Bronchopneumonia in children

Bronchopneumonia is a disease of the lungs, which has an inflammatory nature. It is characterized by affecting small areas of the lung. Most often bronchopneumonia occurs in children under the age of 2 years. In pediatrics, there is also bilateral bilateral bronchopneumonia. It is easily eliminated when treated with antibiotics.

ICD-10 code

Bronchopneumonia took a definite niche in the international classification of diseases. This disease is assigned a specific code for μb 10. All diseases that affect the respiratory system will be presented below.

• J00-J99 Diseases of the respiratory system.
• J00-J06 Acute respiratory infections of the upper respiratory tract.
• J20-J22 Other acute respiratory infections of the lower respiratory tract.
• J30-J39 Other diseases of the upper respiratory tract.
• J40-J47 Chronic diseases of the lower respiratory tract.
• J60-J70 Lung diseases caused by external agents.
• J80-J84 Other respiratory diseases affecting mainly the interstitial tissue.
• J85-J86 Purulent and necrotic conditions of the lower respiratory tract.
• J90-J94 Other diseases of the pleura.
• J95-J99 Other respiratory diseases

J10-J18 Flu and pneumonia.

• J10 Influenza caused by an identified influenza virus.
• J11 Flu, the virus is not identified.
• J12 Viral pneumonia, not elsewhere classified.
• J13 Pneumonia caused by streptococcus pneumoniae.
• J14 Pneumonia caused by haemophilus influenzae [afanaseva-pfeffera].
• J15 Bacterial pneumonia, not elsewhere classified.
• J16 Pneumonia caused by other infectious agents, not elsewhere classified.
• J17 Pneumonia in diseases classified elsewhere.
• J18 Pneumonia without specifying the pathogen.
  • J18.0 Bronchopneumonia, unspecified.
  • J18.1 Shared pneumonia, unspecified.
  • J18.2 Hypostatic pneumonia, unspecified.
  • J18.8 Other pneumonia, causative agent is not specified.
  • J18.9 Pneumonia, unspecified.

Causes of bronchopneumonia in children

The main cause of the disease is the entry into the body of the main pathogen. It can be a hemophilic rod, pneumococcus, staphylococcus and chlamydia. They can penetrate the body through the inhaled air in the form of a fine aerosol, which contains pathogenic microorganisms. But in children of any age, the main cause of bronchopneumonia is the damage to the bronchi and upper respiratory tract.

Most children's pulmonologists believe that with the development of a protracted course of the disease, the child should immediately carry out a survey. Most likely, the immune functions of the body are violated and will cope with this, the immunologist will help. To what all this has been said, the fact is that in children with weak immunity the probability of the development of the disease is very high. Their body is not able to resist penetrating into it pathogenic microorganisms. Therefore, each disease can go into a sharp form and provoke complications, including bronchopneumonia.

The cause of the development of the disease can serve as a visit to children's institutions. Naturally, the child should not be left at home, but it is necessary to monitor his condition constantly. The main preventive measure is the strengthening of immunity.

[1], [2],

Pathogenesis

The development of bronchopneumonia is a protracted process. It is characterized by the manifestation of pathophysiological processes that can develop both sequentially and in parallel. This group includes violations of respiration of various degrees, including external and tissue. It can be a respiratory failure, a toxic effect of an infectious agent. Quite often, microcirculation disorders are added to everything. This is pathogenesis, for it is characterized by the intensity and speed of development of the above described processes.

The initial stage of development is hypoxemia. It originates from an infectious agent, which easily infiltrates into the lung tissue. The perfusion of gases is reduced due to bronchial obstruction, as well as the formation of micro-teleclactases. The overall toxicity of the pathogen only aggravates hypoxemia. After all, in this process, there is a violation of central and humoral regulation of breathing. The blood circulation also falls under the negative influence.

Hypoxemia can be accompanied by respiratory failure, as well as the accumulation of carbon dioxide in the blood. All this leads to irritation of the respiratory center and causes a compensatory reaction. It is characterized by the manifestation of dyspnea and the expansion of the peripheral capillary network. Hypoxemia in increasing form, as well as intoxication can cause a decrease in the functional activity of tissue respiratory enzymes. As a result, the body is depleted.

