What does a child who has had pneumonia have the right to? What complications can pneumonia cause in children? Causes of the disease

The children's body is most susceptible to viruses and bacteria, and therefore the complications of pneumonia in children are the most severe. This is especially true for infants and children under 3-4 years of age, who cannot explain what exactly hurts them. In order to understand what the consequences of pneumonia are, you should understand the mechanism of development of the disease, its symptoms and ways to combat it.

Signs of deterioration in the condition of pneumonia in childhood can form not only during its treatment, but also for a certain time after a period of significant improvement has occurred. Experts highlight acute processes, associated with, as well as the consequences of a remote order. Speaking about the latter, it should be noted that they can manifest as calcifications, myositis and calcareous deposits throughout the patient’s later life.

In this regard, recovery from the consequences of pneumonia in childhood should be competent. It is recommended that in case of primary symptoms of complications of the disease, resort to correct medical recovery measures.

Possible complications

The consequences of pneumonia in children are long lasting and debilitating.

Complications can worsen the child’s entire subsequent life and even pose a real threat to his life.

The most common consequences of pneumonia include:

• pleurisy, or inflammation of the pleura - it is the inner membrane that lines the thoracic area;
• pulmonary destruction, or total progressive destruction of lung tissue;
• Cardiopulmonary failure is one of the main factors in infant mortality.

In addition, in more rare cases, we can talk about lung abscess and bacteremia.

The main thing about pleurisy

The inflammatory process of the pleura, which is two thin balls between the lungs and the sternum, occurs not only in children, but also in adults. In more rare cases, liquid accumulates in the presented space, which is called. This can be a protracted and small-focal form. At least 50% of the total number of patients hospitalized with pneumonia suffer from exudate.

The liquid begins to put pressure on the lungs, which greatly complicates the breathing process, and vomiting is less likely to be provoked. Most often, the body is able to cope with the disease during treatment. In 1 out of 10 cases, the exudate that became the catalyst for pleurisy becomes infected with bacteria.

With such a pathology, the formation of pus is provoked (). The contaminated liquid is removed using a thin needle. In problematic situations, surgical intervention is necessary to resect pus, injuries in the pulmonary area and pleura in children.

Respiratory failure

The presented consequence is one of the most frequently occurring types of complications in children of younger and older ages. Manifestations of complications of pneumonia as insufficiency respiratory type characteristic of the presented state, we are talking about:

• shortness of breath;
• shallow breathing;
• changing the shade of the lips and nasolabial triangle to blue;
• increased respiratory rate.

Experts have developed a specific classification of this pathology, which has 3 sequentially developing stages. The first degree, in which shortness of breath develops as part of a standard physical activity. This is followed by the second stage, when shortness of breath occurs with relatively little exertion, and, finally, the third stage - a permanent, protracted problem and even vomiting at rest.

Heart problems

Manifests itself as part of a severe form of pneumonia in childhood. When there is no adequate treatment, this can provoke the formation of processes of permanent insufficiency of blood flow and endocarditis.

Symptoms of this deficiency in pneumonia in children may appear within a few hours from the onset of the disease. This is triggered by progressive intoxication and the fact that dehydration of the body begins.

With cardiac failure, complications vary. Also, this may be a pulmonary increase in pressure indicators, destabilization of blood circulation in the area of ​​​​the small vessels. In addition, the condition is expressed in a sharp increase in the degree of permeability of membranes and capillaries. This provokes the formation of swelling:

• shortness of breath progresses;
• breathing becomes noisy and bubbling;
• a cough develops with the formation of foamy sputum;
• vomit.

When listening as part of the complication, the tones of the heart muscle remain muffled, and in the pulmonary area there is a significant ratio of moist rales.

Other consequences

Speaking about other complications, it should be noted a pulmonary abscess, which is quite rare in childhood. Mostly observed in people with chronic diseases and depending on alcoholic drinks. With this pathology, cavities filled with purulent masses form in the pulmonary area.

Manifestations of an abscess in patients are typical - a distinct smell of sputum, as well as swelling of the fingers of the upper and lower extremities.

Sometimes a small-focal form occurs, in which individual areas are affected, and not the limbs as a whole. Therapy for an abscess involves intravenous antibiotics for initial stage treatment. After this, you need to take tablets for 4-6 weeks.

The next consequence is bacteremia, which is a specific condition of the child’s body in which viruses and bacteria end up in the bloodstream. Incorrect diagnosis provokes the accumulation of harmful toxins in the child’s hemostasis. This indicates that cytokines are produced in the immune system, which trigger the onset of the inflammatory process.

Thus, a specific and progressive response of the body begins, which is known as blood poisoning. Symptoms of sepsis after pneumonia in children:

• elevated temperature indicators - more than 38 degrees;
• forced heartbeat and respiratory rhythm;
• low blood pressure (hypotension), which provokes vertigo;
• destabilization of mental behavior resembling disorientation;
• decrease in diuresis parameters;
• pallor and moisture of the epidermis;
• brief loss of consciousness.

Due to blood poisoning infectious process may affect other organs and systems of the child’s body. A protracted form of meningitis, peritonitis, as well as septic arthritis or endocarditis is formed.

Treatment of complications

All therapeutic measures, aimed at restoring the child’s body, must have a certain focus. We are talking about 100% elimination residual effects, resorption of possible scars in the pleural area and, which is necessary, stimulation and optimization of immune tone. The main restoration measures include:

• the use of absorbable drugs and biological activators that are approved for use by children;
• physiotherapeutic procedures;
• the use of decoctions and infusions of herbs that have restorative value is permitted after consultation with a specialist, especially if the form is protracted;
• improvement of the intestinal flora after using a course of antibiotics;
• vitamin therapy.

It is permissible to resort to the method of aerotherapy, which is oxygen therapy through a nasal catheter. It is installed in the lower nasal passage. In this case, the child will receive from 25 to 35% of the required oxygen mass ratio. The substance must be supplied continuously over an extended period of time. Usually from 2 to 10 hours - depending on the severity of the disease.

During treatment it is necessary to maintain patency respiratory tract, that is, to optimize the drainage function of the bronchial region. For this purpose, mucolytics (drugs that thin mucous secretions) are used. In order to improve intravascular circulation, 2.4% aminophylline is used, which is administered intravenously in an amount of 0.1 ml/kg to children under 12 months. Next you need to add 1 ml for each next year life for children from 1 year.

Xanthinol nicotinate and warm-moist inhalations may also be effective.

Vaccination and prevention

Preventive medications, or vaccines, are available for infections that affect possible consequences. If a child is likely to develop opportunistic infections, then the vaccine may be a salvation for a weak immune background.

