Could it be pneumonia? Signs of pneumonia

Pneumonia is a disease of the pulmonary system that occurs due to exposure to harmful bacteria and viruses. Pneumonia is not always an independent disease; sometimes it is a complication of other diseases.

Normally, the pulmonary system has a powerful defense system. Firstly, it is the nasal mucosa with fine hairs, secondly, the tonsils, and thirdly, the bronchial mucosa. If viruses and microbes nevertheless overcome these obstacles, then leukocytes and bacteriophages act and neutralize them, then with the help of a natural reflex - a simple cough, the microbes are expelled from the body along with mucus.

When, for certain reasons, viruses and microbes penetrate the lung tissue, inflammation develops, which can be:

focal - the infection affects a small area of the lung;
segmental – infection affects one or two bronchopulmonary segments;
lobar – the infection affects a lobe of the lung;
confluent – foci of infection merge into one larger lesion;
total - the entire lung is inflamed.

With pneumonia, the lung tissue stops functioning properly: the lung vesicles fill with fluid instead of oxygen. Gas exchange is not carried out fully, so the level of oxygen in a person’s blood drops and develops oxygen starvation internal organs.

Causes

The main cause of pneumonia is damage to the lung tissue by viruses and bacteria due to the weakening of the body's defenses. Harmful microorganisms penetrate the lungs not only through direct inhalation, but also “migrate” from upper sections lungs into the lower ones, and also get inside when medical manipulations non-sterile devices. The causes of pneumonia may lie in blood or lymph infection, for example, with sepsis or drug addiction.

With some diseases, the risk of getting pneumonia increases significantly. Such diseases include:

congenital or acquired heart disease;
cystic fibrosis;
malnutrition and hypovitaminosis;
immunodeficiency is hereditary or acquired;
endocrine diseases;
heart failure.

Bad habits – alcoholism, drug addiction, including passive ones, also significantly suppress the body’s immunity, which allows the infection to freely penetrate and multiply in the tissues of the lungs. The risk of developing pneumonia largely depends on your overall lifestyle. In 90% of cases, the lower parts of the lungs are affected, which ordinary life practically do not participate in breathing. Inactivity and physical inactivity do not allow the lungs to work at full capacity, so mucus accumulates in remote areas, which is an ideal environment for the proliferation of bacteria.

Symptoms

Symptoms of pneumonia can vary depending on what pathogens caused it. The causes of “typical” pneumonia are streptococci, staphylococci, and Pfeiffer’s bacillus. Signs of pneumonia in this case are as follows:

a sharp rise in body temperature to 40, less often to 38 degrees;
coughing with sputum;
body chills, fatigue, lethargy;
pain when coughing in any area of the lung.

“Atypical” pneumonia occurs due to atypical pathogens, the clinical picture is slightly different, as in the usual case. Its signs are:

weak manifestation of “classical” signs: no pain in the lungs, an average amount of sputum produced, a slight increase in the level of leukocytes;
headache;
muscle pain (myalgia);
sore throat;
lethargy, sweating;
short-term increase in temperature in the evening;
shortness of breath during exercise.

This type of pneumonia is the most dangerous, since a person does not attach much importance to his condition, attributing it to chronic fatigue or vitamin deficiency. If left untreated, inflammation can lead to tuberculosis or even lung cancer.

Diagnostics

If pneumonia is suspected, the doctor will first prescribe fluorography - an examination of the lung area using x-rays. In order to obtain a clearer picture, two photographs are taken, one from the side and the other from the front.

Next, it is necessary to study the bacteriological composition of sputum. This is done in order to find out which pathogen has entered the lungs, what the condition of the lungs is, and also to check whether Koch’s bacillus, the causative agent of tuberculosis, is among the microorganisms.

A general blood test will give an idea of the state of the body during the period of illness. A high erythrocyte sedimentation rate, as well as an increase in the level of leukocytes, indicate an inflammatory process in the body. An unfavorable sign is an increase in hemoglobin in the blood from the onset of the disease, because oxygen deficiency may develop.

Additionally the following can be used:

computed tomography – high-precision layer-by-layer examination using a computer;
bronchoscopy – examination of the condition of the trachea and bronchi using a bronchofiberscope;
biopsy of the lung or pleura - taking part of the cells for research;
urine analysis for protein and leukocyte content.

The more methods are used, the more complete the doctor’s understanding of pneumonia will be. A correct diagnosis will help you create the most effective treatment plan.

Treatment

Treatment of pneumonia begins after the causative agent of the infection is identified. The doctor prescribes antiviral and antibacterial drugs - antibiotics. In combination with them, agents are prescribed that dilate the bronchi and thin the sputum - in the form of tablets, syrups, inhalations, intravenous solutions. Oxygen masks and oxygen cocktails are used to enrich the blood with oxygen.

In addition, it is necessary to stimulate your own immunity. This is done using ascorbic acid, as well as physiotherapy: physical therapy, vibration massage and so on.

