Bronchial pneumonia. Causes and treatment of bronchial pneumonia in children

The causative agent of bronchopneumonia is less often a specific influenza virus, more often a mixed infection, pneumococcus (not the first groups, i.e. a common inhabitant of the mouth), hemolytic streptococcus (severe pneumonia with suppuration), Staphylococcus aureus, influenza bacillus. The latter, when administered to monkeys, causes tracheobronchitis, hemorrhagic pulmonary edema, bronchiolitis, bronchopneumonia, and in human - inflammation respiratory tract and lungs of varying strength - from catarrhal to necrotizing bronchitis. Up to 5-10% of all cases of pandemic influenza are complicated by pneumonia, probably as a result of a decrease in the body's immune strength.

Anatomically the lungs on the section are mottled - from red-gray protruding areas of compaction;, along with normal, air-containing tissue, bluish areas of collapsed alveoli with blockage of the adductor bronchus and emphysematous parts. The foci of compaction are polygonal, with a dark red center, hyperemic, with a grayish-whitish point in the center, from which a drop of yellow mucopurulent exudate (bronchiolitis) is squeezed out; lesions are isolated or located in groups, sometimes in the form of false lobe “confluent bronchopneumonia.”

Severe inflammation of the interstitial peribronchial and interlobular connective tissue is also detected. The walls of the bronchi are swollen, congested with blood, with mucopurulent exudate, exposed in places (devoid of epithelium), with improper expansion of the bronchi. Anatomically, in severe cases, hemorrhagic ulcerative tracheobronchitis and “variegated pneumonia” occur.

Causes of bronchopneumonia

Pathogenesis influenza bronchopneumonia has not been sufficiently studied in its main links, especially with regard to the undoubted and significant participation of the nervous system. The origin of such leading symptoms of the disease as shortness of breath, cyanosis, cardiovascular collapse, pulmonary edema is closely related to dysregulation of a largely reflex nature, since foci of inflammation are the source of pathological impulses. Certain secondary mechanisms of disease development have been more studied—toxic effects on the central nervous system And vascular wall, disruption of the bronchopulmonary barrier with the transition of the influenza virus and secondary infection to the interstitial peribronchial and interlobular connective tissue. Bacteremia is rare, even in fatal cases. Toxic damage vessels is accompanied by protein sweating, inflammatory pulmonary edema; the secretion of bronchial mucus increases, which reduces the concentration of the toxin; spasm of the bronchi and bronchioles occurs as a result of irritation, which, along with the secretion of mucus, contributes to the development of atelectasis.

Clinically Influenza bronchopneumonia is characterized by the absence of changes in certain periods of the disease and occurs non-cyclically.

Onset against the background of influenza-like lesions of the upper respiratory tract (or seasonal catarrh) with a further rise in fever, the appearance of shortness of breath, cough, and deterioration in general health. Fever is lax or irregular. Often nose bleed; Herpetic rash is rare. The number of respirations is increased to 25-30 per minute, when inhaling, the wings of the nose expand; pulse often lags behind temperature.

When researching chest they find foci of muffling, often bilateral, in the lower fields of the lungs with increased bronchophony and ringing subcrepitating and fine rales, in addition to the phenomena of diffuse bronchitis (common dry rales). Clear bronchial breathing is usually not detected; broncho-vesicular breathing occurs. The lesions may be deeply located and, despite serious condition patient are not detected clinically.

The sputum is uncharacteristic, scanty, mucopurulent, as in bronchitis, or more viscous and bloody. General phenomena range from weakness, weakness to severe headaches, vascular collapse. Cyanosis is observed with extensive confluent bronchopneumonia. From the blood side - leukopenia, acceleration of ROE varying degrees. X-ray examination reveals various changes, most often large-focal, cloud-like infiltrates, hilar, false-lobar, as well as small-spotted rashes that differ little! from the picture of hematogenous tuberculous dissemination.

Course, forms and complications of bronchopneumonia

Based on the flow, one can distinguish between the normal and toxic forms.

The usual form of bronchopneumonia develops from the very beginning or on the 2-4th day of influenza infection, or only on the 4-10th day, already during the period of apparent recovery. Subjective symptoms differ from ordinary bronchitis only in greater shortness of breath and a more persistent increase in temperature.