Symptoms of bronchopneumonia in children

Recognize the inflammatory process in the lungs is not so difficult. True, many parents confuse him with an ordinary cold or flu. Meanwhile, the disease begins to progress. Thus, in children bronchopneumonia is characterized by the same symptoms as ARD.

The first thing is a strong cough, then it is joined by the pallor of the skin and weakness. The child quickly tires, he is listless, there is no desire to play and eat. There is a headache. Over time, cough is characterized by the presence of sputum. Rapid breathing up to 30 beats per minute. Palpitation also becomes rapid and reaches up to 110 beats per minute.

When you listen to breathing, you can clearly hear wheezing. In the blood begin to increase leukocytes, provoking the development of leukocytosis. The rate of erythrocyte sedimentation is also increased. The body temperature can reach 39 degrees. Cases of the disease without increasing the temperature are extremely rare.

First signs

If the disease has developed repeatedly, against the background of the existing bronchitis, all signs are added to fatigue, headache and fever. The child begins to pester a strong cough, including mucopurulent sputum. This is the first sign of the onset of bronchopneumonia.

The main symptom is shortness of breath, as well as rapid breathing of up to 30 beats per minute. The pulse is significantly accelerated to 110 beats per minute. The child can complain about the presence of a pain syndrome in the chest. When tapping, sounds may not change. If the lesions are small or are in the central lobe, they decrease. When listening to small areas, you can determine the presence of small bubble dry rales. Chryps are able to disappear or change their localization. A blood test shows a significant increase in the level of leukocytes. In rare cases, they are below normal.

Bronchopneumonia in newborns

Most often this disease occurs at an early age. It can take quite a bit of time. The general disease of the body occurs exclusively in young children. Most often bronchopneumonia progresses in newborns from six months to 3 years. The main pathogens are pneumococci, less often it is provoked by Influenza sticks, staphylococci and streptococci.

For infection, it is not necessary to obtain a pathogenic microorganism from outside, it is enough to weaken the immunity. In newborns, the body's protective functions are not well developed, which increases the risk of infection. Measles, pertussis and influenza significantly reduce the protective functions of the body, contributing to this ingestion of pneumococcus.

Carry out treatment should be from the first days of the manifestation of the disease. This will avoid complications and severe course of the disease. To eliminate bronchopneumonia resort to medication. The chronic form of the disease is maintained by treatment aimed at overall strengthening of the body.

[3], [4], [5], [6], [7],

Effects

If you do not start treatment of the disease from the first days of manifestation, it will quickly progress. In this case, serious consequences may develop. Most often the disease takes a severe form of the flow and requires more thorough treatment together with strong medications.

Bronchopneumonia can lead to a general intoxication of the body. The child is weakened, the immune system does not perform its protective functions, the condition worsens. Often inflammatory processes in the airways lead to the development of tachycardia. A heart palpitations can pester a child in any condition.

The kid becomes extremely restless. He can not concentrate on performing any task or even playing a game. The child most often refuses to eat, he is listless, the desire to do something is missing. The most severe consequence is convulsions. All this testifies that any disease must be eliminated on time, without provoking the development of complications.

[8], [9], [10], [11]

Complications

If proper treatment is not available, it is possible that the condition worsens. Bronchopneumonia can cause a number of complications, including purulent otitis media or serous pleurisy. All this aggravates the condition of the child. Jade often develops.

If the baby starts to feel bad and the treatment clearly does not give positive dynamics, it is worth changing the therapeutic measures. After all, an incorrect elimination of the disease leads to the fading of the baby. He remains weak, the desire to play, eat and do anything completely absent. This is due to the weakening of the body.

Often, bronchopneumonia can lead to a general intoxication of the body. Tachycardia can develop, which manifests itself both in movement and at rest. The baby pierces excessive anxiety, he begins to be capricious. The most serious complication is the development of seizures. Timely and correct treatment will avoid all possible consequences.

