What are the symptoms of pneumonia in children? How to recognize the first signs of pneumonia in children? Pneumonia in children 12 years old

The respiratory sections of the lungs are the anatomical structures located behind the terminal bronchi - the respiratory, alveolar ducts and alveoli. The incidence of pneumonia in children in the first year of life is 15-20 per 1,000 children, from 1 year to 3 years - 5-6 per 1,000 children. Predisposing factors in children may be the following diseases: perinatal pathology of aspiration, malnutrition, congenital heart disease with circulatory failure, immunodeficiency states.

In older children, predisposing factors are lesions chronic infection, passive and active smoking, hypothermia.

According to etiology, acute pneumonia is divided into:

• bacterial;
• viral;
• mycoplasma;
• rickettsial;
• fungal;
• allergic;
• pneumonia arising from helminth infestations;
• pneumonia that occurs when exposed to physical and chemical factors.

There are seven forms of bacterial pneumonia:

• pneumococcal;
• Friednender's;
• Pseudomonas aeruginosa;
• hemophilic;
• streptococcal;
• staphylococcal;
• a group of pneumonia caused by Proteus and Escherichia coli.

The most common viral pneumonias are:

• influenza pneumonia;
• adenoviral pneumonia;
• parainfluenza pneumonia;
• respiratory sontial pneumonia.

In accordance with the causes and mechanisms of occurrence, primary and secondary pneumonia are distinguished. The latter occur against the background of exacerbations chronic diseases bronchopulmonary system and others somatic diseases child.

For pneumonia to occur in a child, in addition to bacterial or viral agents, a certain set of factors is necessary:

• entry of mucus into the lungs from the upper respiratory tract is an aerogenic route;
• entry of the microorganism into the bronchi;
• destruction of the protective mechanisms of the respiratory tract;
• hematogenous, lymphogenous ways of spreading infection.

When pneumonia occurs in children, ventilation of the lungs and gas exchange are disrupted, and nutrition of the ventricular myocardium is reduced. According to the extent of the lesion, pneumonia can be segmental, lobar, total, unilateral and bilateral. In the mechanism of development of pneumonia, hypoxia with hypercapnia plays an important role, developing as a result of disturbances in both external, pulmonary, and tissue respiration.

Clinical symptoms of pneumonia depend on the type of pneumonia, the size and extent of the process. With focal pneumonia (bronchopneumonia), the process is acute or subacute and develops on the 5-7th day of acute respiratory disease in the form of its second wave.

The following symptoms are characteristic:

• temperature increase;
• weakness;
• headache;
• pain in the chest or under the shoulder blades;
• cough;
• increased intoxication.

Over the affected area, a shortening of the percussion sound is noted; on auscultation - bronchophony, weakened breathing, and sometimes crepitus. X-ray is determined by the strengthening of the pulmonary pattern between the foci of inflammation and the roots of the lung. A blood test reveals neutrophilic leukocytosis with a shift to the left, and an increase in ESR.

Segmental pneumonia

In the case of hematogenous spread, one or more lung segments. Typically, the right segments are more often affected. Segmental pneumonia begins acutely with an increase in temperature, symptoms of intoxication are usually pronounced, pain appears in the area chest, sometimes - in the stomach, cough - rare. Symptoms of respiratory failure appear, objective data are poorly expressed. Secondary segmental pneumonia develops against the background of ongoing respiratory infection, while the symptoms of intoxication are mild. Segmental pneumonia radiographically manifests itself in separate foci that merge and then capture the entire segment.

Lobar pneumonia

The inflammatory process involves a lobe of the lung or part of it and the pleura. Rarely seen. Often caused by pneumococcus. The beginning is acute. The disease begins with dizziness, deterioration of health, and a sharp headache. Temperatures up to 40-41 °C are noted, patients often complain of chills. The cough in the first three days is rare, dry, then with the release of rusty sputum. Cyanosis and shortness of breath quickly appear. Children often develop abdominal syndrome, manifested by pain in the navel, flatulence, and vomiting. There are four stages in the course of lobar pneumonia.

At the first stage - stage of tide, - a shortening of the percussion sound with a tympanic tint, weakened breathing is determined, and crepitus is periodically heard. In the second stage facial hyperemia develops, often on the affected side, a serious condition. On the affected side, shortening of percussion sound, bronchial breathing, and bronchophony are determined. No wheezing can be heard. Third stage develops on the 4-7th day - the cough intensifies, the temperature drops, often critically. The percussion sound takes on a tympanic tone, and crepitus appears.

In the fourth stage - stage of resolution, - the temperature decreases, a frequent cough appears, and abundant wheezing of various sizes appears. Read more about wheezing here. Radiographs also determine the stages of the process: in the first stage - strengthening of the vascular pattern, limitation of the mobility of the diaphragm; in the second stage, dense shadows appear corresponding to the lobes involving the root and pleura; in the third and fourth stages, infiltration disappears gradually.

With lobar pneumonia, there is a sharp neutrophilic leukocytosis with a shift to the left, and an acceleration of ESR. Proceeds atypically lobar pneumonia in children early age. The main symptoms of the disease are usually unclear. Under the influence of antibacterial therapy, the stages of the inflammatory process are shortened. In case of irrational therapy, a protracted course of the disease occurs.

Interstitial pneumonia

Interstitial pneumonia occurs with viral, mycoplasma, Pneumocystis, fungal and staphylococcal infections. More often, this pneumonia is recorded in premature and newborn children, as well as against the background of dystrophy and immunodeficiency conditions in children. The disease may be accompanied by severe intoxication, a fall is possible blood pressure In addition, changes in the central nervous system are often observed, as well as gastrointestinal tract. There is a debilitating cough with scanty foamy sputum. Interstitial pneumonia causes swelling of the chest. Percussion - tympanitis. Single crepitating and dry rales are heard against the background of weakened breathing. X-ray reveals emphysema, peribronchial infiltration, and cellularity of the interstitial-vascular pattern. From the blood side, leukocytosis and increased ESR are detected.