After completing the course of treatment, it is necessary to check the condition of the lungs. X-rays are repeated and sputum is collected for examination.

The medical community insists that the only in a universal way Pneumonia is prevented by vaccination. Vaccination is recommended for the following categories of people:

for persons over 65 years of age;
for persons suffering from liver cirrhosis, anemia, chronic diseases hearts;
for persons who have undergone radiation therapy;
for persons with alcoholism, smokers;
for those who work with a large number of people, especially young children.

Revaccination is carried out after 5 years. Modern vaccines are practically safe, and, most importantly, they significantly reduce the risk of pneumonia and its complications.

– acute lung injury of an infectious-inflammatory nature, which involves all structural elements of the lung tissue, mainly the alveoli and interstitial tissue of the lungs. The clinical picture of pneumonia is characterized by fever, weakness, sweating, chest pain, shortness of breath, cough with sputum (mucous, purulent, “rusty”). Pneumonia is diagnosed based on auscultation patterns and chest x-ray data. IN acute period treatment includes antibiotic therapy, detoxification therapy, immunostimulation; taking mucolytics, expectorants, antihistamines; after the cessation of fever - physiotherapy, exercise therapy.

ICD-10

J18 Pneumonia without specifying the pathogen

General information

Pneumonia - inflammation of the lower respiratory tract of various etiologies, occurring with intra-alveolar exudation and accompanied by characteristic clinical and radiological signs. Acute pneumonia occurs in 10-14 people out of 1000, in the age group over 50 years old - in 17 people out of 1000. Relevance of the morbidity problem acute pneumonia persists despite the introduction of new antimicrobials, just like it is saved high percent complications and mortality (up to 9%) from pneumonia. Among the causes of mortality among the population, pneumonia is in 4th place after heart and vascular diseases, malignant neoplasms, injuries and poisonings. Pneumonia can develop in weakened patients, joining the course of heart failure, oncological diseases, cerebrovascular accidents, and complicates the outcome of the latter. In patients with AIDS, pneumonia is the main immediate cause of death.

Causes and mechanism of development of pneumonia

Among the reasons causing pneumonia, comes first bacterial infection. The most common causes of pneumonia are:

gram-positive microorganisms: pneumococci (40 to 60%), staphylococci (2 to 5%), streptococci (2.5%);
gram-negative microorganisms: Friedlander's bacillus (from 3 to 8%), Haemophilus influenzae (7%), enterobacteria (6%), Proteus, coli, legionella, etc. (from 1.5 to 4.5%);
viral infections (herpes viruses, influenza and parainfluenza, adenoviruses, etc.);

Pneumonia can also develop due to exposure to non-infectious factors: injuries chest, ionizing radiation, toxic substances, allergic agents.

The risk group for the development of pneumonia includes patients with congestive heart failure, chronic bronchitis, chronic nasopharyngeal infection, congenital malformations of the lungs, with severe immunodeficiency conditions, weakened and exhausted patients, patients who have been on bed rest for a long time, as well as elderly and senile people .

People who smoke and drink alcohol are especially susceptible to developing pneumonia. Nicotine and alcohol vapor damage the bronchial mucosa and inhibit the protective factors of the bronchopulmonary system, creating favorable environment for the introduction and propagation of infection.

Infectious pathogens of pneumonia penetrate the lungs through bronchogenic, hematogenous or lymphogenous routes. When there is a decrease in the protective bronchopulmonary barrier in the alveoli, infectious inflammation develops, which spreads through the permeable interalveolar septa to other parts of the lung tissue. Exudate forms in the alveoli, preventing the gas exchange of oxygen between the lung tissue and blood vessels. Oxygen and respiratory failure develop, and with complicated pneumonia, heart failure.

There are 4 stages in the development of pneumonia:

tide stage (from 12 hours to 3 days) – characterized by a sharp blood supply to the vessels of the lungs and fibrinous exudation in the alveoli;
stage of red hepatization (from 1 to 3 days) – compaction occurs lung tissue, with a structure reminiscent of the liver. Red blood cells are found in large quantities in the alveolar exudate;
stage of gray hepatization - (from 2 to 6 days) - characterized by the breakdown of erythrocytes and a massive release of leukocytes into the alveoli;
resolution stage – the normal structure of the lung tissue is restored.

Classification of pneumonia

1. Based on epidemiological data, pneumonia is distinguished:

out-of-hospital (out-of-hospital)
intrahospital (hospital)
caused by immunodeficiency conditions

2. By etiological factor, with specification of the causative agent, pneumonia is:

mycoplasma
fungal
mixed.

3. According to the mechanism of development, pneumonia is distinguished:

primary, developing as an independent pathology
secondary, developing as a complication of concomitant diseases (for example, congestive pneumonia)
aspiration, developing when foreign bodies enter the bronchi (food particles, vomit, etc.)
post-traumatic
postoperative
heart attack-pneumonia, developing as a result of thromboembolism of small vascular branches of the pulmonary artery.

