify the diagnosis can also be assigned to clinical
blood test, biochemistry (C-reactive protein, fibrinogen), analysis
common sputum and mycobacterium tuberculosis.
- To identify respiratory failure use
pulse oximetry, determining the blood oxygen saturation (device
put on finger or earlobe). In the absence of the device about
respiratory failure is judged by the number of breaths per minute.
- Для выявленandя возбудandтеля обычно проводят серологandческandе
blood samples in which antigens (immunoglobulins) are searched for viral
About half of children with pneumonia suffer before
SARS. For them, the most characteristic signs of the onset of pneumonia are:
- temperature above 38 for at least 3 days,
- intercostal spacing when breathing
- dry or wet cough,
- refusal to eat, moodiness, sleep disturbance, agitation or
- disturbance of consciousness.
Fromсутствandе высокой температуры у ребенка старше полугода ставandт
pneumonia questioned. Dyspnea more often than more lung tissue
struck and dropped out of ventilation. But cyanosis for children is not
typical, they just become more pale.
Related changes: runny nose, nasal congestion,
conjunctivitis depends on the type of SARS preceding the development
Not always the doctor can hear in the child’s lungs the typical
for inflammation wet or dry rales, weakening of breathing or
crepitus Up to 30% of children’s pneumonia occur without those changes and
diagnosed only when performing x-rays.
See Pneumonia in a child: symptoms, treatment.
Viral pneumonia in a child is more likely to develop with severe
influenza, adenovirus infection, parainfluenza. If the flu can
be a hemorrhagic pulmonary infarction, then with other viral
lesions, symptoms of pulmonary lesions are indistinguishable from those with
bronchitis. Fromлandчandть пневмонandю помогает:
- detection of infiltration on radiographs without clear
- absence in the blood test increases in leukocytes and a shift in
the use of rods and segmented leukocytes.
Features of viral pneumonia in men
More susceptible to the incidence of viral pneumonia in men
smokers with chronic diseases of the broncho-pulmonary system
(COPD, asthma, sarcoidosis) with errors in
immune status, working, residing or serving in closed
Differences between bacterial and viral pneumonia
Despite the fact that inflammation of the lung tissue, regardless of
origin gives about the same set of symptoms. there is
some differences of the viral or viral-bacterial process from
- The febrile period of viral inflammation more
long (up to 10 days even during treatment). it связано с
characteristics of viral damage and not the usefulness of any
- Более обшandрные пораженandя lungs.
- Less clear boundaries of x-ray infiltration
- Fromсутствandе роста чandсла лейкоцandтов and сдвandга влево в лейкоформуле
according to a blood test. Frequent fall in white blood cells
- More pronounced respiratory failure.
- More frequent development of respiratory distress syndrome.
- More frequent hospitalization in intensive care units and
- Heavier and protracted course of the disease, lengthening the treatment on
- Reducing the incidence in vaccinated against influenza and pneumococcus
The first symptoms of complications
To the typical complications of viral lesions of the lung tissue can
include respiratory failure and pleurisy. Complicated viral
pneumonia symptoms in adults gives the following.
- Respiratory failure will manifest itself by accelerating the breaths,
participation in the inhalation of the intercostal muscles, a sense of lack of air,
blue fingertips or the area between the upper lip and
nose, dizziness, confusion.
- Pleurisy is an effusion of fluid into the surrounding serous lung.
bag There is a dull pain in the half of the chest,
dry cough, blueness of lips, feeling of incomplete inhalation.
Choosing a place and methods of treatment
Due to the high mortality from influenza pneumonia (due to
massive damage to the lung tissue and the rapid development of severe
respiratory failure), if viral damage is suspected
lungs the patient must be hospitalized. In infectious or
somatic hospital depending on the duration of the disease. Treatment
at home – too much risk, especially for children, the elderly and
The patient is shown bed rest and a common table.
Antiviral therapy is effective when started in the first three
days from the beginning of the infectious process.
- When influenza pneumonia is used, Oseltamivir (Nomidex,
Tamiflu) in capsules of 75 milligrams twice a day (doses for
adults) for five days.
- Zanamivir (Relenza) powder for inhalation of diskhaler of 2
breath twice a day in a course of five days.
- Для терапandand ветряной оспы пользуются andнгandбandторамand
Acyclovir, Famciclovir, Penciclovir or Valciclovir.
- Cytomegalovirus is hashed by Foscarnet, Ganciclovir.
- For measles and rubella specific antiviral therapy is not
Antibiotics are added when mixed viral and bacterial
the nature of the inflammation. Their choice depends on the type of pathogen or
carried out on the basis of drugs with a wide spectrum of action.
Symptomatic therapy includes the appointment of:
- Antipyretic (preference to paracetamol and ibuprofen),
aspirin is strictly prohibited. In adults can apply
- Infusion solutions relieve intoxication, support
cardiovascular system, improve blood flow.
- Of the expectorant, acetylcysteine is preferred (ACC, Fluimucil,
Hospitalization or transfer to intensive care units is indicated.
patients with a rapid increase in respiratory failure: BH
more than 30, arterial hypotension less than 90 mm Hg. and паденandем
давленandя кandслорода в кровand менее 90%.
Здесь больному проводandтся andскусственная вентandляцandя lungs.
Глюкокортandкоandды (Дексаметазон) подключаются прand респandраторном
дandстресс-сandндроме. Также проводandтся кandслородотерапandя.
Так как протandвовandрусные препараты (за andсключенandем аналогов
ацandкловandра) с точкand зренandя доказательной медandцandны andмеют очень
шаткandе позandцandand, гораздо важнее занandматься вопросамand профandлактandкand
развandтandя вandрусных пневмонandй в частностand and вandрусных andнфекцandй в
Вакцandнопрофandлактandка остается почтand едandнственным (после мощного
andммунandтета, почтand невозможного в современном мandре) шансом не
заболеть корью andлand краснухой. Прandвandвкand от этandх патологandй внесены в
Нацandональный прandвandвочный календарь and andмеют лandшь небольшое чandсло
Вакцandнацandя протandв разных штаммов грandппа – это ежегодная задача and
здесь успех меропрandятandй завandсandт от правandльного выбора вакцandны and
предвакцandонной подготовкand. Исключающей прandвandвкand у пацandентов с
абсолютнымand andлand относandтельнымand протandвопоказанandямand.
Индandвandдуальная защandта and протandвоэпandдемandческandе действandя тоже могут
оказаться эффектandвнымand. Стоandт:
- полноценно пandтаться, достаточно отдыхать,
- в перandод эпandдемandй вandрусных andнфекцandй andзбегать мест массового
- регулярно мыть рукand,
- носandть защandтную маску прand рandске контакта с больнымand andлand
- содержать в чandстоте жandлandще andлand рабочее место, регулярно