The course varies - either the fever lasts 4-5 days (especially with seasonal flu) with a lytic (more often) decline, or bronchopneumonia drags on for 2-4 weeks or longer with a possible outcome in suppuration and various other pulmonary and extrapulmonary complications.

The toxic fulminant form (usually only with pandemic influenza) begins acutely, in the midst of full health, with signs of severe general illness: severe shortness of breath - up to 60 breaths per minute, rapidly developing (hemorrhagic) pulmonary edema, cyanosis due pulmonary insufficiency and vascular collapse, erythrocytosis from blood thickening. Death occurs suddenly with rapidly progressing prostration and stupor after 1-2 days (the so-called “Spanish flu”, as the severe pandemic flu was called during the First World War).

Influenza bronchopneumonia may also have other course features: it may occur in the form of false lobar (confluent) pneumonia or with toxic effects - vomiting, diarrhea, delirium (especially in children).

A prolonged course is possible as a result of necrosis of lung tissue, suppuration, and pneumosclerosis.

When turning into suppuration, the sputum becomes profuse, yellowish-purulent.

Complications: atelectasis, outcome in suppuration, bronchiectasis, pneumosclerosis, pleural empyema (usually caused by hemolytic streptococcus); various extrapulmonary localizations of secondary infections - otitis, mastoiditis, sinusitis, rarely carditis, nephritis, hemorrhagic encephalitis.

The mortality rate reaches 15% (in severe epidemics it reaches 50%). Pregnant women experience pneumonia more severely. Following an influenza epidemic, pulmonary suppuration (gangrene, abscess) becomes more frequent.

Diagnosis and differential diagnosis of bronchopneumonia

Recognition of influenza bronchopneumonia is helped by: Clinical signs, and x-ray examination (it has been established that it is not so rare that a pneumonic focus is found in a patient with very unclear complaints and symptoms), as well as laboratory data. Friedlander's confluent bronchopneumonia occurs with bloody, sometimes clearly mucoid sputum and often leads to lung abscesses. Streptococcal bronchopneumonia occurs after tonsillitis or as a complication of influenza, without a violent onset, and is often accompanied by pleural empyema.

It is necessary to differentiate influenza bronchopneumonia primarily from tuberculosis, which is not always easy; with influenza bronchopneumonia there may also be little auscultatory data, mild leukocytosis.

The flu is indicated by significant intoxication, headaches, pain in the eyes, severe weakness and inability to work, severe cough, and sometimes herpes; damage predominantly to the lower lobes; tuberculous lobular pneumonia almost does not resolve, is complicated by decay, or scar cords and calcified lesions remain. You should also keep in mind the focal pneumonias listed below.

Prevention and treatment of bronchopneumonia

Prevention of influenza pneumonia is carried out according to the instructions set out in the section on bronchitis. The fight against influenza focal pneumonia is carried out simultaneously with the general anti-influenza fight, headed by a special committee for the fight against influenza.

When treating influenza pneumonia, the regimen follows the same rules as for lobar pneumonia what else has higher value, since there are no specific drugs against the influenza virus known. Sulfonamides and penicillin, however, are widely prescribed, usually from the first days of bronchopneumonia and even with severe bronchitis in a dose approximately 1/3 less than for lobar pneumonia, in order to prevent or suppress secondary infection. For pneumonia caused by hemolytic streptococcus, large doses penicillin, for pneumonia caused by influenza bacillus, streptomycin 2.0 in the first days.

In severe cases it is also widely used oxygen therapy, cardiovascular and nervous system tonics - caffeine, strychnine, lobelia, adrenaline, cortin, for severe collapse - glucose, ascorbic acid, calcium; Digitalis is indicated less frequently in cases of heart failure. To influence the nervous system, water and other skin irritating procedures are used. Good nutrition and clean air are especially important in protracted cases. In case of thick sputum, expectorants are advisable to prevent atelectasis.

Previously, salicylates, methenamine, and quinine were widely used, which hardly shortened the course of the disease; also not very reliable intravenous infusions alcohol and novarsenol to prevent complications.

Bronchial pneumonia is a type of pneumonia. Harmful bacteria and viruses, along with the inhaled air, penetrate into the lungs and infect the most small branches bronchial tree.

What causes bronchopneumonia

Bronchial pneumonia can be caused by many viruses and bacteria. In most cases, inflammation is a consequence of an upper respiratory tract infection. For example, bronchitis or ARVI can lead to the development of the disease. The most common pathogens are bacteria such as streptococcus, pneumococcus, and many viruses.