4. According to the degree of interest of the lung tissue, pneumonia occurs:

unilateral (with damage to the right or left lung)
bilateral
total, lobar, segmental, sublobular, basal (central).

5. According to the nature of the course of pneumonia, there can be:

spicy
acute lingering
chronic

6. Considering development functional disorders pneumonia occurs:

with the presence of functional disorders (indicating their characteristics and severity)
with no functional impairment.

7. Taking into account the development of complications of pneumonia, there are:

uncomplicated course
complicated course (pleurisy, abscess, bacterial toxic shock, myocarditis, endocarditis, etc.).

8. Based on clinical and morphological characteristics, pneumonia is distinguished:

parenchymal (lobar or lobar)
focal (bronchopneumonia, lobular pneumonia)
interstitial (more often with mycoplasma lesions).

9. Depending on the severity of pneumonia, they are divided into:

mild degree - characterized by mild intoxication (clear consciousness, body temperature up to 38°C, normal blood pressure, tachycardia no more than 90 beats per minute), there is no shortness of breath at rest, a small focus of inflammation is determined by x-ray.
moderate degree - signs of moderate intoxication (clear consciousness, sweating, severe weakness, body temperature up to 39°C, blood pressure moderately reduced, tachycardia about 100 beats per minute), respiratory rate - up to 30 per minute. at rest, pronounced infiltration is determined radiologically.
severe – characterized by severe intoxication (fever 39-40°C, clouding of the blood, adynamia, delirium, tachycardia over 100 beats per minute, collapse), shortness of breath up to 40 beats per minute. at rest, cyanosis, extensive infiltration is determined radiologically, the development of complications of pneumonia.

Symptoms of pneumonia

Lobar pneumonia

Characterized by an acute onset with fever above 39°C, chills, chest pain, shortness of breath, and weakness. The cough is disturbing: at first it is dry, unproductive, then, on the 3-4th day, with “rusty” sputum. Body temperature is constantly high. With lobar pneumonia, fever, cough and sputum production last up to 10 days.

In severe cases of lobar pneumonia, hyperemia is determined skin and cyanosis of the nasolabial triangle. On the lips, cheeks, chin, wings of the nose are visible herpetic rashes. The patient's condition is serious. Breathing is shallow, rapid, with flaring of the wings of the nose. On auscultation, crepitus and moist fine bubbling rales are heard. The pulse is frequent, often arrhythmic, blood pressure is reduced, heart sounds are muffled.

Focal pneumonia

It is characterized by a gradual, subtle onset, most often after acute respiratory viral infection or acute tracheobronchitis. The body temperature is febrile (38-38.5°C) with daily fluctuations, the cough is accompanied by the discharge of mucopurulent sputum, sweating, weakness are noted, when breathing - pain in the chest when inhaling and when coughing, acrocyanosis. With focal confluent pneumonia, the patient's condition worsens: severe shortness of breath and cyanosis appear.

On auscultation, hard breathing is heard, exhalation is prolonged, dry small- and medium-bubble rales, crepitus over the source of inflammation.

Features of the course of pneumonia are determined by the severity, properties of the pathogen and the presence of complications.

Complications of pneumonia

The course of pneumonia is considered complicated, accompanied by the development in the bronchopulmonary system and other organs of inflammatory and reactive processes caused directly by pneumonia. The course and outcome of pneumonia largely depend on the presence of complications. Complications of pneumonia can be pulmonary or extrapulmonary.

Pulmonary complications of pneumonia can be obstructive syndrome, abscess, lung gangrene, acute respiratory failure, parapneumonic exudative pleurisy.

Among the extrapulmonary complications of pneumonia, acute cardiopulmonary failure, endocarditis, myocarditis, meningitis and meningoencephalitis, glomerulonephritis, infectious-toxic shock, anemia, psychosis, etc. often develop.

Diagnosis of pneumonia

When diagnosing pneumonia, several problems are solved at once: differential diagnosis inflammation with other pulmonary processes, determining the etiology and severity (complications) of pneumonia. Pneumonia in a patient should be suspected based on symptomatic signs: rapid development of fever and intoxication, cough.

Physical examination reveals compaction of the lung tissue (based on percussion dullness of pulmonary sound and increased bronchophony), a characteristic auscultatory pattern - focal, moist, fine-bubbly, sonorous rales or crepitus. Echocardiography and ultrasound of the pleural cavity sometimes detect pleural effusion.

As a rule, the diagnosis of pneumonia is confirmed after a chest x-ray. With any type of pneumonia, the process most often affects the lower lobes of the lung. X-rays of pneumonia may reveal the following changes:

parenchymal (focal or diffuse darkening various localizations and length);
interstitial (the pulmonary pattern is enhanced due to perivascular and peribronchial infiltration).

X-rays for pneumonia are usually taken at the onset of the disease and after 3-4 weeks to monitor the resolution of inflammation and exclude other pathologies (usually bronchogenic lung cancer). Changes in the general blood test for pneumonia are characterized by leukocytosis from 15 to 30 109/l, band shift leukocyte formula from 6 to 30%, increasing ESR to 30-50 mm/h. A general urinalysis may reveal proteinuria and, less commonly, microhematuria. Sputum analysis for pneumonia allows you to identify the pathogen and determine its sensitivity to antibiotics.