Diagnosis of pneumonia

Diagnosis is carried out on the basis of clinical and radiological data.

Clinical symptoms are:

• temperature reaction;
• signs of respiratory failure: shortness of breath, cyanosis, participation of auxiliary muscles in breathing;
• persistent auscultatory and percussion abnormalities in the lungs;
• X-ray - focal, segmental, lobar infiltrative shadows;
• from the blood: leukocytosis, neutrophilia, increased ESR;
• the effect of the etiological therapy.

The course of pneumonia in children depends on the etiology, age and the presence of various concomitant diseases. Pneumonia caused by hospital strains of Staphylococcus aureus or gram-negative bacteria is especially severe. The course of pneumonia in these cases is characterized by early abscess formation, rapid breakthrough of the inflammatory focus into the pleura and the occurrence of pyopneumothorax with a rapid course of the disease.

In the neonatal period, pneumonia has a serious prognosis. There are acquired and intrauterine pneumonia of newborns. Intrauterine pneumonia occurs as a result of infection of the fetus during pregnancy or aspiration of infected amniotic fluid, and aspiration can be either intrauterine or intrapartum. In newborns, pneumonia is often accompanied by atelectasis, as well as destruction of lung tissue.

Predisposition to allergic exposure may play an important role in the development of pneumonia external factors and the occurrence of catarrhal inflammation of the mucous membranes. With these pneumonias, the addition of asthmatic syndrome is characteristic. The course of pneumonia in these cases takes on a recurrent nature. In children suffering from rickets, pneumonia develops more often and has a protracted course. In children with malnutrition it occurs more often due to a significant decrease in immunity, and mild symptoms of pneumonia are noted.

Treatment of pneumonia in children

In the case of moderate and severe forms children are subject to inpatient treatment. Children of the first year of life - in any form.

Treatment of pneumonia is carried out comprehensively and consists of:

• use of etiotropic drugs;
• oxygen therapy for the development of respiratory failure;
• prescribing drugs that improve bronchial conduction;
• the use of means and methods that ensure the transport of oxygen in the blood;
• prescribing drugs that improve tissue respiration processes;
• using means that improve metabolic processes in the body.

The child's nutrition must correspond to the age and needs of the child's body. However, during the period of intoxication, food should be mechanically and chemically gentle. In connection with cough, foods containing particles that can be aspirated are excluded from the diet. Additional fluid is prescribed in the form of a drink. For this, decoctions of rose hips, black currants, and juices are used.

Immediately after admission to the hospital, sputum and swabs are collected for bacteriological examination, then etiotropic treatment is prescribed, which is carried out under control clinical effectiveness, subsequently - taking into account the obtained results of sputum sensitivity to antibiotics. In case of community-acquired pneumonia, new generation macrolides are prescribed. In case of nosocomial pneumonia, second and third generation cephalosporins and reserve group antibiotics are prescribed.

For pneumonia in children resulting from intrauterine infection, a new generation of macrolides is prescribed - spiromycin, roxithromycin, azithromycin. In case of pneumonia in children with immunodeficiencies, third and fourth generation cephalosporins are prescribed. In case of mixed infection, interaction between the influenza pathogen and staphylococcus, along with the administration of antibiotics wide range action, 3-6 ml of anti-influenza γ-globulin is administered.

Antibiotics are used comprehensively according to the following scheme:

• cephalosporins;
• cephalosporins plus aminoglycosides.

Mucolytic therapy, bronchodilators, physiotherapy, and immunocorrective treatment are prescribed. If secretions accumulate in the respiratory tract, it is necessary to remove the contents of the nasopharynx, larynx, large bronchi. For severe symptoms of respiratory failure, oxygen therapy is used.

For signs of heart failure, cardiac glycosides are prescribed - strophanthin, as well as sulfacamphocaine. Immunotherapy is also used. When treating pneumonia, symptomatic and syndromic therapy is carried out. During the recovery period great importance have breathing exercises, physiotherapeutic methods of treatment. For improvement drainage function bronchi, means are used to increase sputum secretion or dilute it.

Expectorants:

• Sodium benzoate
• Ammonium chloride
• Potassium iodide
• Bromhexine
• Terpinhydrate
• Thermopsis
• N-acetylcystine
• Mukaltin
• Pertusin
• Marshmallow root
• Licorice root
• Breast elixir
• Anise fruit
• Coltsfoot leaves

Drugs that reduce bronchospasm are used. These include aminophylline.

Forecast

The prognosis with timely use of antibacterial therapy is favorable. Those discharged from the hospital during the period of clinical recovery are registered at the dispensary. After discharge from the hospital, the child should not attend childcare facilities for 2-4 weeks. Children under six months are examined once a week for the first month, then twice a month; from six to twelve months - once every ten days during the first month, then once a month. After one year to three years - once in the first month, then - once every three months.

Children are examined by an otolaryngologist and pulmonologist after the age of three - a month after discharge from the hospital, then once a quarter. Rehabilitation in hospital departments or sanatoriums is optimal. The regime is prescribed with maximum use of fresh air. Breathing exercises and exercise therapy with a gradual increase are prescribed daily. physical activity. Nutrition should be rational for the appropriate age. Drug rehabilitation is carried out according to individual indications. Stimulating therapy is carried out in repeated 2-3-week courses: sodium nucleate, methyluracil, dibazole, ginseng, aloe, infusion of eleutherococcus, vitamins B. Herbal medicine is also used for these purposes. It is used to sanitize the bronchi and have a calming effect on the central nervous system: marshmallow root, peppermint leaf, sage herb, elecampane root, coltsfoot, linden blossom, pine buds, thyme, etc. Use with great caution in children prone to allergic reactions. Physiotherapy is widely used. Mustard plasters, alkaline and phytoinhalations, compresses, and ozokerite applications on the chest are used. Chest massage is widely used. After pneumonia, sanatorium treatment is recommended in local sanatoriums, as well as in the resorts of Gagra, Nalchik, Gelendzhik, New Athos, and the southern coast of Crimea.