In addition, in order to avoid complications with pneumonia, it is necessary to contact a specialist if there are symptoms of a cold, acute respiratory viral infection or prolonged cough. A disease detected on time is much easier to treat than in an advanced form. When recovering from an illness, you must adhere to healthy image life, give up alcohol and nicotine addiction.

You should also exercise, get plenty of rest and remember balanced diet. Another effective means of prevention is infection control, which is especially necessary for children. All the measures presented here will help to cope with complications as soon as possible.

Pneumonia can have consequences such as: early period course of the disease, and against the background of general improvement. Pneumonia in newborns is especially dangerous: the consequences of this process often lead to the death of the baby. Intrauterine pneumonia has no less terrible consequences if adequate treatment has not been carried out. conservative treatment. The most common toxic consequence in children is pneumonia. It is usually formed by pneumonia in a child with manifestations of intestinal toxicosis or neurotoxicosis.

Clinical manifestations of intestinal toxicosis in the form of consequences of pneumonia usually begin at an early stage of the disease. All symptoms completely disappear by the time of complete recovery.

There are three stages of toxicosis and three degrees of internal toxicosis:

Toxicosis:
Stage I- with increased functions of all organs and systems; the child is excited, restless; vomiting, liquid and frequent bowel movements, tachycardia are observed;
Stage II- decreased functioning of organs and systems; the child is inactive and indifferent; perhaps a disturbance of consciousness - stupor or stupor;
Stage III- loss of consciousness.

Internal toxicosis:
I degree- loss of body weight up to 5%; the child has moderate thirst, the mucous membranes are dry;
II degree- loss of body weight from 5 to 10%; dry skin and mucous membranes, decreased tissue elasticity, sunken fontanel, tachycardia, arterial pressure reduced; frequent vomiting, stool 10 times a day or more;
III degree- loss of more than 10% body weight; dry mucous membranes, pointed facial features, skin without elasticity, shortness of breath, muffled heart sounds, lack of urination, intestines do not work.

The basic principles of treatment of the toxic effects of pneumonia in newborns are:

• Combating low oxygen levels in the blood and lung tissue;
• Therapy aimed at treating the consequences of toxicosis.

What are the consequences of pneumonia in newborns?

Acute pneumonia in newborns often results in severe and difficult-to-correct conditions. Treatment of toxicosis due to pneumonia in children is carried out in a hospital.

The main measures for treating toxicosis are:

1) normalization of peripheral circulatory disorders by performing a blockade in order to:

• elimination of centralization of blood circulation;
• reducing inadequate activity of brain parts involved in the pathological process;

2) carrying out detoxification therapy for the purpose of:

• collecting toxins and removing them from the body;
• correction of disturbances in water-electrolyte metabolism and acid-base status;
• providing increased energy cellular metabolism with the required amount of fluid;
• changes (improvement) in the rheological properties of blood;

3) treatment of heart failure;
4) prevention and therapy of disseminated intravascular coagulation;
5) symptomatic therapy.

Detoxification therapy for the consequences of pneumonia

Detoxification treatment of the consequences of pneumonia in children is intravenous therapy, in which forced diuresis is assumed. The indicator for intravenous therapy is the comatose or stuporous state of the patient; persistent body hyperthermia, which does not respond to standard treatment methods; the patient has uncontrollable vomiting and intestinal dysfunction, which caused dehydration and electrolyte disturbances; destructive forms of pneumonia with severe infectious toxicosis; dyspeptic digestive disorders, in which standard diets are undesirable.

This therapy begins with drip infusions intravenous glucose and saline solutions. When calculating the amount of sodium required per day, it should be taken into account that a 5% albumin solution contains 154 mmol/l sodium and 0.5 mmol/l potassium, a 5% plasma solution contains 142 mmol/l sodium, 5 mmol/l potassium.

The volume of fluid is calculated in any case depending on the state of the child’s cardiovascular system, the presence of signs of dehydration (degree of internal toxicosis), and the presence or absence of pathological symptoms (diarrhea, fever). Physiological fluid requirements can be determined using the Aberdeen nomogram.

Consequences of pneumonia in children with delayed diuresis

In most cases, the consequences of pneumonia in children manifest themselves in the form of urinary retention. Diuresis is controlled with the help of diuretics (Lasix or furosemide) at a dose of 1-3 mg per 1 kg of child weight. The forced diuresis technique involves accurate hourly recording of diuresis, which is carried out by inserting a catheter into the bladder. Forced diuresis is carried out in three options:

• elimination of dehydration;
• normalization of water salt metabolism;
• relief of symptoms high content fluids in the child's body.

The regimen for eliminating dehydration is indicated when carrying out detoxification therapy in children with pastosity, edema and low rate hematocrit. During the administration of protein preparations, diuresis per 1 hour (less than 2 hours) is taken into account. The amount of liquid for the next hour is equal to the diuresis of the previous one, that is, the number of drops of liquid poured into the vein per unit time is equal to the number of drops of urine excreted. It turns out that the regime for eliminating dehydration is ensured by compensation of physiological losses with a surplus. The liquid is infused: 10% glucose with the addition of potassium, sodium, calcium salts in accordance with physiological needs.

The mode of normalization of water salt metabolism is used in patients with toxicosis without peripheral circulatory disorders or heart failure. The volume of fluid per hour is calculated as the sum of: diuresis for the previous hour + absorption losses (1 ml per kg of weight) + the volume of pathological daily losses (20 ml / kg for vomiting and diarrhea + 10 ml / kg for each degree of elevated temperature).

The regime for eliminating excess fluid is carried out for patients in whom toxicosis is combined with severe peripheral circulatory disorders, but without heart failure.

Forced diuresis should be carried out only in the intensive care unit, by well-instructed personnel and round-the-clock laboratory and functional monitoring for the following indicators: relative density of urine, hematocrit, plasma and erythrocyte electrolytes, blood glucose and urine sugar, residual nitrogen, acid-base state of the blood, central venous pressure, electrocardiogram.

If continuous intravenous therapy must last more than a day, then central veins (subclavian or femoral) are catheterized to carry it out. Monitoring of diuresis is carried out by recording the urine drained by an indwelling catheter. Blood plasma transfusions and blood purification using an artificial kidney apparatus are also used for detoxification purposes.

Differentiated therapy (carried out simultaneously with general treatment):

1. For pulmonary capillary hypertension, a blockade is used, which reduces venous return to the heart and blood flow into the pulmonary artery, pulmonary pressure (nitroglycerin), cardiac glycosides for myocardial insufficiency (digoxin in an age-related dose);
2. If intracellular pressure is low, plasma transfusion is prescribed.