Treatment of pneumonia

Patients with pneumonia are usually hospitalized in the general medical department or the pulmonology department. For the period of fever and intoxication it is prescribed bed rest, plenty of warm drinks, high in calories, rich in vitamins nutrition. In case of extreme events respiratory failure Patients with pneumonia are prescribed oxygen inhalation.

The main thing in the treatment of pneumonia is antibacterial therapy. Antibiotics should be prescribed as early as possible, without waiting for the pathogen to be identified. The choice of antibiotic is carried out by a doctor; no self-medication is acceptable! For community-acquired pneumonia, penicillins (amoxicillin with clavulanic acid, ampicillin, etc.), macrolides (spiramycin, roxithromycin), cephalosporins (cefazolin, etc.) are more often prescribed. The choice of method of antibiotic administration is determined by the severity of the pneumonia. For the treatment of nosocomial pneumonia, penicillins, cephalosporins, fluoroquinolones (ciprofloxacin, ofloxacin, etc.), carbapenems (imipenem), aminoglycosides (gentamicin) are used. If the pathogen is unknown, a combination antibiotic therapy of 2-3 drugs is prescribed. The course of treatment can last from 7-10 to 14 days, it is possible to change the antibiotic.

For pneumonia, detoxification therapy, immunostimulation, and the prescription of antipyretics, expectorants, mucolytics, and antihistamines are indicated. After the cessation of fever and intoxication, the regimen is expanded and physiotherapy is prescribed (electrophoresis with calcium chloride, potassium iodide, hyaluronidase, UHF, massage, inhalations) and exercise therapy to stimulate resolution of the inflammatory focus.

Treatment of pneumonia is carried out until the patient’s complete recovery, which is determined by the normalization of condition and well-being, physical, radiological and laboratory parameters. With frequent repeated pneumonia of the same localization, the issue of surgical intervention.

Prognosis for pneumonia

In pneumonia, the prognosis is determined by a number of factors: the virulence of the pathogen, the age of the patient, underlying diseases, immune reactivity, and the adequacy of treatment. Complicated variants of the course of pneumonia, immunodeficiency states, and resistance of pathogens to antibiotic therapy are unfavorable in terms of prognosis. Pneumonia in children under 1 year of age caused by staphylococcus, Pseudomonas aeruginosa, and Klebsiella is especially dangerous: the mortality rate for them ranges from 10 to 30%.

With timely and adequate therapeutic measures pneumonia ends in recovery. Depending on the types of changes in the lung tissue, the following outcomes of pneumonia can be observed:

complete restoration of the lung tissue structure - 70%;
formation of an area of local pneumosclerosis - 20%;
formation of a site of local carnification – 7%;
reduction of a segment or share in size – 2%;
shrinkage of a segment or lobe – 1%.

Prevention of pneumonia

Measures to prevent the development of pneumonia include hardening the body, maintaining immunity, eliminating the factor of hypothermia, sanitizing chronic infectious foci of the nasopharynx, combating dust, stopping smoking and alcohol abuse. In weakened bedridden patients, in order to prevent pneumonia, it is advisable to carry out breathing and therapeutic exercises, massage, and prescribe antiplatelet agents (pentoxifylline, heparin).

Pneumonia is an infectious disease. It remains one of the most common in the world. This is the leader among nosocomial infections leading to death. It is important to know the symptoms of pneumonia in adults in order to take timely measures. Treatment of pneumonia and prognosis for the development of the disease depend on the nature of the infection, age and general condition patient.

What is pneumonia and why is it dangerous?

Pneumonia in acute form called pneumonia. It is caused by infections that can be transmitted different ways, affects lung tissue. It is in fifth place on the list of diseases that cause death, and medicine does not always help. Death among adults from pneumonia – 10-33%. In-hospital and atypical form carries away more diseases more lives– the risk of dying increases to 50%. In older people and people with weakened immune systems, the prognosis for pneumonia is often disappointing.

Common pneumonia kills 1-3% of young patients who do not have diseases that could impair treatment. Among patients old age mortality rate up to 40-50%. Causes of death from pneumonia:

accompanying illnesses, such as heart pathologies, existing respiratory diseases (such as bronchitis), diabetes, problems in genitourinary system;
bad habits (smoking, especially for a long time, drug addiction, alcoholism);
poor living conditions;
weakened immunity.

Pulmonary disease poses a particular risk to pregnant women. She herself is heavy because dangerous pathologies. For a woman carrying a child, it is doubly dangerous - for expectant mother and fruit. On early stages the disease threatens the embryo, whose tissues and organs are not yet formed. In the last trimester, pneumonia is less dangerous for the child than for the mother. Prevention is simple: strengthening the mother's immunity.