Contraindications to sanatorium treatment are:

• activity of the inflammatory process in the bronchopulmonary system;
• signs of an asthmatic condition;
• the presence of a “pulmonary heart”.

Towards primary prevention relate healthy image life of parents, excluding the impact of harmful substances on the fetus during pregnancy, rational feeding of children, hardening procedures.

Secondary prevention includes:

• prevention and treatment of acute respiratory viral infection;
• early hospitalization of children with pneumonia with aggravated premorbid background;
• timely treatment of malnutrition, rickets, immunodeficiency states;
• sanitation of chronic foci of infection.

Modern medicine makes it possible to successfully treat pneumonia in children, but a prerequisite for a favorable outcome is timely diagnosis and the prescription of adequate treatment. Pneumonia in a child is dangerous, which can occur when signs of the disease are detected too late.

Causes of pneumonia in a child

How smaller child, the more vulnerable he is to various diseases. The reason is the imperfection of the growing organism, anatomical and physiological. Age characteristics factors that influence the development of pneumonia in children are:

• insufficient formation respiratory system, its functional instability;
• smaller airway lumen than in adults;
• immaturity of lung tissue;
• delicacy of the mucous membranes lining Airways;
• abundance blood vessels in mucous membranes;
• abdominal breathing, which impedes gas exchange in case of any, even minor, intestinal problem;
• general immaturity immune system body.

The risk of pneumonia increases in cases where the baby was born or underweight, with artificial feeding and lack of quality care. Children who grow up with smoking parents get sick more often.

Endogenous and exogenous pathogens

Pneumonia as a disease is characterized by polyetiology - a variety of pathogens that cause an inflammatory process in the lungs. Mycoplasma also ranks first in frequency; they are found in almost a third of sick children. Every fourth child with pneumonia is diagnosed with pneumococcus.

Pathogens also differ depending on age and environmental factors. In children who do not have contact with other children and do not attend preschool institutions, the inflammatory process is more often caused by pneumococcus. Kindergarten and primary schoolchildren are affected by mycoplasma. Chlamydia is the causative agent of the disease in adolescent schoolchildren.

Pneumonia in children is caused by both exogenous pathogens (located in the environment) and representatives of the internal nasopharyngeal bacterial microflora (endogenous pathogen). An endogenous factor can be aspiration of vomit and belching (pathogens are staphylococcus and E. coli). Various factors can activate your own bacteria:

• hypothermia;
• avitaminosis;
• diseases of the cardiovascular system;
• colds.

The primary (lobar) form develops after pathogens enter the respiratory tract, and secondary pneumonia in a child can be caused by acute respiratory diseases. Pneumonia can be the result of a descending infection, not only bacterial, but also viral. Some types of pneumonia have. Secondary pneumonia () is much more common.

Inflammation caused by so-called hospital-acquired strains in a child hospitalized due to another disease is especially difficult to treat. Nosocomial infections are resistant to drug treatment using.

The clinical picture of the development of pneumonia in children depends on several factors:

• pathogen;
• patient's age;
• tissues involved in the inflammatory process (unilateral or bilateral pneumonia, focal, lobar, etc.).

The classification divides pneumonia into unilateral and bilateral, etc. When the infection spreads to surrounding tissues, symptoms of the corresponding disease are observed (, etc.).

Symptoms of this disease may be similar to the clinical picture of others respiratory diseases, and therefore is definitely needed differential diagnosis. Any slightest sign of the disease must be treated carefully, because pneumonia in children develops very quickly, and in the absence of proper timely treatment, complications, even death, should be feared.

Hard breath

The very first sign of pneumonia is that the patient begins to breathe heavily and rapidly. This is caused by the fact that the inflamed lung tissue cannot take part in gas exchange and falls out of the respiratory process. This condition is called respiratory failure. To replenish the missing oxygen, the patient has to make more breathing movements, breathing is heavy and tense. At the same time, the child flares his nostrils, his nasolabial triangle turns pale, and then acquires a bluish tint.

Long-term colds

Parents should be alert to a persistent cold that lasts more than a week and is accompanied by a high fever. At the same time, antipyretic drugs bring temporary relief: the temperature quickly returns to its previous level. The highest temperature, up to 40 °C, is observed in children older than 6–7 years. This is the body's natural defense reaction to infection. Pneumonia in children is more younger age may be accompanied by a temperature not exceeding a low-grade fever due to a weak immune system. This is dangerous because pneumonia can masquerade as a common cold.

Cough

The symptom can be of varying intensity and nature, in some cases there is a dry cough for a long time, and in other sick children the cough is very strong, paroxysmal, and in acute pneumonia it is suffocating.

Pneumonia in infants is accompanied by difficulty breathing and coughing attacks, during which the nasolabial area becomes distinctly pale and takes on a grayish tint. Temperatures can rise to 38°C or higher. The baby breathes through the mouth, as the nasal passages are blocked due to swelling of the nasal mucosa.

It is common for children of all ages to have pneumonia when they are unable to breathe deeply. Attempts to take a deep breath end in a fit of suffocating coughing.

Atypical form

Most cases are mistaken for bronchitis and treated accordingly. Subsequently, inappropriate treatment can lead to chronicity of the disease and relapse of inflammation. Listening with a phonendoscope does not make it possible to diagnose the disease with high accuracy; more accurate diagnostic methods are needed.

Diagnostic measures

Self-determination of the disease, as well as self-treatment, does not lead to anything good. A sick baby should be shown to a doctor for a comprehensive examination.

Pneumonia in children can be diagnosed at the very beginning of the disease. To do this you need:

• fully examine the child to assess his condition;
• listen to the lungs;
• undergo an x-ray examination;
• take a blood test.

X-rays should be taken in two projections (anterior and lateral) in order to assess as accurately as possible how much inflammation the lungs have. A blood test will not only indicate the presence of a focus of inflammation, but will also help to accurately identify the pathogen. Without this, it is impossible to prescribe the necessary medication course of treatment.