With increased permeability of the alveolar-capillary membrane, the following is carried out:

A) normalization of hemodynamics of the pulmonary circulation (using aminophylline, nitroglycerin);
b) fight against low content oxygen in the blood;
V) appointment hormonal drugs(initial dose of prednisolone - 1-2 mg/kg i.v.) and antihistamines(1 mg/kg IM three times daily);
G) correction of metabolic acidosis (cocarboxylase, and after normalization of ventilation - sodium bicarbonate intravenously depending on the acid-base state of the blood);
d) intravenous infusions of solutions of calcium gluconate and ascorbic acid.

In case of bloating and increased production of intestinal gases, a massage of the abdomen is performed, sorbitol is administered intravenously (1 ml per 1 kg of body weight in the form of a 10% solution in a 5% glucose solution or isotonic solution sodium chloride), 10% albumin solution, 20% vitamin B5 solution (0.5 -1 ml). For hypokalemia, potassium supplements are prescribed under the control of electrolytes. Cerucal (0.1 ml of 1% solution per year of life) or prozerin (0.1 ml of 0.05% solution per year of life), vitamins B1 (0.3-0.5 ml of 2.5% solution) are administered intramuscularly. ). In case of severe staphylococcal decay of the lungs and in the presence of flatulence, Trasylol or Contrical is added to therapy (1000 units per 1 kg IV drip). If these measures are ineffective, intravertebral anesthesia is performed. Systematic vomiting and regurgitation is an indication for gastric lavage to wash out mucus.

Prevention of intravascular coagulation with heparin is indicated for all children on artificial ventilation lungs and on full intravenous nutrition, in case of sepsis, destructive pneumonia. For this purpose and for the prevention of thrombosis of regional vessels and catheter with complete parenteral nutrition Heparin is prescribed at a dose of 0.2 units per 1 ml of any solution.

Consequences after pneumonia in the form of seizures

Children often experience consequences after pneumonia in the form of seizures. To relieve convulsive syndrome, special medical methods are used. For seizures, treatment measures are aimed at eliminating the main causes: low levels of oxygen in the blood, cerebral edema. Drugs that reduce brain excitability are used: seduxen (0.05-0.1 ml/kg 0.5% solution) or g-hydroxybutyric acid (GHB) intravenously or intramuscularly, phenobarbital
intravenously or intramuscularly (initial dose - 20 mg/kg the first day and then 3-4 mg/kg daily), magnesium sulfate intramuscularly (0.2 ml/kg 25% solution per injection). The anticonvulsant effect of GHB can be enhanced by simultaneous administration of droperidol (0.1 ml/kg 0.25% solution intramuscularly or intravenously, but the dose of GHB is reduced to 50 mg/kg per injection). If drug relief of seizures is ineffective, a spinal puncture is indicated (for therapeutic and diagnostic purposes).

Treatment of the consequences of pneumonia with surgical methods

In children, treatment of the consequences of pneumonia surgical method Used only in cases of lung collapse. In case of staphylococcal decay of the lungs, it is necessary to use different routes of antibiotic administration: intravenous, intramuscular, aerosol, and, if indicated, locally - into the pleural cavity or abscess. For staphylococcal pneumonia, clear positive effect will create antistaphylococcal immunoglobulin at a dose of 20 AE/kg daily or every other day, 5-7 injections. Other immunoglobulins are administered. At the height of severe toxicosis, a number of clinics successfully use blood and plasma purification, which promotes the release of bacterial toxins and autotoxic substances arising during the course of the disease from the patient’s blood.

Due to the ability to suppress the enzymatic activity of microorganisms and increase their antibiotic sensitivity wide application In the treatment of purulent infections, drugs that inhibit protein breakdown have been found. For this purpose, Trasylol is used at a dose of 500-1000 inhibitory units or Contrical at a dose of 250-500 units per 1 kg of body weight intravenously twice a day for the first 5-6 days, then according to indications.

A patient with staphylococcal decay of the lungs is monitored jointly by a pediatrician and pediatric surgeon. The tactics of surgeons boil down to the following: with simple inflammatory foci, in most cases, surgical assistance is not required; tense air cavities puncture and remove air. For abscesses with good physiological separation of sputum, treatment measures consist of creating a drainage position, performing breathing exercises, and prescribing alkaline aerosols with antibiotics 4-6 times a day. In case of progressive pneumonia with a large accumulation of fluid in the pleural cavity, bronchoscopy with lavage is indicated in most cases bronchial tree proteolytic enzymes (chymotrypsin, Mucomist). Hyperimmune antistaphylococcal gammaglobulin is prescribed intramuscularly 3 to 5 times depending on the severity of the disease.

With giant abscesses, there is a constant threat of its breakthrough and infection of the pleural cavity, and puncture only accelerates this process. In these cases, urgent surgical intervention (drainage) is recommended.

For all pulmonary-pleural complications of staphylococcal destruction of the lungs, emergency surgical care is required: pleural puncture (purulent inflammation of the pleura of the pleura), and drainage of the pleural cavity with active removal of pus or radical surgery - removal of the affected part of the lungs. Children with tension (“valvular”) pneumothorax (blockage of air in the pleural cavity and compression lung tissue) is necessary emergency help: an internal puncture is made in the front or back chest wall using a thick puncture needle, thereby converting a closed tension pneumothorax into an open one. This simple surgical action helps doctors save the life and health of a child. To do this you need to convert it to surgery department where direct drainage of the pleural cavity is performed or radical surgery is performed.

Pneumonia should be understood as an acute or chronic infectious-inflammatory process that develops in the lung tissue and causes a syndrome of respiratory distress.

Pneumonia is a serious disease of the respiratory system in children. The incidence is sporadic, but in rare cases, outbreaks of the disease may occur among children in the same group.

The incidence rate of pneumonia in children under 3 years of age is about 20 cases per 1 thousand children of this age, and in children over 3 years old - about 6 cases per 1 thousand children.

Causes of pneumonia

Pneumonia is a polyetiological disease: different pathogens of this infection are more typical for different age groups. The type of pathogen depends on the condition and on the conditions and location of children with the development of pneumonia (in a hospital or at home).

Pneumonia can be caused by:

• pneumococcus – in 25% of cases;
• – up to 30%;
• chlamydia – up to 30%;
• (golden and epidermal);
• coli;
• fungi;
• mycobacterium;
• hemophilus influenzae;
• Pseudomonas aeruginosa;
• pneumocystis;
• legionella;
• viruses (parainfluenza, adenovirus).