Pneumonia can also result from food entering the Airways, compression of the lungs by a tumor, inhalation of toxic gases, postoperative complications.

Who is at risk of getting sick

Absolutely anyone can get pneumonia. But there are groups of people who are especially vulnerable to this disease.

High-risk groups include:

Newborns and children under 3 years of age;
Children with congenital diseases respiratory system;
Children with congenital or hereditary defects immune system(immunodeficiencies);
Elderly over 65 years of age;
People who already have lung diseases (such as asthma and bronchitis);
HIV-infected;
Suffering from heart disease and diabetes;
Smokers.

The main signs of the disease are:

Fever. Increase in body temperature to 37.5 - 39 degrees within 1-3 days. Accompanied by severe weakness, loss of appetite or complete refusal of food, sweating and chills, insomnia, pain in the calf muscles. Fever is a manifestation of the body's fight against inflammation. Therefore, at temperatures up to 37.5-38C, it is not recommended to take antipyretic drugs.
Cough. At the beginning of the disease it is dry, frequent, irritating. As pneumonia progresses, sputum appears. The sputum has a characteristic greenish-yellow color, sometimes streaked with blood.
Dyspnea. In adults with severe course illness, there is a feeling of lack of air, frequent shallow breathing. Sometimes shortness of breath persists even at rest.
Chest pain. Worried when coughing or deep breath. With pneumonia, pain appears on the side of the affected lung, often stabbing or pulling, and goes away after coughing.

Features of symptoms in children

Due to the fact that children's airways are short and do not yet have protective immune barriers, inflammation is sometimes lightning fast. Bronchopneumonia is especially dangerous in newborns and infants.

Symptoms such as heat body and cough, in children may be mild or absent. Sometimes pneumonia can develop at normal or reduced body temperature. Loud wheezing and shortness of breath come to the fore.

To suspect pneumonia in children, parents should pay attention to prolonged bronchitis or ARVI, the child’s lethargy and lack of appetite, increased breathing, and shortness of breath.

What diagnostic examination should be performed?

If the above symptoms appear, you should consult a doctor. At your appointment, the doctor will conduct an initial examination, which includes:

Measuring body temperature.
Tapping (percussion) of the lungs. Using his fingers, the doctor taps on the surface of the lungs (above the collarbones, between the shoulder blades, in lower sections chest). In the presence of pneumonia, a shortening of the sound over the affected area is characteristic.

IN currently this method is considered uninformative and is almost never used in the diagnosis of pneumonia.

Listening (auscultation) of the lungs. It is carried out using a stethoscope or phonendoscope. The essence of the method is to listen to wheezing, weakened breathing, and pleural friction noise in the affected area. The appearance of these sound phenomena depends on the period of the disease (beginning, peak, recovery) and cannot always be heard.

Based on complaints, characteristic symptoms and examinations can establish a diagnosis of pneumonia.

To document the disease, a chest X-ray and a series of laboratory tests must be performed. IN special cases will be needed CT scan, sputum analysis, pathogen identification tests, bronchoscopy.

Chest X-ray is the gold standard for diagnosing pneumonia. This research method must be performed twice - when making a diagnosis and after treatment. This method makes it possible to evaluate the effectiveness of the treatment and determine the future prognosis.

Treatment includes measures on regimen, nutrition, as well as prescription medical supplies and physiotherapy.

Mode.

At the onset of the disease it is recommended bed rest. Be sure to ventilate and clean the room. When body temperature normalizes, walks are allowed. fresh air. Resumption of hardening from 2-3 weeks after the end of pneumonia. Resumption physical activity from the 6th week of recovery.

Diet.

There are no food restrictions. Nutrition should be balanced, with high content proteins and vitamins. Small and frequent meals are recommended. It is mandatory to use large quantity liquids in the form of warm fruit drinks, herbal teas, warm mineral water.

Physiotherapeutic treatment.

It should be started after body temperature has normalized. Chest massages and inhalations with drugs that facilitate breathing and sputum discharge are useful.

Types of drugs used

The use of antibiotics is the main treatment for pneumonia. The choice of antibiotic is made individually for each patient. The type of pathogen, risk factors, and severity of the disease are taken into account.