Will complement as much as possible clinical picture information from parents. The younger the children, the more attentive mothers and fathers should be to their health, so that they can then answer the doctor’s questions instead of the child, when the first signs appeared, whether there was a cough initially, etc.

Treatment of pneumonia in children

Pneumonia in a child can be treated only in accordance with the doctor’s recommendations. Traditional anti-cold and restorative drugs serve only as an addition to the main therapy. It is forbidden:

• stop taking medications;
• at your discretion, replace some drugs with others;
• increase or decrease the dose of the drug.

The basis drug treatment constitute antibiotics. The susceptibility of a particular pathogen to a given antibiotic drug is determined based on an assessment of the condition of a small patient after three days of taking the prescribed medication.

The interval between taking tablets (injections) must be strictly observed: a double dose means a dose after 12 hours, a three-time dose means a dose after 8 hours. This is necessary to maintain the required concentration. active substance drug in the blood, otherwise the effectiveness of treatment will decrease.

You should not take antibiotic drugs longer than the prescribed course of treatment (a week for cephalosporins and penicillins, 5 days for macrolides), as dysbiosis may develop.

If appetite improves, we can say that the treatment is effective

Antipyretic medications are prescribed for use only at temperatures above 38 °C in children under one year of age and above 39 °C after one year. If a child, even with low-grade fever convulsions are observed, antipyretic is necessary. We can talk about the effectiveness of therapy if:

• appetite improved;
• breathing became easier, shortness of breath decreased;
• the temperature has dropped.

If this does not happen three days after the start of treatment, drug therapy needs to be adjusted.

Complementary therapy

Medicines are prescribed to thin the mucus and make it easier to cough up. Drinking plenty of fluids will ease the child’s condition: when the body is dehydrated, the mucus thickens, which makes coughing difficult. To maintain strength can be prescribed vitamin complexes. Care and nutrition are mandatory part treatment. The child needs to ensure cleanliness and humidity in the room. Meals should be light.

Indications for hospitalization if pneumonia develops in a child

Pneumonia in children under three years of age can only be treated in a hospital setting: at this age, children do not yet have strong immunity, the body’s defenses are weak, so qualified personnel must monitor the patients’ condition.

Children over three years of age are subject to hospitalization in cases where:

• there is no possibility of proper care and treatment at home;
• the child is in serious condition;
• pneumonia accompanies chronic diseases.

The doctor may insist on hospitalization even in the absence of these reasons.

Danger and possible complications of pneumonia

The main danger with pneumonia is the development. Other dangers and complications include:

• a sharp drop in pressure accompanied by heart failure;
• respiratory failure;
• disturbance of consciousness;
• convulsive state;
• sepsis;
• accumulation of fluid in the pleural cavity;
• infectious-toxic shock.

If you suspect the development of any of these conditions, you should seek medical help if pneumonia is treated at home.

Which doctor should I contact?

If you have a low temperature, you should contact your pediatrician

If you suspect pneumonia, you should not take your child to the clinic, since there is a high risk of catching something else. infection against the background of a weakened immune system. At initial symptoms you need to call a local pediatrician to your home, and in case of sudden onset high temperature and others acute symptoms- first aid.

Early diagnosis and rapid initiation of treatment, compliance with all doctor’s instructions will help cure a child of pneumonia and avoid complications and relapses. To improve health, preventive measures are mandatory.

According to statistics, 1% of minor children suffer from pneumonia at least once in their lives. This can be explained by a decrease in immunity due to intensive growth of the body. The provoking factors of the disease are infections, poor nutrition, and poor hygiene. Clinical signs pneumonia appears within 3 days after the onset of general malaise.

In adolescents, pneumonia becomes a consequence of age-related changes in the endocrine and immune systems. Children have a fragile body, and meeting with any new infection goes away with complications if left untreated. Pneumonia is dangerous at the age of 11-16 years, when the child is growing rapidly. Lack of vitamins and microelements important for growth undermines defenses.

Bacteria constantly surround humans. They are in the air, rising along with the dust. Within normal limits, streptococci are not capable of harming a teenager, but even their small concentration in the larynx is enough for the development of diseases of the respiratory system during the period common cold, flu, injury. Intensive development of pneumonia begins after the appearance of sore throat, bronchitis, and sinusitis.

The causative agents of pneumonia in adolescents are pneumococci and streptococci. Less commonly, the respiratory tract is affected by Haemophilus influenzae, Mycoplasma or Klebsiella. The bacterial environment always manifests itself in different ways. But before the formation of inflammation, the patient always feels a deterioration in health. This symptom is a sign of the onset of pathogenic microorganism activity.

Based on the type of infection acquired, a distinction is made between hospital-acquired and community-acquired pneumonia. In adolescents, the first type of pneumonia occurs as a result of acute respiratory infections. The second case occurs in a clinical setting after contact with a sick person or artificial ventilation. Based on the scale of inflammation in the respiratory organ, focal, lobar, and segmental pneumonia are distinguished.

Consequences of untreated inflammation

Pneumonia is dangerous because complications arise after it varying degrees severity:

• Pleurisy.
• Broncho-obstructive syndrome.
• Pneumothorax.
• Infectious-toxic shock can result in damage to the brain and parts of the heart. Sepsis requires urgent measures to thin the blood and destroy the bacterial environment.
• Lung abscess.
• Swelling of tissues that makes it difficult for a person to breathe.
• Tuberculosis, lung cancer.
• Acute lung destruction.
• Acute failure of the heart and blood vessels.
• Death.
• Postpneumonic pneumosclerosis.
• The occurrence of mediastinitis.

The listed complications require urgent resuscitation of the patient. The result of a serious condition may be the formation of fibrous tissue in the lung, which will have to be removed surgically.

How does inflammation manifest?

Pneumonia does not occur suddenly; people often do not pay attention to the first signs of pneumonia. The painful process begins with a rise in body temperature to values ​​above 38 degrees. The teenager’s activity decreases, lethargy and lack of desire to do physical work are observed.