Thus, in children aged from the second half of life to 5 years old who fall ill at home, pneumonia is most often caused by Haemophilus influenzae and pneumococcus. In children of preschool and primary school age, pneumonia can be caused by mycoplasma, especially during the transitional summer-autumn period. In adolescence, chlamydia can cause pneumonia.

When pneumonia develops outside a hospital setting, the patient's own (endogenous) bacterial flora located in the nasopharynx is more often activated. But the pathogen can also come from outside.

Factors contributing to the activation of one’s own microorganisms are:

• development ;
• hypothermia;
• aspiration (entry into the respiratory tract) of vomit during regurgitation, food, foreign body;
• in the child’s body;
• Congenital heart defect;
• stressful situations.

Although pneumonia is mainly bacterial infection, it can also be caused by viruses. This is especially true for children in the first year of life.

With frequent regurgitation in children and possible entry of vomit into the respiratory tract, pneumonia can also be caused by Staphylococcus aureus, and E. coli. Pneumonia can also be caused by Mycobacterium tuberculosis, fungi, and in rare cases, Legionella.

Pathogens enter the respiratory tract and from outside, by airborne droplets(with inhaled air). In this case, pneumonia can develop as a primary pathological process (lobar pneumonia), or it can be secondary, occurring as a complication of the inflammatory process in the upper respiratory tract (bronchopneumonia) or in other organs. Currently, secondary pneumonia is more often recorded in children.

When infection penetrates into the lung tissue, swelling of the mucous membrane of the small bronchus develops, as a result of which the supply of air to the alveoli becomes difficult, they collapse, gas exchange is disrupted, and oxygen starvation develops in all organs.

There are also hospital-acquired (nosocomial) pneumonias, which develop in a hospital setting during treatment of a child for another disease. The causative agents of such pneumonia can be “hospital” strains resistant to antibiotics (staphylococci, Pseudomonas aeruginosa, Proteus, Klebsiella) or microorganisms of the child himself.

Development hospital-acquired pneumonia The antibacterial therapy the child receives contributes: it has a detrimental effect on the normal microflora in the lungs, and instead of it, flora alien to the body populates them. Hospital-acquired pneumonia occurs after two or more days of hospital stay.

Pneumonia in newborns in the first 3 days of life can be considered a manifestation of hospital pneumonia, although in these cases it is difficult to exclude intrauterine infection.

Pulmonologists also distinguish lobar pneumonia, caused by pneumococcus and involving several segments or the entire lobe of the lung with a transition to the pleura. More often it develops in preschool and school age children, rarely up to 2-3 years. Typical for lobar pneumonia is damage to the left lower lobe, less often to the right lower and right upper lobes. IN infancy it manifests itself in most cases as bronchopneumonia.

Interstitial pneumonia is manifested by the fact that the inflammatory process is predominantly localized in the interstitial connective tissue. It is more common in children in the first 2 years of life. It is particularly severe in newborns and infants. It is more common in the autumn-winter period. It is caused by viruses, mycoplasma, pneumocystis, chlamydia.

In addition to bacterial and viral, pneumonia can be:

• occur when;
• associated with the action of chemical and physical factors.

Why do young children get pneumonia more often?

How smaller child, the higher the risk of developing pneumonia and the severity of its course. Frequent occurrence Pneumonia and its chronicity in children are facilitated by the following characteristics of the body:

• the respiratory system is not fully formed;
• the airways are narrower;
• the lung tissue is immature, less airy, which also reduces gas exchange;
• mucous membranes in the respiratory tract are easily vulnerable, have a lot blood vessels, quickly with inflammation;
• the cilia of the mucosal epithelium are also immature and cannot cope with the removal of mucus from the respiratory tract during inflammation;
• abdominal type of breathing in babies: any “problem” in the abdomen (bloating, swallowing air into the stomach during feeding, enlarged liver, etc.) further complicates gas exchange;
• immaturity of the immune system.

The following factors also contribute to the occurrence of pneumonia in babies:

• artificial (or mixed) feeding;
• passive smoking, which occurs in many families: has toxic effect on the lungs and reduces the supply of oxygen to the child’s body;
• malnutrition, rickets in a child;
• insufficient quality of child care.

Symptoms of pneumonia

According to existing classification, pneumonia in children can be one- or two-sided; focal (with areas of inflammation 1 cm or more); segmental (inflammation spreads to the entire segment); drain (the process involves several segments); lobar (inflammation is localized in one of the lobes: the upper or lower lobe of the lung).

Inflammation of the lung tissue around the inflamed bronchus is interpreted as bronchopneumonia. If the process extends to the pleura, pleuropneumonia is diagnosed; if fluid accumulates in the pleural cavity, this is already a complicated course of the process and has arisen.

The clinical manifestations of pneumonia largely depend not only on the type of pathogen that caused the inflammatory process, but also on the age of the child. In older children, the disease has more clear and characteristic manifestations, and in children, with minimal manifestations, severe respiratory failure and oxygen starvation can quickly develop. It is quite difficult to predict how the process will develop.

Initially, the baby may experience slight difficulty in nasal breathing, tearfulness, and loss of appetite. Then the temperature suddenly rises (above 38°C) and persists for 3 days or longer, increased breathing and pallor of the skin, pronounced cyanosis of the nasolabial triangle, and sweating appear.

Auxiliary muscles are involved in breathing (the retraction of the intercostal muscles, supra- and subclavian fossae during breathing is visible to the naked eye), and the wings of the nose swell (“sail”). The respiratory rate during pneumonia in an infant is more than 60 per minute, in a child under 5 years old it is more than 50.

A cough may appear on days 5-6, but it may not exist. The nature of the cough can be different: superficial or deep, paroxysmal, unproductive, dry or wet. Sputum appears only if the bronchi are involved in the inflammatory process.

If the disease is caused by Klebsiella (Friedlander's bacillus), then signs of pneumonia appear after previous dyspeptic symptoms (and vomiting), and a cough may appear from the first days of the disease. It is this pathogen that can cause an epidemic outbreak of pneumonia in a children's group.

In addition to palpitations, other extrapulmonary symptoms may occur: muscle pain, skin rashes, diarrhea, confusion. IN early age The baby may appear at high temperatures.

When listening to the child, the doctor may detect weakened breathing in the area of ​​inflammation or asymmetric wheezing in the lungs.

With pneumonia in schoolchildren and adolescents, there are almost always previous minor manifestations. Then the condition returns to normal, and a few days later chest pain and a sharp rise in temperature appear. The cough occurs over the next 2-3 days.