The first signs of pneumonia

One-sided and two-sided

The inflammatory process is concentrated either on one side, or it is bilateral. Unilateral pneumonia is divided into two types:

Right-sided - occurs more often, the right bronchus is wider than the left and shorter than it, the infection penetrates there more freely.
Left-sided - develops less often, with it stagnant processes in the lung are observed.

Bilateral covers both lungs: the entire lung tissue becomes inflamed, and the disease is provoked by bacteria (pneumococcus, Haemophilus influenzae). Against the background of one infection, other harmful microorganisms additionally multiply, and a mixed infection develops. Several pathogens enter the fight against humans; it is difficult to select antibacterial drugs for treatment.

Basal

The focus of inflammation located along lung root, difficult to diagnose. Such cases are called hilar pneumonia. Used for diagnosis computed tomography. The doctor must rule out tuberculosis and lung cancer, the focus of inflammation looks like a tumor in the picture. Conducted tuberculin tests. If medications against tuberculosis are mistakenly prescribed, but they do not have an effect, this is considered diagnostic sign.

Bronchopneumonia

Bronchial pneumonia characterizes defeat small branches bronchial tree sick. Bronchopneumonia is classified as focal. The healing process will take a lot of time. Sometimes the disease is secondary, developing against the background of bronchitis. A person tries to cure bronchitis, but it drags on, the condition worsens, weakness appears, and the temperature rises. The cough that accompanies bronchitis intensifies, unpleasant purulent sputum is released, sometimes streaked with blood.

Important symptoms: shortness of breath, increased heart rate up to 110 beats per minute, . Not only bronchitis, but also ARVI leads to the development of bronchopneumonia. Viruses and bacteria often cause this type of pulmonary inflammation; in order to treat the disease correctly, the causative agent is identified and antiviral or antibacterial drugs are prescribed. How long the disease is treated depends on the type of pathogen.

Hospital

In addition to community-acquired pneumonia developing in normal conditions, there is a severe form of the disease - hospital, or nosocomial. The diagnosis is made when inflammation appears two days or more after a person is admitted to a hospital hospital with a completely different diagnosis. This is the most merciless species, killing 50% of patients. Disease is caused by microorganisms. Types of nosocomial pulmonary inflammation:

related to artificial ventilation lungs;
postoperative;
intrahospital - in hospitalized patients in serious condition.

The patients’ immunity was weakened, the body was fighting another disease, and was not ready for the invasion of new microbes. To save the situation, patients are given IVs and intravenous nutrition is used to maintain vitality body, use new generation drugs, potent drugs. It is not always possible to cure hospital-acquired pneumonia. Treatment of the disease at home in this case is excluded.

Lobar pneumonia affects the lobes of the lung and pleura. With this type of disease, it is important to prescribe antibiotic injections in a timely manner, the duration of which is determined by the doctor. Physiotherapy and detoxification are used. The disease begins suddenly and acutely. There are three forms:

upper lobe – is difficult, with neurological disorders;
lower lobe – gives a pseudo-picture “ acute abdomen“, which is confusing during diagnosis, characterized by chills and “rusty” sputum;
central - inflammation develops deep in the lung, symptoms are mild and difficult to determine.

Krupoznaya

It is acute. The nature of the lung damage is bilateral. If the pathology is not recognized and treatment is not started quickly, the patient will die from brain hypoxia and cardiovascular failure. The first day the patient has a dry cough. The next day, rust-colored sputum comes out and vomiting occurs. On the third day it gets worse, shortness of breath appears, and tachycardia develops. The patient is unable to climb one floor. Lobar pneumonia is treated in pulmonology, in hospital or intensive care. The patient's pulmonary lobes are completely affected on both sides.

Video

Pneumonia - dangerous disease, it is important to determine it early stages when treatment is effective even folk remedies at home. In the video below, experts will talk in detail about the symptoms of the disease and teach you what to look for if the disease occurs without typical symptoms. Timely detection will help avoid irreversible consequences.

Pneumonia is a serious infectious disease. Under normal conditions, it can have a fairly pronounced clinical course, but certain factors can greatly blur the main manifestations of the disease.

Pneumonia in adults: causes under normal conditions

This disease occurs due to the development of microflora in the lung tissue and its gradual destruction. Such a pathological process can be initiated by the entry into the body of a wide variety of infections.

Another factor contributing to the development of pneumonia is a local or general decrease in immunity.

Among the main symptoms of this disease It is necessary to note, first of all, an increase in body temperature, a severe cough, the occurrence of shortness of breath with the slightest physical exertion, and poor general health.

Pneumonia in adults: symptoms, causes, types in unusual conditions

There are two main reasons why the clinical manifestations of the inflammatory process in the lungs will differ from the classics. Among them, the following should be noted:

decreased immunity;
uncontrolled reception antibacterial agents.

Both of these reasons can change quite a lot clinical picture pneumonia.