The child may feel discomfort when breathing, which manifests itself in conditions ranging from small tingling sensations with a long breath to acute pain in the sternum. This symptom is accompanied by a cough, first dry and infrequent, then prolonged with sputum. The discharged liquid becomes yellow-green in color, this shade is due to pus.

Gradually, the teenager’s breathing becomes shallow and therefore rapid. Due to pain in the sternum, the patient has no desire to breathe full breasts. Sweating increases, heart rate increases. In acute stages, headaches often occur and digestion is disturbed. At the moment when the bacterial environment enters the blood, conditions close to critical are formed.

Severe cough and lack of air lead to clouded consciousness, primarily the heart suffers. With prolonged infection, meningitis can form in the body. Brain damage is one of the severe consequences of pneumonia.

How to determine the type of inflammation?

Interviewing the patient and parents helps narrow down the search for the cause of the disease. If there are similar cases in a school group, then the extent of the spread of pneumonia is assessed. It can be transmitted by airborne droplets. Provoking factors in adolescents are taken into account:

• Smoking, nutrition, physical condition.
• State environment. Place of residence.
• Diseases of the respiratory system: bronchitis, sinusitis, rhinitis, tonsillitis. Dental problems.
• Decreased immunity for another reason: illness internal organs, poisoning, injury, surgery.
• It is taken into account whether artificial ventilation was performed on the eve of the illness.
• Stressful conditions, taking potent drugs.
• Visiting public places: camps, sporting events, trips to swampy areas with high humidity.

To assess the condition of a teenager, the following methods are used:

1. Serological studies.
2. Images of the sternum: x-ray, ultrasound, MRI.
3. Microbiological research.
4. Differential diagnosis.

From the images you can clearly see large lesions of the lungs the size of a penny coin. The croupous type of pneumonia is difficult to see in the photograph. It passes with the formation of small infectious points. Which are very blurred, it is impossible to draw clear conclusions about the cause of the disease. Additional methods analysis of a person's condition are blood and urine indicators. Elevated white blood cells in the blood indicate the onset of inflammation in the body, but the exact cause can only be determined after identifying the type of pathogen in the sputum released with a cough.

To assess the condition of the lungs, the method of auscultation and bronchophony is used. Sounds characteristic of the disease are detected when the sternum is tapped. A shortening of the percussion tone indicates the onset of inflammation. Pathological phenomena are: wheezing, bursts during breathing are formed due to the accumulation of fluid in the respiratory organ.

However, atypical pneumonia requires a more careful analysis of the symptoms present. They are less pronounced and comparable to ordinary acute respiratory infections. There is a deterioration in health, an increase in temperature, and slight discomfort in the larynx and lungs. Often patients begin to self-medicate and trigger the ongoing inflammation.

Anti-inflammatory therapies

In adolescents, based on test results, treatment is carried out using antibiotics: amoxycyclines, cephalosporins, doxycyclines, macrolides. They continue to take the drugs even after the clinical symptoms disappear. Often the duration of therapy lasts more than 10 days, depending on the severity of complications.

Positive treatment results are accompanied by the following conditions:

• Significant decrease in body temperature.
• Normalization of digestion.
• Signs of intoxication disappear.
• Breathing is normalized. The patient does not feel pain or discomfort in the sternum.
• There are no febrile manifestations.
• Cough and phlegm disappear.
• Blood and urine test results are normal.

Treatment of pneumonia is carried out in a hospital setting. At any moment, your health may deteriorate and you will need urgent help to reduce intoxication in the body. Therapy can be carried out at home as prescribed by a doctor only in mild cases of inflammation.

Type medicine selected based on the results of an analysis of the bacterial environment for sensitivity to active substance. This approach allows you to choose the most effective drug from those available for sale. Let's look at the main types of medications prescribed for pneumonia:

• Benzylpenicillin is effective against staphylococcal pneumonia, pneumococci or Haemophilus influenzae.
• For mycoplasma and legionella, choose doxycycline or erythromycin.
• When the source of inflammation is pneumococcus with gram-negative flora, treatment is started with second or third generation cephalosporins.
• When it is necessary to replace penicillin-based drugs, nitorfuran or macrolide agents are chosen.

In some cases, it is advisable to choose a method of drug administration. This becomes important in moments of critical conditions. This way, a dropper can remove intoxication within 10 minutes, make the patient feel better, and also restore the water balance in the body. Infections are diagnosed in case of complications in digestive system. The negative effect of the drug on the stomach and intestines is excluded.

The dose of drugs is selected individually and is often overestimated. This is done to avoid developing antibiotic-resistant bacteria. Additional help Oxygen therapy is used; when tissues are saturated with its molecules, internal metabolic processes are normalized. This measure significantly reduces the duration of treatment.

Pneumonia is a disease that occurs quite often among children. According to statistics, it accounts for about 80% of all pathologies of the respiratory system. Discovered on early stage signs of pneumonia in a child allow you to start treatment on time and speed up recovery.

Causes of the disease

The causative agents are pathogenic viruses, bacteria, and various fungi. Depending on the nature of the disease, a treatment regimen is selected.

Provoking factors for the development of pneumonia are:

• Weakening of the immune system.
• Lack of vitamins.
• Past respiratory disease.
• Penetration of a foreign object into the respiratory tract.
• Stress.

Staphylococcal and streptococcal pneumonia can be associated with other diseases and occur after influenza, measles, and whooping cough. Due to underdeveloped respiratory muscles little patient it is not possible to clear the phlegm that accumulates in the bronchi. As a result, ventilation of the lungs is disrupted, pathogenic microorganisms settle in them, which causes an inflammatory process.

Pathogenic bacteria also cause other diseases. Streptococcus pneumoniae in the throat often causes acute tonsillitis.

First signs

Symptoms of pneumonia in children manifest themselves in certain ways. It depends on various factors. For example, aspiration pneumonia in children develops gradually; at the initial stage, its signs may not be noticed. After some time, cough, chest pain and other symptoms appear, depending on the location of the aspiration. This form of the disease is distinguished by the absence of chills and fever. With atypical pneumonia in children, the symptoms are more pronounced - there is a lump in the throat, watery eyes, headaches, and a dry cough.