With pneumonia caused by chlamydia, catarrhal manifestations in the pharynx and enlarged neck are noted. And with mycoplasma pneumonia, the temperature may be low, a dry cough and hoarseness may be noted.

With lobar pneumonia and spread of inflammation to the pleura (that is, with lobar pneumonia) breathing and coughing are accompanied by severe pain in the chest. The onset of such pneumonia is violent, the temperature rises (with chills) to 40°C. Symptoms of intoxication are expressed: vomiting, lethargy, and possibly delirium. Abdominal pain, diarrhea, and bloating may occur.

Herpetic rashes on the lips or wings of the nose and redness of the cheeks often appear on the affected side. Can be . The breath is moaning. The cough is painful. The ratio of respiration and pulse is 1:1 or 1:2 (normally, depending on age, 1:3 or 1:4).

Despite the severity of the child’s condition, when listening to the lungs, scanty data are revealed: weakened breathing, intermittent wheezing.

Lobar pneumonia in children differs from its manifestations in adults:

• “rusty” sputum usually does not appear;
• not everything is always affected lung lobe, more often the process captures 1 or 2 segments;
• signs of lung damage appear later;
• the outcome is more favorable;
• wheezing in the acute phase is heard in only 15% of children, and in almost all of them it is in the resolution stage (moist, persistent, not disappearing after coughing).

Special mention should be made staphylococcal pneumonia, given its tendency to develop complications in the form of abscesses in the lung tissue. Most often, it is a variant of nosocomial pneumonia, and Staphylococcus aureus, which caused the inflammation, is resistant to Penicillin (sometimes to Methicillin). Outside the hospital, it is recorded in rare cases: in children with an immunodeficiency state and in infants.

Clinical symptoms of staphylococcal pneumonia are characterized by a higher (up to 40°C) and longer-lasting fever (up to 10 days), which is difficult to respond to antipyretics. The onset is usually acute, and symptoms (blueness of the lips and extremities) increase quickly. Many children experience vomiting, bloating, and diarrhea.

If there is a delay in starting antibacterial therapy An abscess (ulcer) forms in the lung tissue, posing a danger to the child’s life.

Clinical picture interstitial pneumonia differs in that signs of damage to the cardiovascular and nervous systems come to the fore. Sleep disturbance is noted, the child is first restless, and then becomes indifferent and inactive.

Heart rate up to 180 per minute may be observed. Severe blueness of the skin, shortness of breath up to 100 breaths in 1 minute. The cough, initially dry, becomes wet. Foamy sputum is characteristic of Pneumocystis pneumonia. Elevated temperature within 39°C, wavy in nature.

In older children (preschool and school age), the clinical picture is poor: moderate intoxication, shortness of breath, cough, low-grade fever. The development of the disease can be both acute and gradual. In the lungs, the process tends to develop fibrosis and become chronic. There are practically no changes in the blood. Antibiotics are ineffective.

Diagnostics

Auscultation of the lungs will suggest pneumonia.

Various methods are used to diagnose pneumonia:

• A survey of the child and parents makes it possible to find out not only complaints, but also to establish the timing of the disease and the dynamics of its development, clarify previous diseases and the presence of allergic reactions in the child.
• Examination of the patient gives the doctor a lot of information in case of pneumonia: identifying signs of intoxication and respiratory failure, the presence or absence of wheezing in the lungs and other manifestations. When tapping the chest, the doctor can detect a shortening of the sound over the affected area, but this sign is not observed in all children, and its absence does not exclude pneumonia.

In small children clinical manifestations may be small, but intoxication and respiratory failure will help the doctor suspect pneumonia. At an early age, pneumonia is “seen better than heard”: shortness of breath, retraction of auxiliary muscles, cyanosis of the nasolabial triangle, refusal to eat may indicate pneumonia even if there are no changes when listening to the child.

• An X-ray examination (x-ray) is prescribed if pneumonia is suspected. This method allows not only to confirm the diagnosis, but also to clarify the localization and extent of the inflammatory process. This data will help prescribe the correct treatment for your child. This method is also of great importance for monitoring the dynamics of inflammation, especially in the event of complications (destruction of lung tissue,).
• A clinical blood test is also informative: with pneumonia, the number of leukocytes increases, the number of band leukocytes increases, and the ESR accelerates. But the absence of such changes in the blood characteristic of the inflammatory process does not exclude the presence of pneumonia in children.
• Bacteriological analysis of mucus from the nose and throat, sputum (if possible) allows you to identify the type of bacterial pathogen and determine its sensitivity to antibiotics. The virological method makes it possible to confirm the involvement of the virus in the occurrence of pneumonia.
• ELISA and PCR are used to diagnose chlamydial and mycoplasma infections.
• In case of severe pneumonia, if complications develop, they are prescribed biochemical analysis blood, ECG, etc. (according to indications).

Treatment

Treatment in a hospital setting is carried out for young children (up to 3 years), and at any age of the child if there are signs of respiratory failure. Parents should not object to hospitalization, as the severity of the condition can increase very quickly.

In addition, when deciding on hospitalization, other factors should be taken into account: malnutrition in the child, developmental abnormalities, the presence of concomitant diseases, the child’s immunodeficiency state, socially vulnerable family, etc.

For older children, treatment can be arranged at home if the doctor is confident that the parents will carefully follow all prescriptions and recommendations. The most important component of treating pneumonia is antibacterial therapy taking into account the probable pathogen, since it is almost impossible to accurately determine the “culprit” of inflammation: it is not always possible to obtain material for research from a small child; In addition, it is impossible to wait for the results of the study and not begin treatment until they are received, so the choice of a drug with the appropriate spectrum of action is based on the clinical characteristics and age data of young patients, as well as the experience of the doctor.

The effectiveness of the selected drug is assessed after 1-2 days of treatment based on the improvement of the child’s condition, objective data during examination, and dynamic blood tests (in some cases, repeated radiography).

If there is no effect (preservation of temperature and deterioration of the X-ray picture in the lungs), the drug is changed or combined with a drug from another group.

To treat pneumonia in children, antibiotics from 3 main groups are used: semisynthetic penicillins (Ampicillin, Amoxiclav), cephalosporins of the second and third generations, macrolides (Azithromycin, Rovamycin, Erythromycin, etc.). At severe course diseases, aminoglycosides, imipinemes can be prescribed: they combine drugs from different groups or in combination with Metronidazole or sulfonamides.

