Pneumonia lobular

 

 

Contents :

• Symptoms and course of focal pneumonia
• Recognition of focal pneumonia
• Treatment of focal pneumonia

• Pneumonia Pneumococcal

• Symptoms (signs) of pneumococcal pneumonia
• Complications of pneumococcal pneumonia
• Treatment of pneumococcal pneumonia  
  

Pneumonia lobular

Symptoms and course of focal pneumonia.

Lobular pneumonia, bronchopneumonia, occur as a complication of acute or chronic inflammation of the upper respiratory tract and bronchi in patients with congestive light, heavy, debilitating disease in the postoperative period. The body temperature rises to 38-39 °  C, rarely higher. Appears or increasing cough, dry or with mucopurulent sputum. Can chest pain when coughing and inhaling. When confluent lobular pneumonia patients condition deteriorates: marked dyspnea, cyanosis. Breathing can be reinforced with vesicular portions of the bronchial, listen finely and medium bubbling rale.

Pneumonia lobular

Recognition of focal pneumonia.

Based on the clinical picture, radiological survey data (foci of inflammatory infiltration in lung tissue, with the discharge pneumonia – slivayuschiessya among themselves). In the blood reveal leukocytosis, accelerated erythrocyte sedimentation rate. 
 

Treatment of focal pneumonia.

In light flow can be at home, but the majority of patients require hospitalization. In the midst of the disease requires bed rest, light diet with plenty of vitamins A and C, excessive drinking, antibiotics (including sensitivity to them microflora), other antibacterial drugs. There may be a need for a gamma globulin for desintoxication therapy. With the disappearance or significant reduction of intoxication extend mode, assign remedial gymnastics, physiotherapy (inhalation, UHF, shortwave diathermy). If necessary, can be therapeutic bronchoscopy.

 

 

Pneumonia Pneumococcal

It remains the most common in children 6 months – 4 years, occupying a significant place among the pneumonia and the older children. Of the 83 serotypes of pneumococcus 20-25 rise to more than 95% of all cases of pneumonia. High level of maternal immunity to pneumococcus children lose the end of the first year of life, increase in antibody titers (carriage, infection) is accelerated after 3 years. Several serotypes (3, 5, 9) is characterized by high virulence, they, like others, new to the patient serotypes often have complicated forms. According crops lung punctate, pneumococcus is often accompanied by Haemophilus influenzae in noncapsulated form.

Pneumonia Pneumococcal

Symptoms (signs) of pneumococcal pneumonia.

 

 Pneumococcal pneumonia occurs in different forms. «Classical» were lobar (lobar) and similar to her krupnoochagovaya, in which homogeneous shadow takes 1-2 segment, or a spherical form. Getting sharper, with temperatures up to 40-41 ° C, dry cough, sometimes with brown sputum, leukocytosis with a leftward shift, increased ESR. Often there are cold sores, redness of cheeks on the side of destruction, pain (groan) when breathing (pleurisy dry), often radiating to the abdomen, which may divert attention from the physician of changes in the lungs.

With less reactive forms the beginning is not so rapid, physical picture is consistent with that of bronchopneumonia on chest radiograph –  inhomogeneous shadow in the zone 1.2 segments with fuzzy boundaries. Changes in the blood pressure are small or absent.

Bilateral localization process is rare and is usually a serious disease, occurring with complications.

 

 

 

 

Complications of pneumococcal pneumonia.

 

 Pneumococcus is the most frequent causative agent of pleurisy, lung and suppurations pneumoempyema. The presence of fluid in the pleura in the beginning of the disease (pleurisy sinpnevmonichesky) increases the probability of destruction. Pleurisy well gives therapy without drainage, as evidenced by a decrease in cytosine and other signs of suppuration with repeated puncture. In many cases, however, his «replaced» Education metapnevmonicheskogo effusion with cytosine below 1000 in 1 l and an abundance of fibrin. Clinically, it manifests the rise in body temperature after 1-2 days of decline and the accumulation of fluid, erythrocyte sedimentation rate increases sharply, although the number of leukocytes in the absence of degradation is reduced. Fever constant type or hectic, the duration of an average of 7 days, but in the next 2-3 weeks can be observed rises in body temperature, inferior treatment of anti-drugs (steroids, indomethacin) in adolescents, they can be a symptom of outbreaks of tuberculosis. Echographic often reveal a pericardial effusion that does not require special treatment. 
If the source of destruction is also stored fever against the background of an effective therapy, leukocytosis (often against the background of metapnevmonicheskogo pleurisy) before emptying ulcer through bronchus or pleural cavity. Formed in the lung cavity, often thin-walled (bull), in the early days with the level of liquid, often tense because of the valve mechanism in the bronchi, gradually decreases and disappears within 2-4 weeks. Abscess with a thick wall formed rarely, usually with superinfection (Pseudomonas, anaerobes).

Small, unstrained pneumoempyema can be cured without drainage, in many cases, however, the drainage is unavoidable, its duration is often reaches 3 weeks.

Treatment of pneumococcal pneumonia.

Drugs of choice are penicillin, ampicillin, levomycetin, lincomycin, cephalosporins of the first generation (the last 3 drugs used in intravenous therapy, and intolerance to penicillins), Biseptol, macrolides, with metapnevmonicheskom pleurisy – non-steroidal anti-inflammatory drugs. Thoracostomy with pleurisy does not speed up recovery and reduces the frequency of destruction. Repeated puncture of the pleura is shown with an increase in effusion. Puncture of lung cavities or bronchoscopic drainage shows them only in rare cases after unsuccessful conservative treatment (antibiotics, mucolytics, drainage provision).