[12], [13], [14]

Diagnosis of bronchopneumonia in children

Bronchopneumonia is diagnosed on the background of clinical symptoms. First of all, the doctor should familiarize himself with the manifested symptoms, then conduct an examination of the baby. Attention is drawn to the nature of the percussion sound, wheezing. When the disease shows signs of toxicosis, as well as respiratory failure. This symptom begins to increase as the disease develops. Diagnosis of bronchopneumonia in children in several stages.

To verify the presence of bronchopneumonia, an X-ray examination is performed. When the lungs are damaged in places where infection is localized, blackouts are observed. Along with instrumental diagnostics, laboratory investigations are carried out. It allows you to track the level of leukocytes in the blood and the index of ESR. For this, a general blood test is performed. The child takes the material from the finger. To establish the correct diagnosis, the data of instrumental and differential research are combined.

[15], [16], [17], [18],

Analyzes

First of all, examine the skin of a child. With bronchopneumonia, they take a pale shade. After this, the main tests are taken. This includes the delivery of a general analysis of blood and urine.

Blood tests can determine the level of leukocytes. In the presence of an inflammatory process in the body, the level of leukocytes begins to increase significantly, thereby provoking the development of leukocytosis. In some cases, white blood cells decrease. In the blood also determine the index of ESR. It measures the time of erythrocyte sedimentation. Urine analysis shows the acid content. Changes in the analysis of peripheral blood are not observed. To identify a bacterial infection, sputum is taken for testing.

By these indicators it is easy to calculate the presence of an inflammatory process in the body. As additional analyzes, instrumental methods can be assigned. They are an x-ray study. Regarding this technique, we will discuss below.

[19], [20], [21], [22], [23],

Instrumental diagnostics

Often to diagnose the disease, an X-ray examination is performed. Radiography is one of the most important methods of instrumental diagnostics. At the initial stage, it is possible to detect augmentation of the pulmonary pattern on the affected segments. In this case, the transparency of the lung tissue can be quite normal or partially reduced.

The compaction stage is characterized by intensive darkening of the lungs, which are covered by inflammation. With a lesion that captures most of the lung, the shadow is uniform, in the central regions it is more intense. At the resolution stage, the size and intensity of the inflammatory infiltration may disappear. The structure of the lung tissue is gradually restored, but the root of the lung can remain extended for a long time.

In especially difficult cases, they resort to computed tomography. This is important if differential diagnosis is performed, which consists in examining pleural effusion and changes in lung tissue.

Differential diagnostics

This method of research includes a number of activities aimed at the correct diagnosis of the problem. The first thing to pay attention to changes in blood indicators. In the inflammatory process, there is an increased number of leukocytes. Differential diagnosis includes a biochemical blood test, however, it is not capable of giving specific information. However, it can indicate the presence of lesions in the organs and systems of the body.

To determine the severity of respiratory failure, a study is needed to determine the blood gases. An important role is played by microbiological studies. It allows you to identify the bacteria that led to the development of the disease. Simultaneously with sowing, sputum is done and smears followed by bacterioscopy. If the condition is extremely severe, it is necessary to sow venous blood.

Often resorted to immunological studies and the definition of antigens. They allow to determine in the urine the presence of a specific soluble antigen. However, this technique is not available in every clinic.

[24], [25], [26], [27], [28], [29]

Treatment of bronchopneumonia in children

Therapy of the disease is a difficult and consistent process. This includes the fight against the infectious beginning, as well as the elimination of cardiovascular and respiratory failure. It is important to restore all functions of the body and eliminate morphological changes in the lungs. Thus, in children the treatment of bronchopneumonia is a complex process, which includes a number of specific actions. Elimination of the disease should take place in accordance with the phase of pathogenesis.

Hospitalization is possible only if there is an unfavorable premorbid background, a severe course of the disease, and a threat of complications. In other cases, everything is done at home under the supervision of a nurse. If the child is in the hospital, then he is allocated a special box or a separate room. In the common room, babies are buried in the nose of interferon, this will avoid the re-infection or aggravation of the situation.

All diagnostic procedures should be gentle. This condition applies to future treatment. The main condition for the success of treatment is the individual care. It is necessary to provide a thorough nose toilet, sleep in the open air or an open window, as well as regular airing. You should carry out the quartz of the room. Optimum is considered the air temperature not exceeding 20 degrees.