So, newborns For the treatment of pneumonia that developed in the early neonatal period (within the first 3 days after birth), Ampicillin (Amoxicillin/clavulanate) is used in combination with third-generation cephalosporins or an aminoglycoside. Pneumonia in more later occurrence is treated with a combination of cephalosporins and Vacomycin. In case of isolation of Pseudomonas aeruginosa, Ceftazidime, Cefoperazone or Imipinem (Tienam) are prescribed.

Babies in the first 6 months after birth, the drug of choice is macrolides (Midecamycin, Josamycin, Spiramycin), because most often in infants it is caused by chlamydia. Pneumocystis pneumonia can also give a similar clinical picture, therefore, if there is no effect, Co-trimoxazole is used for treatment. And for typical pneumonia, the same antibiotics are used as for newborns. If it is difficult to determine the likely pathogen, two antibiotics from different groups are prescribed.

Legionella pneumonia is preferably treated with Rifampicin. For fungal pneumonia, Diflucan, Amphotericin B, and Fluconazole are necessary for treatment.

In case of non-severe community-acquired pneumonia and if the doctor has doubts about the presence of pneumonia, the start of antibacterial therapy can be postponed until the results of the X-ray examination are obtained. In older children, in mild cases, it is better to use internal antibiotics. If antibiotics were administered by injection, then after the condition improves and the temperature normalizes, the doctor transfers the child to internal medications.

Of these drugs, it is preferable to use antibiotics in the form of Solutab: Flemoxin (Amoxicillin), Vilprafen (Josamycin), Flemoclav (Amoxicillin/clavulanate), Unidox (Doxycycline). The Solutab form is very convenient for children: the tablet can be dissolved in water and can be swallowed whole. This form gives less side effects in the form of diarrhea.

Fluoroquinolones can be used in children only in extremely severe cases for health reasons.

• Along with antibiotics or after treatment, it is recommended taking biological products to prevent dysbacteriosis (Linex, Hilak, Bifiform, Bifidumbacterin, etc.).
• Bed rest is prescribed for the period of fever.
• It is important to ensure required volume of liquid in the form of drinks (water, juices, fruit drinks, herbal teas, vegetable and fruit decoction, Oralit) - 1 liter or more, depending on the age of the child. For a child under one year of age, the daily fluid volume is 140 ml/kg body weight, taking into account breast milk or formula. The liquid will ensure normal flow and, to some extent, detoxification: toxic substances will be removed from the body with urine. Intravenous administration of solutions for the purpose of detoxification is used only in severe cases of pneumonia or when complications occur.
• In case of extensive inflammatory process, in order to prevent the destruction of lung tissue in the first 3 days, they can be used antiproteases(Gordox, Kontrikal).
• In cases of severe hypoxia (oxygen deficiency) and severe disease, it is used oxygen therapy.
• In some cases, the doctor recommends vitamin preparations.
• Antipyretics Prescribed at high temperatures for children at risk of developing seizures. They should not be given to your child systematically: firstly, fever stimulates defenses and the immune response; secondly, many microorganisms die at high temperatures; thirdly, antipyretics make it difficult to assess the effectiveness of prescribed antibiotics.
• If complications occur in the form of pleurisy, they can be used in a short course; for persistent fever - (Diclofenac, Ibuprofen).
• If a child has a persistent cough, use mucus thinners and facilitating its release. For thick, viscous sputum, mucolytics are prescribed: ACC, Mukobene, Mucomist, Fluimucin, Mukosalvan, Bisolvon, Bromhexine.

A prerequisite for thinning sputum is sufficient drinking, since with a lack of fluid in the body, the viscosity of sputum increases. In terms of mucolytic effect, inhalation with warm alkaline mineral water or a 2% solution of baking soda is not inferior to these drugs.

• To facilitate the discharge of sputum, it is prescribed expectorants, which increase the secretion of liquid sputum contents and enhance bronchial motility. For this purpose, mixtures with marshmallow root and iodide, ammonia-anise drops, Bronchicum, and “Doctor Mom” are used.

There is also a group of drugs (carbocysteines) that thin mucus and facilitate its passage. These include: Bronkatar, Mucopront, Mukodin. These drugs help restore the bronchial mucosa and increase local immunity mucous membrane.

As expectorants, you can use infusions of plants (ipecac root, licorice root, nettle herb, plantain, coltsfoot) or preparations based on them (Mukaltin, Eucabal). Cough suppressants are not indicated.

• For each individual child, the doctor decides on the need for antiallergic and bronchodilator drugs. Mustard plasters and cupping are not used in children at an early age.
• The use of general stimulants does not affect the outcome of the disease. Recommendations for their use are not supported by evidence of their effectiveness.
• Physiotherapeutic methods of treatment (microwave, electrophoresis, inductothermy) can be used, although some pulmonologists consider them ineffective for pneumonia. Physical therapy and massage are included in treatment early: after the fever disappears.

The air in the room (ward or apartment) with a sick child should be fresh, humidified and cool (18°C -19°C). You should not force feed your child. As your health and condition improve, your appetite will appear, this is a kind of confirmation of the effectiveness of the treatment.

There are no special dietary restrictions for pneumonia: nutrition must meet age requirements and be complete. A gentle diet may be prescribed in case of bowel dysfunction. IN acute period For illness, it is better to give your child easily digestible foods in small portions.

For dysphagia in infants with aspiration pneumonia, it is necessary to select the position of the child during feeding, the thickness of the food, and the size of the hole in the nipple. In particularly severe cases, feeding the child through a tube is sometimes used.

During the recovery period, it is recommended to carry out a set of health measures (rehabilitation course): systematic walks in the fresh air, drinking oxygen cocktails with juices and herbs, massage and physical therapy. The diet of older children should include fresh fruits and vegetables and be complete in composition.

If a child has any foci of infection, they need to be treated (carious teeth, etc.).

After suffering from pneumonia, the child is observed by a local pediatrician for a year; blood tests and examinations by an ENT doctor, an allergist, a pulmonologist, and an immunologist are periodically performed. If the development of chronic pneumonia is suspected, an x-ray examination is prescribed.

In case of relapse of pneumonia, a thorough examination of the child is carried out in order to exclude an immunodeficiency state, abnormalities of the respiratory system, congenital and hereditary diseases.

Outcome and complications of pneumonia

Children are prone to developing complications and severe pneumonia. Collateral successful treatment and a favorable outcome of the disease is timely diagnosis and early initiation of antibacterial therapy.

In most cases, complete recovery of uncomplicated pneumonia is achieved in 2-3 weeks. If complications develop, treatment lasts 1.5-2 months (sometimes longer). In particularly severe cases, complications can cause the death of the child. Children may experience recurrent pneumonia and the development of chronic pneumonia.