Treatment involves prescribing antibiotics in the form of tablets or injections (intravenous or intramuscular).

Also in the treatment of bronchopneumonia, antipyretics, expectorants, antiallergic drugs, and vitamins are used. In some cases, oxygen is prescribed.

Therapy in childhood

Treatment of children is carried out only in a hospital. If necessary, the child can be placed in a ward intensive care.
When prescribing drugs, the dose is calculated based on the patient's weight. If pneumonia is caused by viruses, then in severe cases antiviral drugs may be prescribed.

Children are more at risk of dehydration. The threat is especially high against the background elevated temperature body, so much attention is paid to maintaining water balance. Sometimes the missing fluid is administered using droppers. To prevent shortness of breath, oxygen inhalations are used.

Currently, due to effective treatment bronchitis and ARVI early stages, the number of children with severe forms of pneumonia is quite rare.

Consequences of inflammation and prevention

For most people, pneumonia goes away without leaving a trace. Residual manifestations of the disease (weakness, shortness of breath when walking quickly) disappear within 1 month.

To prevent relapse, you must follow simple rules:

Wash your hands regularly;
Avoid smoking;
Avoid contact with sick people;
Stick to a healthy diet;
Exercise;
Get enough sleep, rest regularly.

Bronchopneumonia is an acute infectious and inflammatory disease affecting the walls of bronchioles in limited areas of lung tissue. Bronchial pneumonia is also called bronchogenic pneumonia, or bronchial pneumonia.

The inflammatory process in bronchopulmonary pneumonia manifests itself in the terminal bronchi and involves single or multiple foci in one lobe or group of lobes of the lung. For this reason, the pathology is also called lobular pneumonia (not to be confused with lobar pneumonia, in which inflammation affects the entire lobe of the lung).

Most often, bronchopulmonary pneumonia in an adult patient has secondary character, that is, it develops as a complication of previous acute respiratory diseases bacterial and viral nature, which occurred with symptoms of bronchitis or tracheobronchitis. The number of cases of bronchopneumonia increases sharply during influenza outbreaks. This is explained by the fact that the influenza virus is capable of increasing the susceptibility of tissues of the respiratory system to opportunistic and pathogenic microorganism. The list of pathology provocateurs can also include parainfluenza viruses, rhinoviruses, respiratory syncytial viruses, and adenoviruses.

Bronchopneumonia in adults can be a consequence of other primary pathologies, the list of which can include:

measles;
scarlet fever;
whooping cough;
purulent otitis;
typhoid fever;
meningococcal meningitis;
peritonitis;
dysentery;
liver abscess;
furunculosis;
osteomyelitis.

Not all diseases that can provoke bronchopulmonary pneumonia as a complication are listed above.

The list of pathogens that can become causative agents of focal bronchopneumonia includes the following microorganisms:

pneumococci;
Friedlander's wand;
staphylococcus;
streptococcus;
meningococcus;
coli;
rickettsia;
chlamydia;
mycoplasma.

Note! If the causative agent of the pathology is staphylococcus, then complications such as lung abscessation and pleural empyema are possible.

If the nature of the disease is primary, then the route of infection is bronchogenic. In case of secondary pathological process lymphogenous and hematogenous pathways are added to it.

Factors that may contribute to the progression of the disease are:

Reduced functionality of the immune system.
Hypothermia of the body.
Stressful conditions.
Inhalation of toxic substances.
Deterioration of the ventilation function of the lungs in the case of emphysema, pneumosclerosis.
Smoking abuse.
Poor environmental conditions.

Sizes of lesions inflammatory process predetermine the division of pathology into small-focal and large-focal. In addition, foci of the disease can be either single or multiple. In most cases, the bronchi, bronchioles and alveolar ducts are sequentially involved in the pathology, that is, the disease develops in the longitudinal direction. In more rare situations, the nature of the spread is peribronchial.

In pathogenesis bronchial pneumonia The following important aspects should be noted:

The inflammatory exudate during the development of bronchopneumonia is serous with an admixture of epithelium and leukocytes, and less often it is hemorrhagic.
The most common area of damage is the posteroinferior segments of the lungs, that is, left- or right-sided lower lobe bronchopneumonia develops more often. Less commonly, the disease affects the upper lobe segments.
Inflamed tissues are gray-red in color and have a compacted structure. The areas of the affected tissue alternate with light emphysematous and dark atelectatic ones, which is why the lung has a non-uniform structure.
In most cases, bronchopneumonia results in complete recovery, however, such outcomes as abscess, lung gangrene and chronic pneumonia cannot be excluded.