It is important to follow some recommendations regarding nutrition. Food should be nutritious, enriched with vitamins and easily digestible. Eat often and in small portions. Babies under 6 months should be given breast milk. In the food it is necessary to introduce a sufficient amount of liquid. This will avoid dehydration. It is advisable to give the child mineral water, 5% glucose solution and fruit and vegetable decoctions.

Medications

Antibiotic therapy should be urgent. She is appointed immediately after the diagnosis. It is important that the drugs are exactly the age of the baby. Antibiotic therapy is carried out for 2 weeks. Preference is given to the antibiotic to which the microflora, allocated from the bronchial secretion of the patient, is sensitive.

At a severe stage of the disease, antibiotics of a wide spectrum should be used. It can be Erythromycin, Azithromycin, Augmentin and Zinnat. They can be taken either individually or in combination with each other. If within 2 days there is no positive dynamics of the drug should be replaced by others. Most often, children are prescribed Nystatin and Levorin. These drugs are antifungal and are taken with antibiotics. To stabilize the pressure, use Euphyllin.

• Erythromycin. The agent is applied inwards, 20-40 mg per kilogram of weight. The dose depends on the severity of the child's condition. Use the drug is not necessary for hypersensitivity, liver or kidney failure. Perhaps the development of nausea, vomiting, noise in the ears and urticaria.
• Azithromycin. The drug is administered intravenously an hour before meals, or 2 hours after it. Dosage is prescribed by the doctor depending on the individual course of the disease. Do not take drugs for children under 12 years. May lead to the development of allergic reactions, dizziness, diarrhea, nausea, vomiting.
• Augmentin. The dose is assigned individually, depending on the condition of the person, his age and weight. Use the drug is not necessary for hypersensitivity, as well as impaired functionality of the liver. Possible development of nausea, dyspeptic phenomena and leukopenia.
• Zinnat. The drug is applied on a single tablet 2 times a day. The duration of therapy is on average 10 days. Use the drug is not necessary for hypersensitivity, as well as children under the age of 3 years. May cause disorders of the gastrointestinal tract and allergic reactions.
• Nystatin. The agent is prescribed for 250,000 units 3-4 times a day. The dose can be adjusted by the attending physician. He also prescribes the duration of therapy. Medication is not used in newborns for up to a year. Can lead to intestinal disorders, nausea and allergic reactions.
• LeVorin. The drug is taken at 25 thousand units per kilogram of weight per day. The optimal dose is prescribed by the attending physician. The drug is not used for hypersensitivity and at the age of 2 years. May cause frustration on the part of the digestive tract.
• Euphyllinum. The drug is used 4 times a day, at the rate of 7-10 mg per kilogram of weight. The drug is not used until the age of 3 years, as well as with hypersensitivity. May lead to the development of a disorder of the gastrointestinal tract.

Alternative treatment

At this stage, the child needs to ensure maximum care. Parents should always be with the baby, and surround him with the necessary care and warmth. Help in this treatment with the help of alternative means.

To start the elimination of the disease is necessary with the help of effective means. So, birch kidneys and honey have a good effect. Take 750 grams of honey and mix it with 100 grams of kidney. All ingredients are heated on the stove and cooked for 7 minutes. When the broth is ready it needs to be cooled. He takes one dessert spoon, diluted with a small amount of liquid, before going to bed.

In this case, well-proven tar tar. It is necessary to take a clean three-liter glass jar and fill it with 500 ml of medical tar. Then fill the vessel with water to the edges, preferably with boiling water. Then hide the jar for 9 days in a warm place. When the agent is infused, it is possible to start treating the child. It is necessary to use one spoon before bedtime. The taste of tar water is pretty nasty, so the baby needs to be allowed to seize the food with something tasty. These two recipes are the most sought after and effective in their kind.

[30], [31], [32], [33], [34]

Herbal Treatment

Who would have thought that an ordinary plantain can cope with even such a serious disease. So, herbal treatment had time to prove itself since ancient times. With the help of plantain can overcome many diseases, including bronchopneumonia.