Complications of pneumonia can be pulmonary or extrapulmonary.

Pulmonary complications include:

• lung abscess (ulcer in the lung tissue);
• destruction of lung tissue (melting of tissue with the formation of a cavity);
• pleurisy;
• broncho-obstructive syndrome (obstruction of the bronchial tubes due to their narrowing, spasm);
• acute respiratory failure (pulmonary edema).

Extrapulmonary complications include:

• infectious-toxic shock;
• , endocarditis, (inflammation of the heart muscle or internal and outer shell hearts);
• sepsis (spread of infection through the blood, damage to many organs and systems);
• or meningoencephalitis (inflammation of the membranes of the brain or the substance of the brain with membranes);
• DIC syndrome (intravascular coagulation);

Most frequent complications are destruction of lung tissue, pleurisy and increasing pulmonary-heart failure. Basically, these complications arise from pneumonia caused by staphylococci, pneumococci, and Pseudomonas aeruginosa.

Such complications are accompanied by an increase in intoxication, high persistent fever, an increase in the number of leukocytes in the blood and an acceleration of ESR. They usually develop in the second week of the disease. The nature of the complication can be clarified by repeated x-ray examination.

Prevention

There are primary and secondary prevention of pneumonia.

Primary prevention includes the following measures:

• hardening of the child’s body from the first days of life;
• quality child care;
• daily exposure to fresh air;
• prevention of acute infections;
• timely sanitation of foci of infection.

There is also vaccination against Haemophilus influenzae and against pneumococcus.

Secondary prevention of pneumonia consists in preventing the occurrence of relapses of pneumonia, preventing reinfection and the transition of pneumonia to chronic form.

Summary for parents

Pneumonia is a common serious lung disease among children that can threaten a child’s life, especially at an early age. The successful use of antibiotics has significantly reduced mortality from pneumonia. However, untimely consultation with a doctor, delayed diagnosis and late initiation of treatment can lead to the development of severe (even disabling) complications.

Taking care of the child’s health from early childhood, strengthening the baby’s defenses, hardening and proper nutrition are the best protection against this disease. In case of illness, parents should not try to diagnose their child themselves, much less treat him. A timely visit to the doctor and strict implementation of all his prescriptions will protect the child from unpleasant consequences diseases.

Which doctor should I contact?

Pneumonia in a child is usually diagnosed by a pediatrician. She is being treated in inpatient conditions pulmonologist. Sometimes additional consultation with an infectious disease specialist or phthisiatrician is necessary. During recovery from an illness, it will be useful to visit a physiotherapist, a specialist in physical therapy and breathing exercises. If you have frequent pneumonia, you should contact an immunologist.

We present to your attention a video about this disease.

This is due to the anatomical features of the structure of the respiratory organs and reduced immunity. Pneumonia in young children should be treated only in a hospital setting. This is due to the fact that there are often severe complications that worsen the patient’s condition and complicate treatment. Complications of pneumonia in children may occur due to improper treatment or too low immunity.

Why is pneumonia dangerous in children?

Pneumonia in children is considered a dangerous disease. This is due to the fact that the child’s fragile body is not able to fully fight the infection. If your child is often sick respiratory diseases, then the situation worsens significantly. Against the background of weak immunity, pneumonia is often complicated, especially in children under 4 years of age.

The danger of pneumonia is that the inflamed respiratory organs cannot fully participate in the respiratory process. This leads to oxygen deficiency with all the ensuing consequences.

The deterioration of a sick child’s condition can become noticeable both during treatment and when the baby’s condition has already noticeably stabilized. Most often, this is observed if, at the slightest sign of improvement in the child’s condition, the child stops receiving antibacterial drugs. A superinfection develops that is resistant to many antibiotics and antimicrobial agents.

Treatment of pneumonia in young children should be carried out only in a hospital setting. This will avoid a number of serious complications.

Immediate complications

Pneumonia is dangerous due to its immediate complications. These include pathological conditions that arose in the first couple of days of the disease:

1. Malignant intoxication. With pneumonia, a huge amount of toxic bacterial breakdown products is concentrated in the patient’s blood. This leads to high fever and other symptoms of intoxication. It is very difficult to eliminate hyperthermia; the danger is that the heart suffers and there is a possibility of death.
2. Neurotoxicosis. This is a serious complication that is caused by the effect of toxins on the brain. The disease manifests itself with convulsions, respiratory arrest and other symptoms of brain damage. Temperatures can rise above 40 degrees.

A child who experiences complications from pneumonia is placed in the intensive care unit or intensive care unit. Such patients must be constantly monitored by doctors.

Delayed consequences

Complications of pneumonia can also be delayed. In this case, a deterioration in the condition is observed after pneumonia, against the background of almost complete well-being:

The delayed consequences of pneumonia include multiple destruction. It is manifested by the formation of cavities in the lung tissue. With this complication, a lot of sputum is produced, up to a liter per day.

If any complications of pneumonia occur, the doctor carefully selects medications. Antibiotics of different drug groups are prescribed at the same time.

The most dangerous consequences

There are a number of complications of pneumonia that often lead to fatal outcome. Such complications occur when a doctor is contacted late or treatment is prescribed incorrectly. The cause of such complications may be too reduced immunity:

In case of such complications, the patient is immediately hospitalized. If the condition is severe, resuscitation measures are carried out. Further treatment depends on the age of the patient, his condition and the diagnosis.

Other consequences of pneumonia in a child

Other consequences of pneumonia include a chronic inflammatory process that leads to frequent relapses. In addition, pneumonia can be complicated by the following conditions:

• Acute respiratory failure. This pathology is often observed in preschool children. It occurs with shortness of breath and blue discoloration of the nasolabial triangle. Shortness of breath may be accompanied by dizziness and vomiting.
• Heart diseases. Heart problems often occur in children after suffering from pneumonia. There may be endocarditis or chronic insufficiency of blood flow.

As a result of pneumonia, asthenic syndrome may also occur. It is manifested by general weakness, loss of appetite and sleep.

Meningitis can also be a complication of pneumonia in children. This consequence is especially common in children under 3 years of age.

Diagnosis of complications

To diagnose complications of pneumonia, it is necessary to take into account not only the complaints of the sick child or his parents. A repeat x-ray is required; in case of complications, the image will show a darkened area.

The patient must undergo blood and urine tests. With an acute inflammatory process in the blood, the ESR and the level of leukocytes will increase.

For timely recognition of complications, diuresis is monitored hourly. In addition, the functioning of important organs - the heart, brain and kidneys - is carefully monitored. If signs of oxygen deficiency appear, the patient is connected to a ventilator.