By the end of the first week of the disease, the cough intensifies, and the temperature during pneumonia in children can rise to 40⁰C. Possible addition of rhinitis, tracheitis. Many parents are interested in what temperature is considered normal for pneumonia. It depends on the state of the child's immune system. Some types of pneumonia occur without fever at all.

On initial stage Pneumonia symptoms in children can manifest themselves in different ways.

Signs of pneumonia in a child under one year old:

• Cyanosis skin, especially in the area of ​​the nasolabial triangle.
• A sharp increase in temperature.
• Difficulty breathing due to accumulation of mucus in the lungs.
• Cough.
• Lethargy.

How pneumonia manifests itself in infants helps determine the number of respiratory movements in 1 minute. For a 2 month old child it is equal to 50 breaths. As you grow, this figure decreases. So, for a child of 3 months it is already 40, and by the year it decreases to 30 breaths. If this indicator is exceeded, you should contact your pediatrician.

Cyanosis of the skin

For pneumonia in children, symptoms and treatment differ depending on at different ages. For children of the older age group, sputum appears when pathological process reaches the bronchi. Pneumonia is suspected when wheezing and bluish lips are observed. The main symptom – shortness of breath – helps to recognize inflammation. If it does not disappear after a course of treatment, then additional examination is required.

As Dr. Evgeniy Komarovsky assures, the first symptoms do not cause as much harm as subsequent ones. Therefore, it is important to be able to distinguish the signs of the disease at the initial stage.

Symptoms characteristic of pneumonia

Each type of disease manifests itself differently depending on the location of the inflammatory focus.

Left-sided pneumonia

With this form of the disease, the pathological process develops on the left side. Left-sided pneumonia is much more dangerous compared to other types due to the irreversibility of the consequences that may occur. The lung becomes inflamed due to previous respiratory diseases, when a weakened immune system cannot resist the effects of pathogens. Left-sided pneumonia has mild symptoms, which makes diagnosis difficult.

Among the most characteristic:

• Pain in the left chest.
• Nausea.
• Cough with sputum production, which may contain purulent patches.
• A sharp rise in temperature, accompanied by chills.
• Feeling severe pain during inhalation.

It happens that left-sided pneumonia occurs without fever or other obvious signs. Delayed treatment in this case can cause serious complications and increases the risk of death.

Right-sided pneumonia

A form of the disease, which is characterized by the presence of a lesion in one of the lobes of the lung - upper, middle or lower. It is much more common than left-sided pneumonia. Each of the five cases are children under 3 years of age. The disease is most severe in newborns and children under 2 years of age.

It is distinguished by:

• Cough, in which there is copious sputum production.
• Tachycardia.
• Cyanosis of the skin, especially in the area of ​​the nasolabial triangle.
• Leukocytosis.

Often the right-sided form occurs with mild symptoms.

Bilateral pneumonia

A disease where both lungs become inflamed. It is very difficult, especially in children under one year old. Therefore, bilateral pneumonia in a child is treated only in a hospital setting.

In newborns and children of the 1st year of life characteristic feature is pale skin, shortness of breath, cough, asthenic syndrome, bloating, hypotension. Wheezing can be heard in the lungs. The disease is progressing rapidly and the little man needs urgent hospitalization.

In children 2 years of age, symptoms of inflammation often appear as a result allergic reaction. In children 3–5 years old, the disease often develops after an acute respiratory infection. When treating, you need to pay attention to elevated temperature that lasts longer than three days.

At the age of over 6 years, pneumonia occurs with alternating sluggish course and exacerbation.

Regardless of age, the following signs help to recognize bilateral pneumonia in a child: fever up to 40⁰C, rapid breathing, decreased appetite, shortness of breath, cyanosis, cough, drowsiness, weakness. Percussion sound when listening is shortened on the affected side, wheezing is heard in the lower parts of the lungs.

Bilateral pneumonia in a child threatens complications such as otitis media, sepsis, and meningitis.

For any viral pneumonia in children, the symptoms and treatment are not much different from the manifestations of the disease and treatment for adults.

Bronchopneumonia

The disease most often occurs in children under 3 years of age. It is an inflammatory process affecting the walls of the bronchioles. The disease has another name - sluggish pneumonia due to the vagueness of symptoms.

They look like slight shortness of breath, cough, arrhythmia, sometimes appearing without fever. Later they intensify, there is a rise in temperature to 39⁰C, and headaches.

Bacterial pneumonia

The pathogens that cause bacterial pneumonia are pneumococci, staphylococci, streptococci, and gram-negative bacteria. The first signs of pneumonia in children are noticed earlier than in adults. They manifest themselves in the form of rapid breathing, vomiting, and pain in the abdominal area. Children with a temperature in the lower part of the lungs sometimes feel feverish.

Mycoplasma and chlamydial pneumonia

Mycoplasma infection, in addition to the main symptoms, causes a rash in the throat and pain. Chlamydia pneumonia in children infancy may provoke the development of a dangerous form of conjunctivitis. With pneumonia caused by this intracellular bacterium, rhinitis and tracheobronchitis are often diagnosed. Chlamydia pneumonia in children also manifests itself as extrapulmonary symptoms - arthralgia, myalgia. It is believed that this disease accounts for up to 15% of all community-acquired diseases. During epidemic outbreaks, this figure increases to 25%.

The disease can develop either acutely or gradually, becoming protracted. The main symptoms are nasal congestion, difficulty breathing, hoarse voice, and slight mucous discharge from the nose. After these signs appear, the inflammatory process lasts from 1 to 4 weeks. Cough and general malaise sometimes persist for several months. The disease can occur without fever.

Video

Video - pneumonia

Hidden pneumonia

The course of the disease without pronounced symptoms poses the greatest danger to children under 2 years of age. At this age, they cannot yet communicate what exactly is bothering them. Latent pneumonia in children can manifest itself as a barely noticeable malaise. Having noticed them, parents often attribute it to a cold or teething. Only when the child’s condition deteriorates sharply does treatment begin.