Inappropriate use of antibiotics

Today, the uncontrolled use of antimicrobial drugs has become a real problem for society. The fact is that over time, this circumstance gradually leads to the formation of resistance to the antibacterial agent in the infection. Eventually antimicrobial drug simply ceases to have a sufficient effect on pathogenic bacteria.

In addition, self-administration of such drugs can significantly reduce the severity of the main clinical manifestations of the disease. For example, pneumonia occurs in children and adults. Without a temperature reaching high enough levels, few people will immediately become concerned and decide to see a doctor. As a result, the disease will occur in a latent form, and the patient will not receive rational treatment. This will lead to gradual involvement in pathological process more and more new areas of lung tissue. As a result, the patient will experience other, more health-threatening clinical manifestations. The main signs of pneumonia in adults without fever are an increase in shortness of breath, the appearance of blood streaks in the sputum released during coughing, as well as chest pain that occurs when the pleura is involved in the pathological process.

Now doctors are trying to limit the self-administration of antibacterial drugs by patients. One of the main ways was to issue such drugs only with a doctor’s prescription.

About decreased immunity

The clinical picture can change greatly not only under the influence of antibacterial agents, but also under conditions of decreased protective properties body. As a result typical firsts Signs of pneumonia in adults may be absent. As a result, the patient does not immediately notice a serious problem. Signs of pneumonia in adults without fever in such conditions are expressed in the appearance of a painful blush on the side of the affected lung tissue. Particularly high diagnostic value this symptom has in the case of an isolated lesion of one lung.

In this case, an increase in temperature is not observed due to the fact that the body’s defenses are depleted. At the same time, hyperthermia is the most important factor of defense. The fact is that in conditions of elevated temperature it is much more difficult to grow and reproduce. As a result, they are gradually destroyed by white blood cells.

Additional signs

Without fever, adults are quite varied. First of all, we are talking about the appearance of a painful blush. This sign It is especially noticeable if the patient has unilateral pneumonia without fever. The signs are less noticeable, since the blush will be located on both cheeks.

In addition, a patient with pneumonia for which no rational treatment is carried out has pale color faces. When breathing, there may be a delay in the excursion of that half of the chest in which the inflammatory process occurs. Naturally, such signs of pneumonia in adults without fever are clearly detected only in cases with unilateral pathology. In this case, the second cheek may be paler than usual.

There are several other signs that pneumonia is developing in children and adults. Without fever, people often experience pain in the chest, which intensifies with every breath. This approach is dangerous because you can miss serious pathology. So if you experience pain in the chest that intensifies during inhalation, it is better to consult a specialist so that he can rule out an inflammatory process in the lung tissue.

When should shortness of breath give you pause?

The symptoms of pneumonia without fever in adults, as you can already see, are quite varied. One of the manifestations of the disease is shortness of breath. Normally, it can occur in any person after certain physical activity. If shortness of breath occurs at rest, one of the reasons may be an inflammatory process occurring in the lung tissue. At the same time, despite the lack of physical activity, without rational antibacterial therapy, shortness of breath gradually increases.

However, this symptom does not always indicate that pneumonia is developing without fever. Signs of the same type occur in cardiac pathology, when the patient gradually develops congestion. A chest x-ray will help identify the exact cause of shortness of breath.

It must also be remembered that Special attention Young patients should be alerted to shortness of breath at rest, since in the vast majority of cases they do not have significant cardiac pathology.

What should you do first?

If the typical first signs of pneumonia in adults occur, you should immediately contact a specialist - a general practitioner or a pulmonologist. They will spend general examination, including auscultation of the lungs. Based on the results of the primary diagnostic measures the doctor will decide whether it is necessary to carry out X-ray examination chest organs. If the doctor suspects something and sends the patient for such an examination, then under no circumstances should he refuse. After the x-ray, the doctor will be able to accurately establish the diagnosis and prescribe rational treatment.

How dangerous is pneumonia without fever?

This disease, if it occurs without hyperthermia, is very insidious. The fact is that in itself, even with timely rational treatment, pneumonia is very, very dangerous. If, in case of inflammation of the lung tissue, antibacterial therapy is not carried out, then there is a real danger that the disease will lead to the most disastrous consequences. But this is not the only thing that should scare you about pneumonia without fever. This disease is also dangerous because the patient most likely has a weakened immune system, or has recently taken certain antibacterial drugs. In both cases, it is usually necessary to use some of the most modern antimicrobial agents. In a situation with reduced immunity, we are talking about the fact that the body itself does not have the strength to resist infection. In the second situation, stability has already developed in pathogenic microorganisms to one or another type of antibiotic.

How to reduce the risk of pneumonia?

First of all, it is necessary to avoid severe hypothermia. The fact is that with a significant decrease in temperature in a particular area human body the level also decreases local immunity. As a result, pathogenic microorganisms have an excellent opportunity to multiply unhindered, affecting more and more new areas of lung tissue.

In addition, it is very important to take strictly according to the recommendations of doctors. At the same time, it is necessary to stop using them not when signs of one or another infectious disease will stop making themselves felt, but only after completing a full course of treatment. Otherwise, some pathogenic microorganisms will remain. Moreover, the next time the use of the same antibiotic will have much more modest success, and the drug will have to be changed.