How to prevent all this from happening

The consequences of pneumonia in children are most often observed when they do not consult a doctor in a timely manner. Parents should remember that the more advanced the disease, the greater the likelihood of complications and the worse the prognosis for the patient.

To prevent dangerous consequences, you should consult a doctor if severe cough and high temperature in the child. Sometimes the cause of such ailment is a common cold, but it is better to be safe.

It is extremely important to follow all doctor's recommendations. If for some reason a child is treated on an outpatient basis, all doctor’s instructions should be strictly followed. It is unacceptable to stop taking antibiotics at the first signs of improvement.

It is important to strengthen children's immunity. Morning exercises and a contrast shower should be mandatory. It’s good if a child attends a sports section or dances, all this helps to increase the vitality of the body.

Nowadays, cases of pneumonia in children are becoming more common. The reason for this is many pathogenic bacteria and viruses that enter the body when the immune system is weakened. At the same time it rises heat, severe cough, shortness of breath and, as a consequence, pulmonary edema appear. Treatment of such patients takes place in a hospital setting and using modern antibiotics. But the disease has subsided, and the doctors are sending me home. That's all? No! There are many complications after the disease. The body, especially children’s, needs to be restored further!

The child suffered from pneumonia. Consequences

After pneumonia in a child, a number of negative consequences for the body can be identified. They can be divided into two groups:

1. consequences related specifically to the lungs;
2. extrapulmonary consequences.

The group of complications associated with changes in the lungs includes: pleurisy (exudative, adhesive, pleural empyema), pulmonary destruction, cardiopulmonary failure and, probably the most harmless thing, a prolonged cough with sputum production. Also, untreated pneumonia can take a chronic form, which will lead to decreased immunity, constant relapses and deformation of the chest.

Exudative pleurisy - when it occurs, fluid accumulates in the pleural cavity - exudate. Manifests painful sensations and heaviness in the affected area, dry cough, shortness of breath, fever and sweating. It is treated by puncturing and pumping out fluid.

Adhesive pleurisy – with this type, fibrin accumulates in the pleural area. Which, over time, sprouts connective tissue, which leads to the formation of fibrous adhesions. The sheets of the pleura stick together, and eventually it becomes overgrown. At the same time, there is a strong paroxysmal cough, heat, sharp pain in the anterior chest, shortness of breath, fatigue, sweating. Can only be treated by abdominal surgery on the lung.

Empyema of the pleura or purulent pleurisy - inflammation of the pleural layers with the accumulation of pus in them. Occurs due to harmful microorganisms and bacteria entering this area. In this case, the child will have chills, high body temperature, stabbing pain in the chest extending to the shoulder blade, cough, increased fatigue, and headaches. Treatment is carried out through antibacterial therapy.

Pulmonary destruction – a very dangerous complication that can lead to the death of the child. Massive necrosis and destruction of lung tissue occurs. Destruction manifests itself when the main symptoms of pneumonia subside. Seems baby is coming on the mend, but then again the temperature rises sharply, cough, chills, chest pain, strong smell of rot from the mouth. My health is deteriorating very quickly. And if you don’t promptly identify the beginning of lung decomposition and don’t start necessary treatment, the child will simply die.

Cardiopulmonary failure – may occur due to long-term intoxication of the body and respiratory failure during pneumonia.

The second group includes such consequences as: asthenic syndrome, sepsis, urinary retention, convulsions.

Asthenic syndrome – decreased appetite, lethargy, fast fatiguability, low temperature bodies. The most harmless complication that goes away quite quickly.

Sepsis – a very terrible and serious complication, the mortality rate from which reaches 100%, that is, it is impossible to cure it. It occurs when an infection enters the bloodstream and spreads throughout the body. In this case, purulent spots appear on various parts body and the temperature rises sharply.

Urinary retention – this disease occurs very often in children who have recovered from the disease. In this case, diuresis is restored with the help of diuretics.

Convulsions – this complication is also common in young children. Treatment is to stop convulsive syndrome caused by a lack of oxygen in the blood and swelling of the brain. For this, various drugs prescribed by a doctor are used, and in some severe cases, a spinal puncture is performed.

Fortunately, in our time of advanced medicine severe complications are rare, thanks to timely treatment with modern antibacterial and other drugs. But you cannot rely only on hospital treatment; a favorable outcome of the disease also depends on further rehabilitation after the child is discharged home. What needs to be done so that the child can easily endure this illness without consequences for his body?

Prevention of complications after pneumonia

After discharge from the hospital, the child must be registered with a pediatrician and specialized specialists, such as an ENT doctor, an immunologist and a pulmonologist for a period of 1 year. Doctors draw up an individual follow-up plan for each child separately, depending on the severity of the disease and the consequences that arise. Must be done every 2 months clinical analysis blood and urine, and in the case of residual pulmonary effects - X-ray studies. The attending physician will also prescribe a course rehabilitation activities, such as:

1. Physiotherapy - such types as ionogalvanization with calcium or bromine salts, electrophoresis, general ultraviolet irradiation have proven themselves well;
2. Therapeutic exercise and massage;
3. Vitamin therapy and the use of immunomodulators to restore the body’s immune forces;
4. Taking air baths - aerotherapy;
5. Prescribed drugs for recovery intestinal microflora impaired after antibacterial therapy;
6. Herbal infusions are prescribed, as well as, if necessary, inhalations and expectorants;
7. Hardening procedures are carried out, which begin with wiping the body with water, the temperature of which should be equal to 32 degrees and gradually reducing it;
8. Walking in the fresh air, healthy sleep, and a nutritious diet rich in vitamins and minerals are mandatory.
9. To avoid relapses in the future, after the child has fully recovered, preventive vaccinations are carried out directly against pneumonia, as well as against influenza, because pneumonia is often a complication of this virus.

You also need moist, fresh air in the children's room, and you must ensure that the child does not breathe tobacco smoke.

And in no case should you let everything take its course; rehabilitation after an illness is mandatory!

How long should a child who has had pneumonia be isolated?

How quickly a child recovers from pneumonia depends on the severity of the disease, the rehabilitation measures taken and the general strength of the body.

With a mild course of the disease, complete recovery can occur in 10-14 days, given the absence of complications. But in most cases, treatment is delayed for 2-3 months. Naturally, all this time you cannot visit public places with large crowds of people. Since the body is still very weakened, the risk of infecting the child with colds and other diseases must be eliminated. You can begin visiting children's educational institutions no less than 10 days after the pediatrician declares a complete recovery.