It is necessary to take the leaves of plantain and rinse them thoroughly. Then remove from them excess fluid and give the plant time to dry. On the bed, lay the sheet or a large towel, the main ingredient is evenly spread out on top. It is advisable to do this procedure at night. After everything is ready, you should put the baby on the plantain. The remaining leaves are laid out on the baby's belly. Then the child should be properly wrapped in woolen material. The procedure is repeated as many times as necessary.

You can try and garlic. To do this, it needs to be washed and put in a plastic cup. Before that, the glass should be pierced. It is enough to make a few holes with an awl. Garlic finely chopped and placed in a prepared cup. Then it is necessary to give the baby a sniff of this remedy. The procedure is repeated several times a day.

Homeopathy

To date, homeopathic treatment is very popular. So, homeopathy is perfectly suitable for people with intolerance to potent chemicals. For many patients this is really a way out of a difficult situation. Homeopathic remedies allow qualitatively and finally to cure bronchopneumonia.

At the initial stage it is recommended to resort to the help of Aconite in 3 breeding. After that, the Bryonia tool is used in the same dilution. Excellent helps to cope with the disease Belladonna. Over time, start to prescribe drugs depending on the clinical manifestations. In the presence of blood in phlegm, Phosphorus is used in 6 dilutions or Ipecacuanu in 3 dilutions. If wet rales are observed, Antimonium Tartaricum is used in the 3rd and 6th dilutions. Iodum in 3 and 6 dilutions and Kalium Yodatum in 3 and 6 dilutions allow to cope with bouts of coughing. Veratrum Viride in 3 and 3 dilutions is used for heart failure.

It is necessary to understand that the children's organism does not require any experiments. Therefore, it is not worthwhile to start treatment independently with the help of homeopathic remedies. Everything is done under the supervision of an experienced specialist.

Operative treatment

Surgical intervention is not so often. To surgical treatment proceed if the inflammation of the respiratory tract leads to a violation of bronchial patency. The point is that the mechanism of the appearance of bronchiectasis has not been fully studied.

Bronchial obstruction is characterized by bronchial obstruction, which leads to its significantly widening. The end result of this process is the exclusion of the entire lung or a part of it from the act of breathing. This condition requires immediate surgery. Otherwise, the baby simply can not breathe.

Surgical intervention is the removal of the lung or its individual segments. This operation is extremely rare. If a child under the age of 7 did not suffer from the formation of bronchiectasises, the hope that they will not arise is preserved. It is worth noting that surgery is performed only in the case of severe chronic bronchopneumonia.

Prevention

Primary preventive actions include tempering the child. It is advisable to start doing this from the first months of life. Sufficient stay in the air and good care is the basis of any prevention. It is necessary to sanitize foci of chronic infection in a timely manner. Any illness should be eliminated on time, thereby reducing the risk of complications in the form of bronchopneumonia.

Secondary preventive actions include the prevention of recurrent diseases. It is important to start treatment on time, its effectiveness plays an important role. Do not assume a protracted or chronic form of the disease. Reinfection should be carefully prevented. This is especially important in those cases when it took no more than 2 months after acute pneumonia. It is necessary to treat and accompanying diseases, including rickets, dystrophy and anemia. Active and generally encouraging and stimulating therapy should be conducted. This will avoid the emergence of new foci of inflammation.

Forecast

If the treatment was done on time and gave its positive results, then there is nothing to worry about. In this case, the outlook will be favorable. When the first symptomatology appears, you should immediately seek help from a doctor. This will reduce the risk of serious complications. After all, they can greatly aggravate the situation and make the forecast unfavorable.

Insufficient treatment, the presence of viral or bacterial reinfection can lead to the formation of a protracted or even a chronic process. With a destructive process or a severe course of pneumonia, the prognosis becomes unfavorable.

The child's organism is too susceptible to various kinds of infections. The immune system of the baby is not able to withstand many diseases. Therefore, they begin to actively progress in the body. If no qualitative treatment is prescribed, a negative development of the situation is possible. This indicates that the health of the baby should be monitored constantly and on time to take him to the doctor.

[35], [36], [37]