Therefore, it is important to know how to recognize pneumonia in a child, and not to lose sight of such symptoms of pneumonia in children as:

• Pallor of the skin.
• Blush on the cheeks in the form of spots.
• Shortness of breath that appears with little exertion.
• Increased sweating.
• Breathing with grunting.
• Temperature rises to 38⁰C.
• Refusal to eat.

With latent pneumonia in children, the symptoms listed above can appear either singly or in combination, sometimes without fever. Having discovered them, you should immediately show the baby to the doctor.

Diagnostics

The question of how to determine pneumonia in a child is easily resolved today with the help of modern diagnostic methods. When collecting anamnesis, the time of detection of the first signs of illness is determined, what diseases preceded the onset of inflammation, and whether there is an allergy. A visual examination can reveal existing respiratory failure, wheezing, and other symptoms characteristic of pneumonia.

Laboratory methods help diagnose the disease.

A blood test for pneumonia in a child is carried out to determine the causative agent of the disease:

• Biochemical analysis determines indicators such as the number of leukocytes, ESR, and hemoglobin level.
• Thanks to two blood cultures, it is possible to exclude bacteremia and sepsis.
• Serological analysis reveals the presence of immunoglobulins.

Sputum culture and scraping are also performed back wall throats.

A more accurate diagnosis can be made by determining the extent of lung damage (as well as recognizing bronchitis in a child and any other bronchopulmonary disease) using radiography.

General principles of treatment

Treatment is usually carried out in a hospital setting. How long you stay in the hospital with pneumonia depends on the severity of the disease and the state of your immune system. The main component of the treatment course for the inflammatory process is antibiotics.

You can cope with the disease only by strictly following all the doctor’s prescriptions. Self-medication for such a serious illness is unacceptable. The medicine is taken according to the schedule determined by the doctor. Penicillins, cephalosporins, and macrolides are usually used in treatment. The effectiveness of the use of a particular drug is assessed only after 72 hours. To ensure that the intestinal microflora does not suffer from the action of antibiotics, probiotics are additionally prescribed. In order to cleanse the body of toxins remaining after antibacterial therapy, sorbents are used.

Plays an important role in the treatment process proper nutrition. The patient's diet should contain easily digestible food. These can be vegetable soups, liquid porridges, boiled potatoes, fresh vegetables and fruits. As a drink, it is best to give children rosehip infusion, juices, and raspberry tea.

Prevention

• Do not allow the child to become hypothermic.
• Provide quality nutrition that includes all the necessary vitamins.
• Perform hardening procedures.
• Walk more with your children in the fresh air.
• Avoid contact with a sick person who can transmit the infection.
• Do not visit during epidemic periods kindergarten and crowded places.
• Teach your child to wash their hands thoroughly, lathering them for at least 20 seconds.
• Treat infectious diseases in a timely manner.

Taking care of your baby’s health, starting from the first days of his life, is the best protection against disease.

Vaccination helps reduce the risk of infection. Vaccination forms immunity to the causative agent of pneumonia. However, the duration of such protection is no more than 5 years.

In Russia, pneumonia is diagnosed in 10 young children out of 1000. Signs of pneumonia in a child depend on the age and type of the disease. Infants and children under 4 years of age are most susceptible to this pathology. Pneumonia in young children can be diagnosed using fluoroscopy. After confirming the medical report, the doctor makes a decision on hospitalization of the patient and selects antibacterial therapy. The disease lasts on average 7-10 days.

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Types of childhood pneumonia

Depending on the location of the inflammation, pneumonia can be:

• share;
• segmental;
• right-sided;
• left-handed;
• bilateral.

Based on their form, they distinguish between community-acquired (home-acquired), hospital-acquired and congenital pneumonia. The least common is atypical childhood pneumonia caused by mycoplasma. Pneumonia, characteristic of patients with immunodeficiency conditions, is classified separately.

Most common the following types pneumonia:

• focal bronchopneumonia;
• lobar pneumonia (pneumococcal);
• segmental (polysegmental) bronchopneumonia;
• interstitial acute.

Moreover, each type of pneumonia can be divided into uncomplicated and complicated. This form sometimes entails more serious illnesses, such as effusion pleurisy, lung destruction, etc.

Depending on the duration of the disease, pneumonia can be:

• acute current (lasting up to 4 weeks);
• protracted (stated when the inflammatory process in the lungs continues for more than 4 weeks).

Any untreated pneumonia, especially in children under 3 years of age, becomes chronic. This form is characterized by irreversible changes in the bronchial tree and constant relapses.

Types of childhood pneumonia

Causes of pneumonia

Pneumonia is a complication of diseases such as bronchitis and bronchial asthma, laryngitis, pharyngitis, sore throat, ARVI.

In newborns, pneumonia is most often caused by streptococci and staphylococci. Sometimes pneumococci and Haemophilus influenzae can be the cause.

Congenital pneumonia manifests itself during the first 72 hours of a baby’s life. Infection with bacteria and chlamydia can occur during childbirth, then neonatal pneumonia manifests itself from the 6th to the 14th day of the child’s life.

Another reason for the occurrence of the disease is the presence of intrauterine infection against the background of fragile immunity. Herpes viruses and cytomegalovirus can also be causative agents of the disease. Sometimes contribute to the disease birth defects development.

In children older than one year, the causes of pneumonia are:

• chronic infections;
• complicated sinusitis, adenoiditis, problems of the cardiovascular and central nervous systems;
• improper treatment of acute respiratory infections and acute respiratory viral infections (in the case of the use of cough suppressants).

Frequent use of vasoconstrictor drugs, or their use when there is a strong discharge from the nose, can contribute to the descent of the virus into the bronchi.

Despite the general misconception, it is extremely rare that the cause of pneumonia is severe hypothermia in a child.

Symptoms of pneumonia

The clinical picture depends on the following factors:

• forms;
• pathogen;
• degree of severity;
• child's age.