One more important point is immune support. In order for it to be normal, it is necessary to maintain normal level physical activity, eat properly and in sufficient quantities, devote proper time to sleep and regular rest.

About laboratory tests

They are carried out if there are signs of pneumonia in adults. This disease occurs without fever or with hyperthermia - laboratory research necessary. First of all, we are talking, of course, about a general blood test. This study allows you to evaluate how pronounced infectious process occurs in the lung tissue. In this case, the doctor is most interested in the number of leukocytes, as well as the erythrocyte sedimentation rate. About what the process has infectious etiology, will indicate an increase in the level of white blood cells (more than 9 * 10 9 / l). An increased level of erythrocyte sedimentation rate will indicate that inflammation is occurring in the body. Often the doctor prescribes something other than the usual general analysis blood, but a study with a formula that allows the doctor to determine what type of microorganisms caused the development of pathology. At elevated level neutrophils, we can talk about bacterial pneumonia, and with an increase in the number of lymphocytes, we can talk about the viral etiology of this disease.

You can identify signs of pneumonia in a timely manner if you consult a doctor without waiting serious symptoms. Pneumonia is life-threatening, especially for children. After all, easily coping with the growing immune system child, the disease progresses over several hours.

The causative agent of the disease is most often streptococcal (Streptococcus pneumoniae). Normally, this bacterium is present in the lungs. But with inflammation it quickly multiplies against the background colds and reduced immunity. This also happens with prolonged severe hypothermia.

The manifestation of pneumonia depends on its pathogens. In professional circles it is customary to classify types pathological conditions on various shapes. In modern times, the concept of “atypical pneumonia” has also appeared.

What causes lead to the development of pneumonia:

decreased body resistance to bacteria;
reproduction of pathogens - streptococcus, enterobacteria, staphylococcus.

Atypical pneumonia - causes and symptoms

The type of pneumonia can be determined by the type of pathogen. If typical pneumonia occurs from the proliferation of coccal pathogens, then atypical pneumonia occurs when colonies of mycoplasma, chlamydia, legionella, and hemophilus influenzae grow in the respiratory tract.

Damage to the lungs by chlamydia is associated with the sensitivity of microorganisms to protein molecules of the receptors of the bronchial system and alveoli. Chlamydia multiplies inside the cell, complicating antibiotic therapy. When antibacterial medicine enters the bloodstream, chlamydia hides in the cell, so severe symptoms disappear. Refusal of an antibiotic sharply activates bacteria, and the disease becomes chronic.

Mycoplasma causes disease in young people, in combination with genitourinary tract infections. It is difficult to recognize this type - there are no acute symptoms.

Legionella is a rare guest in the respiratory tract, but its reproduction in the lungs is most dangerous and most often leads to a tragic end.

Haemophilus influenzae - provokes pneumonia in smokers. Activated when pathological changes V respiratory system, which, in turn, are observed in smokers, in most cases.

All of these pathogens lead to only half of the cases of pneumonia per year. globe. In the 21st century, medicine is faced with other, new pathogens for which there are no drugs yet. If natural immunity fails, the person dies from damage to the alveoli and lack of oxygen - that is, simply suffocates. An example is bird and swine flu, outbreaks of which in the recent past shocked world medicine and claimed many lives.

Other disease factors:

The first signal of problems in the respiratory system is the destruction of cells in the respiratory tree. The body tries to free itself from dead cells and eliminate their particles from the lumens in the alveoli and bronchi. From the outside it looks like a dry cough and sore throat.

A little later, the immune system joins the battle, the lungs become inflamed, and the cough turns into a wet one, phlegm accumulates in the bronchi, the cough intensifies, because the body strives to get rid of phlegm.

The disease goes through three stages, in medical terms:

tide, hepatization, reparation.

Depending on the volume of lung damage, it can be:

focal disease;
segmental disease;
shared;
lobar.

Classic course of pneumonia

Traditionally, pneumonia progresses through congestion, hepatization, and resolution. The disease ends within a month. In a child, the disease may last longer and be characterized by more severe symptoms.

Symptoms of red flush or flush

A hot flash can be recognized by redness of the facial skin, high or moderate. elevated temperature, shortness of breath, swelling of the alveoli, painful sensations in the chest due to increased air filling of the lungs.

Gradually, inflammation in the alveoli increases, fluid collects there, preventing normal metabolic processes oxygen and its entry into the blood. Hot flush symptoms last 48–60 hours. Red swelling can be recognized as vascular damage and the accumulation of red blood cells in the infiltrate. Such observation is possible after taking the appropriate tests.

Symptoms of hepatization - gray hepatization

At this stage, leukocytes “interfere” in the inflammation process, destroying the cells of the causative agents of the disease. The first symptom of the body's struggle is the filling of the alveoli with exudate - sputum, which is separated with a cough, freeing the alveoli. The exudate will drain for quite a long time until all the dead bacteria are released. This period is called hepatization because the lung tissue resembles liver cells, and in gray hepatization the accumulation of blood cells, fibrin and other cells forms a gray dense content when viewed under a microscope.

Resolution stage - symptoms

New symptoms will help you know that the disease has entered the resolution stage, that is, the final phase:

Pathological processes gradually disappear, the amount of inflammatory fluid decreases, freeing the alveoli. Shortness of breath and cough gradually disappear. But swelling in the airway area may still remain for some time, and tissues that have lost elasticity cause chest pain.

Fibrin clots dissolve, breathing is restored, and the long process of eliminating edema begins - here short list the main symptoms of the third, reparative stage of the disease in the classical version.

Croupous pneumonia

Pneumonia that affects both lungs is called lobar or bilateral. Let's look further at how to recognize it and what its symptoms are. Usually, in both a child and an adult, the causative agent of this type of pneumonia is called the Friendler's bacillus in a combination of other microorganisms, fungi and viruses.

Symptoms to recognize pneumonia:

shortness of breath, intoxication;
excessive sweating;
increase in body temperature;
bluish facial coverings;
swelling of the nasolabial triangle area;
sputum separation.

In a child, sweating and blue discoloration are most noticeable. Moreover, cyanosis in a child can be observed at the level of the abdomen and upper limbs. The first sign of pneumonia is cough and weakness.

Some patients experience pathology of other organs - for example, gastrointestinal disorder, which can be identified by stool instability, gas formation in the stomach, pain and loss of appetite. The child has lobar pneumonia may be accompanied by loss of consciousness, delirium, hallucinations, especially when the temperature rises.

Adults often note severe weakness and inability to move, even to sit up in bed or walk to the toilet.

In case of intoxication, there is severe insufficiency of the respiratory and cardiovascular systems. Mental condition resembles a disorder with depressed central nervous system activity. If you are not hospitalized in time with these disorders, especially small child– there is a risk of a tragic outcome for the patient. Modern therapy allows you to stop the disease in the first 3–4 days of its course in a hospital setting. This requires timely seeking emergency medical care.

How to recognize pneumonia in a child

The causes of pneumonia in a child are similar to those that cause this disease in adults. But the course of the disease in children may have a number of features that are taken into account when choosing treatment methods.

Features of pneumonia in a child:

temperature not higher than 38;
the febrile state cannot be controlled by any medications;
shortness of breath and rapid breathing, cough may be absent;
at infant shortness of breath is combined with retraction of the spaces between the ribs.

Later, the child develops other adult symptoms.

Atypical pneumonia

The causes of atypical pneumonia have already been listed above, so let’s look at its first signs:

fever and fever;
dyspnea;
increase in heart rate to 100 at rest;
pain in the sternum;
Possible diarrhea, headaches and skin rash due to worsening protective functions body. Atypical pneumonia occurs with a dry, non-productive cough.

Further development depends on the causative agent of the disease and leads to complications such as edema, abscess, psychosis, and pneumothorax.

The widespread use of antibiotics, which has increased in Lately, leads to the fact that some inflammatory processes in the lungs may occur without symptoms.

Bacterial infections and pneumonia

The bacterial causative agent of pneumonia is characterized by a sharp sudden increase in body temperature, even up to 41 degrees. This temperature can last up to 3 days and is an indication for taking antibacterial drugs. If within 72 hours the temperature changed abruptly, then we can conclude that viral infection, which is not amenable to antibiotic treatment. Bacterial pneumonia characterized brown sputum, a constant obsessive cough, attacks of which are worse at night. The fatigue of patients is reduced, so they can move around without experiencing much discomfort. When inhaling, pain is felt in the sternum.

If not applied urgent treatment, pneumonia can destroy lung tissue, forming cavities and abscesses, a sign of which will be incipient intoxication.

Viral pneumonia

The virus penetrates the cells of the alveoli, forming swelling of the lung tissue. In this case, the blood supply is disrupted, and medications cannot be delivered to lesions through the bloodstream. Symptoms of a viral infection are also accompanied by high temperature, chest pain, cough. Antiviral and symptomatic drugs are used for treatment.

SARS syndrome

A new disease within the concept of pneumonia, which appeared in international classification about 10 years ago. It can be caused by viruses of the Paramyxoviridae and Coronavirus families. These pathogens multiply in the cells of the upper respiratory tract, causing tissue changes and swelling that is not eliminated by antibiotics. Often such viruses claim human lives in 4-5 days. The first three days are decisive, and if there is regression, then the body can cope with the disease itself, but if it worsens, the prognosis is very disappointing.

Signs of SARS syndrome:

cyanosis of the facial skin;
decreased blood pressure and swelling;
swelling of the lymph nodes;
increase in the number of lymphocytes in the blood.

Lung pathologies can lead to heart failure and kidney inflammation, brain disorders. It is important to pay attention to the disease at its first symptoms in order to avoid complications and unfavorable outcomes.