Clinical symptoms of bronchopneumonia

Bronchopneumonia often develops as a secondary pathology, and therefore its onset cannot always be accurately determined. But still, more often the disease manifests itself acutely, with an increase in temperature to 38-39 degrees, the appearance of weakness, and headaches. Symptoms of bronchopneumonia in adults also include cough, which, depending on the provocateur of the pathology, can be unproductive or productive (with mucous or mucopurulent sputum). Pain in the chest area and increased breathing are also signs of pathology.

Acute bronchopneumonia without fever or with its rise to low-grade fever can be observed in weakened people and in elderly patients. In other categories of patients, the duration of the febrile period is from three to five days.

If treatment is started in a timely manner, the patient recovers within 12-14 days, and x-ray recovery is recorded by the end of the second or third week. The duration of the disease also depends on the extent of the process. Bilateral bronchopneumonia is more severe than right-sided bronchopneumonia or left-sided bronchopneumonia.

We can highlight some features of the course of pathology caused by one or another pathogen:

Streptococcal pneumonia is often complicated by pleural empyema and exudative pleurisy.
Pneumonia caused by staphylococcus or Friendlander's bacillus can be aggravated by the formation of an abscess. This is accompanied by increased symptoms of intoxication of the body, an increase in the volume of sputum, and it becomes purulent in nature. Also, staphylococcal pneumonia can be complicated by conditions such as pulmonary hemorrhage, pyopneumothorax, amyloidosis, purulent pericarditis, and sepsis.
Viral pneumonia can cause progression of hemorrhagic syndrome. This manifests itself in the form of nosebleeds, less commonly pulmonary and gastrointestinal bleeding

Note! Bronchial pneumonia, which develops after surgery, can cause cardiac and respiratory failure.

Tactics for diagnosing the disease

A doctor can make a diagnosis of bronchopneumonia based on the patient’s complaints, objective examination data: auscultation, percussion, as well as on the results of instrumental and laboratory research. An important point is a necessity differential diagnosis bronchial inflammation of the lungs with pathologies such as lung abscess, pulmonary infarction, alveolar cancer, tuberculosis.

A mandatory test for suspected bronchopneumonia is radiography. Classic cases of the disease are characterized by the identification of foci of pathology against the background of peribronchial and perivascular infiltration on a radiograph. If the interpretation of the radiograph is in doubt, computed tomography and magnetic resonance imaging, as well as bronchoscopy, are additionally prescribed.

In order to determine the provocateur of the disease, sputum or bronchial washings are examined. The following laboratory tests are performed:

microscopy;
polymerase chain reaction;
bacteriological research.

A general blood test reveals an increase in erythrocyte sedimentation rate and neutrophilic leukocytosis. IN biochemical analysis dysproteinemia is observed in the blood, high level C-reactive protein.

Important! In case of severe pathological process, blood culture is necessary to exclude septicemia.

Treatment of bronchial pneumonia

Treatment of bronchopneumonia in adults involves the prescription of antibiotic drugs. In this case, the doctor takes into account clinical, radiological and microbiological diagnostic data. Most often, it is advisable to use a combination of several antibiotics from different groups.

Bronchopneumonia should be treated with penicillin, cephalosporin, and fluoroquinolone drugs, and the course of treatment should not be less than 10-14 days. More often, administration is prescribed using intramuscular and intravenous injections, in certain clinical situations, endobronchial, intrapleural and endolymphatic routes of administration are rational.

The acute period of the disease requires detoxification and anti-inflammatory measures. In addition, it is rational to treat bronchopneumonia in severe clinical situations with corticosteroid medications.

As symptomatic therapy, bronchodilators and mucolytics are prescribed, which dilute mucus and facilitate its removal from the respiratory tract. Such medications are used in the form of tablets, syrups, and inhalations.

Important! Traditional treatment pneumonia is unacceptable. This disease is treated in a hospital setting and under strict medical supervision.

In severe clinical situations with progression of respiratory failure, oxygen therapy is prescribed. If heart failure has developed, then the use of diuretics and cardiac glycosides is required. In the most severe cases, plasmapheresis is necessary.

When the acute phase of the pathological process has subsided, physiotherapy is prescribed. Procedures may include chest massage, ultra-high frequency therapy, decimeter therapy, and medicinal electrophoresis.

Prognosis in case of bronchopneumonia

Recovery is recorded after disappearance clinical symptoms and normalization of the results of instrumental and laboratory studies. Timely initiation of treatment helps prevent the development of complications and chronicity of the inflammatory process. After treatment, it is recommended to be observed by a pulmonologist for six months.

The least favorable prognosis is typical for the case of staphylococcal pneumonia and pneumonia caused by viral infection. Therefore, it is extremely important to immediately consult a doctor when the first symptoms of illness appear.

Bronchial pneumonia is a type of pneumonia. Harmful bacteria and viruses, along with the inhaled air, penetrate the lungs and infect the smallest branches of the bronchial tree.

What causes bronchopneumonia

Pneumonia can also be a consequence of food entering the respiratory tract, compression of the lungs by a tumor, inhalation of toxic gases, or a postoperative complication.

Who is at risk of getting sick

Absolutely anyone can get pneumonia. But there are groups of people who are especially vulnerable to this disease.

High-risk groups include:

Newborns and children under 3 years of age;
Children with congenital diseases of the respiratory system;
Children with congenital or hereditary defects of the immune system (immunodeficiencies);
Elderly over 65 years of age;
People who already have lung diseases (such as asthma and bronchitis);
HIV-infected;
Suffering from heart disease and diabetes;
Smokers.

The main signs of the disease are:

Fever. Increase in body temperature to 37.5 - 39 degrees within 1-3 days. Accompanied by severe weakness, loss of appetite or complete refusal of food, sweating and chills, insomnia, pain in the calf muscles. Fever is a manifestation of the body's fight against inflammation. Therefore, at temperatures up to 37.5-38C, it is not recommended to take antipyretic drugs.
Cough. At the beginning of the disease it is dry, frequent, irritating. As pneumonia progresses, sputum appears. The sputum has a characteristic greenish-yellow color, sometimes streaked with blood.
Dyspnea. In adults with severe disease, there is a feeling of lack of air and frequent shallow breathing. Sometimes shortness of breath persists even at rest.
Chest pain. Disturbs when coughing or taking a deep breath. With pneumonia, pain appears on the side of the affected lung, often stabbing or pulling, and goes away after coughing.

Features of symptoms in children

Symptoms such as fever and cough may be mild or absent in children. Sometimes pneumonia can develop at normal or reduced body temperature. Loud wheezing and shortness of breath come to the fore.

To suspect pneumonia in children, parents should pay attention to prolonged bronchitis or ARVI, the child’s lethargy and lack of appetite, increased breathing, and shortness of breath.

What diagnostic examination should be performed?

If the above symptoms appear, you should consult a doctor. At your appointment, the doctor will conduct an initial examination, which includes:

Measuring body temperature.
Tapping (percussion) of the lungs. Using his fingers, the doctor taps on the surface of the lungs (above the collarbones, between the shoulder blades, in the lower parts of the chest). In the presence of pneumonia, a shortening of the sound over the affected area is characteristic.

At the moment, this method is considered uninformative and is almost not used in the diagnosis of pneumonia.

Listening (auscultation) of the lungs. It is carried out using a stethoscope or phonendoscope. The essence of the method is to listen to wheezing, weakened breathing, and pleural friction noise in the affected area. The appearance of these sound phenomena depends on the period of the disease (beginning, peak, recovery) and cannot always be heard.

Based on complaints, characteristic symptoms and examination, a diagnosis of pneumonia can be made.

To document the disease, a chest X-ray and a series of laboratory tests must be performed. In special cases, computed tomography, sputum analysis, pathogen identification tests, and bronchoscopy will be needed.

Treatment includes measures on regimen, nutrition, as well as the prescription of medications and physical therapy.

Mode.

At the onset of the disease, bed rest is recommended. Be sure to ventilate and clean the room. When body temperature normalizes, walks in the fresh air are allowed. Resumption of hardening from 2-3 weeks after the end of pneumonia. Resumption of physical activity from the 6th week of recovery.

Diet.

There are no food restrictions. Nutrition should be balanced, high in proteins and vitamins. Small and frequent meals are recommended. It is mandatory to drink plenty of liquid in the form of warm fruit drinks, herbal teas, and warm mineral water.

Physiotherapeutic treatment.

It should be started after body temperature has normalized. Chest massages and inhalations with drugs that facilitate breathing and sputum discharge are useful.

Types of drugs used

Treatment involves prescribing antibiotics in the form of tablets or injections (intravenous or intramuscular).

Also in the treatment of bronchopneumonia, antipyretics, expectorants, antiallergic drugs, and vitamins are used. In some cases, oxygen is prescribed.

Therapy in childhood

Treatment of children is carried out only in a hospital. If necessary, the child may be placed in an intensive care unit.
When prescribing drugs, the dose is calculated based on the patient's weight. If pneumonia is caused by viruses, then in severe cases antiviral drugs may be prescribed.

Children are more at risk of dehydration. The threat is especially high against the background of elevated body temperature, so much attention is paid to maintaining water balance. Sometimes the missing fluid is administered using droppers. To prevent shortness of breath, oxygen inhalations are used.

Currently, due to the effective treatment of bronchitis and ARVI in the early stages, the number of children with severe forms of pneumonia is quite rare.

Consequences of inflammation and prevention

For most people, pneumonia goes away without leaving a trace. Residual manifestations of the disease (weakness, shortness of breath when walking quickly) disappear within 1 month.

To prevent relapse, you must follow simple rules:

Wash your hands regularly;
Avoid smoking;
Avoid contact with sick people;
Stick to a healthy diet;
Exercise;
Get enough sleep, rest regularly.

Bronchial pneumonia is acute inflammation the walls of the bronchioles, as a result of which isolated foci of hepatization are formed within the lobules of the lung. This concept combines different forms of pneumonia that arise as a result of infection entering the body through the bronchi.

Nature of occurrence, symptoms and classification

Depending on the nature of its occurrence, the most common bronchial pneumonia is bacterial and viral.

Can be caused by action Staphylococcus aureus, coli, Klebsiella or Pseudomonas.

The invasion of bacteria into the bronchioles provokes inflammation, as a result of which the alveoli fill with fluid from blood vessels, forming lesions.

Some pathogenic bacteria, after entering the body, can suppress even strong immunity. The pneumonia they cause is highly contagious. But there are other, potentially dangerous microorganisms with which a person constantly comes into contact, and the disease occurs in conditions of a weakened immune system.

Viral bronchopneumonia is less common in adults. This disease mainly affects children and people over 65 years of age. The causative agents are influenza, parainfluenza, chickenpox, adenovirus, coronavirus, human metapneumovirus, respiratory syncytial virus.

Pathogenesis: after entering the upper respiratory tract, the virus multiplies in the epithelial area, then is transmitted with blood and secretory fluid to the lungs, contributing to their secondary infection. Correctly selected and organized treatment provides a favorable outcome for immunocompetent patients in most cases.

Symptoms of pneumonia depend on the type of virus that caused it, but big picture clinical manifestations rarely includes chest pain. At viral form The vascular pattern of the lung changes, making it difficult to make a diagnosis using radiography.

Viral pneumonia is contagious, but it mainly affects people with weak body defenses. In other cases, pathogenic viruses provoke other, less severe diseases.

Treatment for these two forms of pneumonia is different methods: for bacterial it is prescribed antibacterial therapy, whereas viral requires administration antiviral drugs such as Remantadine, Acyclovir and Ribavirin.

Put differential diagnosis This is difficult due to the high prevalence of mixed bacterial-viral pneumonia.

Clinical picture different forms The disease has its own characteristics, but there are typical symptoms of bronchial pneumonia:

There are cases when pneumonia occurs without fever and cough, then the diagnosis is made late and treatment becomes difficult. In such situations, it is important to pay attention to other symptoms and undergo additional tests.

Focal

The diagnosis is made based on the results X-ray studies. To obtain an accurate picture, side and frontal photographs are taken. They also perform auscultation and percussion of the lungs to determine the causative agent of the disease. In some cases, a computed tomography scan is required.

There are several types of bronchopneumonia, and it is extremely important to differentiate them, because only in this case can you receive adequate treatment.

Classification is usually made according to several criteria:

nature of occurrence;
the nature of the disease;
degree of damage;
localization.

According to the nature of the disease, it can be:

Sharp;
Protracted;
Chronic.

Features of acute bronchopneumonia

Acute bronchopneumonia is characterized by the shortest duration. Complete recovery occurs within 4 weeks from the onset of the lesions. Its symptoms are most pronounced, and its pathogenesis is intense.

If the diagnosis was not made in a timely manner, treatment was inadequate or was stopped until the patient had fully recovered, acute form bronchial pneumonia develops into prolonged pneumonia. This happens in almost 30% of cases. To cure the disease, it is necessary to resume therapy and, if necessary, adjust it in accordance with the analysis of the patient’s condition and the degree of effectiveness of the measures taken.

It is highly undesirable to treat protracted bronchopneumonia on your own, exclusively at home, as this may lead to complications such as chronic disease and not only.

Chronic form of the disease

Chronic bronchopneumonia flows from an unresolved protracted one. This process is determined not by timing, but by the lack of progress according to X-ray data and the repeated occurrence of exacerbation of inflammation in the same areas.

For determining chronic form X-rays alone are not enough. The diagnosis also depends on the results of the following studies:

Pathogenesis is characterized irreversible changes part of the bronchial tree, as a result of which its cleansing function is disrupted.

In the remission phase, symptoms are absent or mild, and during an exacerbation, they are similar to the manifestations of acute and protracted pneumonia.

Treatment with antibiotics for exacerbation of chronic bronchopneumonia is combined with procedures to improve bronchial patency. During the period of remission, secondary prevention measures are carried out.

Forms of pneumonia of varying degrees of damage

The following can be distinguished:

Pathogenesis occurs as follows: the focal form tends to develop into a confluent form, the segmental form into a polysegmental one. The result of the progression of bronchial pneumonia can be lobar pneumonia. It arises not only as a result of focal, but also as independent disease caused by pneumococcus. This form of inflammation of the lung tissue is a separate category and does not apply to bronchial.

In bronchopneumonia, focal inflammation develops isolated within the lobules of the lung, forming so-called foci. Their size ranges from 1 to 4 cm.

It is a complicated focal form and is formed as a result of the union of lesions into areas up to 10 cm in size.

expressed by the localization of inflammatory processes within the bronchopulmonary segment. It is the second most common form of the disease after focal.

Polysegmental bronchopneumonia affects several segments of the lung. Its pathogenesis is characterized by rapidity: polysegmental pneumonia progresses rapidly, so it should be treated immediately. Otherwise, even death is possible. As a result of damage to the pleura, severe discomfort is observed.

Localization of the inflammatory process and treatment

Depending on the location of the lesions, the following are distinguished:

Left-sided bronchopneumonia is characterized by smooth symptoms and some difficulty in diagnosing, therefore, in addition to radiography, computed tomography is performed.

Right-sided bronchopneumonia occurs more often than left-sided bronchopneumonia due to the characteristics anatomical structure: adjacent to the right side lung bronchus wider and shorter, which facilitates the penetration of infection.

Bilateral bronchopneumonia is extremely dangerous. Its pathogenesis depends on many factors, in particular the size of the lesions and their tendency to merge. Risk fatal outcome with this type of disease it increases.

Just as contagious as other forms of the disease. Its pathogenesis differs in that the multiplication of pathogens occurs already in the area of large bronchi, and infiltration of exudate is noted in the area between the pulmonary and mediastinal pleura.

Catarrhal bronchopneumonia occurs only in animals, especially farm animals, and is not contagious to humans.

From the walls of the bronchioles, the infection enters the lung parenchyma and causes the following symptoms:

Complications for this form can lead to. Their occurrence is possible when treatment was started untimely.

Treatment of bronchial pneumonia is carried out in five areas:

Antibacterial or antiviral therapy(depending on the type of pathogen).
Increased immune system reactivity.
Cleansing the bronchi.
Physiotherapy.
Physical therapy (if your health allows and there is no elevated temperature).

According to statistics, only about 20% of patients with pneumonia require hospitalization. In other cases, the patient can be successfully treated in an outpatient clinic. At home, additional procedures prescribed by a doctor are carried out, and medications can be taken traditional medicine, but strictly after consultation with a specialist.

It is important to understand that full treatment impossible at home - self-selected antibacterial drugs may not correspond to the type of pathogen or have a weak effect on it. In such conditions, the disease drags on, and complications appear in the form of respiratory distress syndrome, lung abscess, sepsis, pleurisy, and distributive shock.