The main symptom of pneumonia is shortness of breath. A deep paroxysmal cough may occur. Possible chest cavity. If the disease is severe, the child may have attacks of suffocation during or immediately after coughing. Children's breathing quickens, becomes shallow, and it becomes impossible to take a deep breath. Pneumonia can also be recognized by wheezing in the lungs.

Additional symptoms:

1. Increased body temperature, swelling of the legs.
2. The face, especially the lips, turns pale or takes on a gray/bluish tint. As a rule, this is characteristic of bacterial pneumonia, and is caused by spasms of blood vessels.
3. Appetite decreases or disappears completely. The child may lose significant weight.
4. Lethargy, irritability, and increased fatigue appear.

In the video, the famous doctor talks about the symptoms of pneumonia. Video taken from the Doctor Komarovsky channel.

Signs in children of the first year of life

Pneumonia in newborns and babies in the first year of life is manifested by general lethargy and excessive drowsiness. The child refuses to eat, cries a lot, and behaves restlessly. Symptoms increase gradually. As soon as the baby’s mother notices such symptoms, you need to contact your pediatrician, even at normal body temperature. The chances of survival in young patients, especially infants, depend on the timeliness of care medical care. Pneumonia in newborns, especially intrauterine pneumonia, often ends in death.

Depending on the age of the child, signs of pneumonia are:

1. U one month old baby There is respiratory failure, which occurs due to the underdevelopment of the immune system of babies.
2. In a two-month-old baby, the disease is characterized by multiple small focal lesions of the lungs.
3. When three-month-old babies get sick, two lungs are affected at once.
4. U one year old child Segmental pneumonia develops more often, which can cause the most complications.

A doctor must identify the presence of pneumonia; the diagnosis is confirmed by x-rays and a blood test. The number of leukocytes, an increase in which is a sign of the development of pneumonia in children, helps to understand the presence of the disease.

First signals

The first signs of the disease in babies:

• behavioral disturbances in the direction of increased moodiness;
• frequent or loose stools;
• The cough is paroxysmal, worsens when crying, is accompanied by vomiting, yellow or green clots may be coughed up.
• the baby begins to spit up frequently between feedings;
• sleep is disturbed - it becomes intermittent, restless.

Body temperature

This is what cyanosis of the nasolabial triangle looks like in a baby

Signs in preschool children

The first sign of pneumonia in children 3-5 years old is an increase in body temperature from the 3rd to the 5th day of acute respiratory viral infection.

Additional symptoms:

1. Intoxication of the body increases significantly, the child becomes irritable.
2. There are problems with sleep - the baby tosses and turns, wakes up, behaves restlessly, with lethargy and decreased appetite.
3. Another sign of the development of pneumonia is a body temperature that is difficult to reduce. The drugs that helped before stop working.
4. There is chest pain and increased sweating.
5. The cough appears from the 5th day of illness or is absent.
6. Sometimes they appear skin rashes and muscle pain.
7. Tachycardia may develop. Breathing becomes more frequent - more than 50 breaths per minute.

Signs in schoolchildren

In children 7-12 years old, symptoms are expressed as follows:

• breathing is heavy and harsh, increasing up to 60 times per minute;
• against the background of the development of pneumonia, fine wheezing appears in the lungs, muffled tones can be heard at the site of inflammation;
• body temperature rises to 39-40 degrees and lasts for 3 days, as a rule, without further increase;
• sputum does not come out well, the child suffers from a dry cough;
• pallor or blueness of the lips is noted.

Segmental pneumonia

Segmental pneumonia affects entire segments of the lungs, causing them to become deformed. It can develop at any age; children aged 3-7 years are most susceptible to the disease. It is characterized by severe intoxication of the body with an increase in body temperature above 38.5 degrees. During the course of the disease, respiratory failure develops. Segmental pneumonia is treated for a long time, usually in an inpatient setting. Cough is rare. Recovery of lung cells lasts for 2-3 months. Bronchiectasis may form - enlargement of individual areas.

This is what the lungs of a child with segmental pneumonia look like on an x-ray

Indications for hospitalization

Newborns and children under 3 years of age must be hospitalized. Children over 3 years of age are admitted to the hospital if the disease is severe or complicated by other chronic diseases. The decision to keep the child in the hospital or at home is made by the attending physician after assessing the condition of the sick baby and the results of the analysis.

Indications for hospitalization in children of primary and senior school age are lesions of several lobes of the lung, abscess or sepsis. If the pressure drops, the child faints or feels excessively weak, it is advisable to hospitalize him for constant monitoring. Any disturbance of consciousness is a reason for emergency hospitalization. At any age, children with obstructive syndrome or pleurisy are admitted to the hospital.

Treatment of the disease

The principles of treating pneumonia depend on the causative agent of the disease. Viral pneumonia resolve on their own within 7 days and do not require additional treatment. Bacterial infections can only be cured with antibiotics. It is very important to provide enough fluids, even if the child refuses to drink on his own.

Standards of treatment for childhood pneumonia include the use of the following medications:

1. Cough. Drugs are used to thin sputum and facilitate its removal. It can be used in the form of tablets or syrups; the composition can be chemical or natural. Well-proven ones are Ambroxol (from birth), Bromhexine (from 3 years).
2. Temperature. Antipyretic medications are used if the body temperature is above 38.5 degrees. The most popular are Paracetamol (from birth) and Nurofen (from birth).
3. Antibiotics. First of all, penicillin is prescribed, but the choice depends on the form of pneumonia. Popular ones are Amoxicillin (from birth), Erythromycin (from 4 months).
4. Probiotics - Linex (from birth), Bificol (from 6 months).

If pneumonia occurs against the background of an acute respiratory viral infection, it is important to treat a runny nose. For swelling of the mucous membrane, be sure to use vasoconstrictor drugs - Otrivin (from 6 years), Nazivin (from 1 year). Rinse saline solutions— Aqua Maris, Quick, Spritz, all of them can be used from birth.

For bronchial obstruction, treatment with Berodual or Eufillin is prescribed. The drugs can be used from birth under the supervision of a doctor.

The types of medications for pneumonia, dosage and method of administration are shown in the table: