Bronchopneumonia in children

Bronchopneumonia is a lung disease of inflammatory nature. It is characterized by affecting small areas of the lung. Most often, bronchopneumonia occurs in children under 2 years of age. In pediatrics, bilateral bronchopneumonia is also observed. It is easily eliminated with antibiotic treatment.

ICD-10 code

Bronchopneumonia has occupied a certain niche in the international classification of diseases. This disease is assigned a specific code according to ICD 10. Below will be presented all diseases affecting the respiratory organs.

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

J10-J18 Influenza and pneumonia.

• J10 Influenza due to identified influenza virus.
• J11 Influenza, virus not identified.
• J12 Viral pneumonia, not elsewhere classified.
• J13 Pneumonia due to streptococcus pneumoniae.
• J14 Pneumonia due to Haemophilus influenzae.
• J15 Bacterial pneumonia, not elsewhere classified.
• J16 Pneumonia due to other infectious organisms, not elsewhere classified.
• J17 Pneumonia in diseases classified elsewhere.
• J18 Pneumonia, unspecified.
  • J18.0 Bronchopneumonia, unspecified.
  • J18.1 Lobar pneumonia, unspecified.
  • J18.2 Hypostatic pneumonia, unspecified.
  • J18.8 Other pneumonia, agent unspecified.
  • J18.9 Pneumonia, unspecified.

Causes of bronchopneumonia in children

The main cause of the disease is the entry of the main pathogen into the body. This can be Haemophilus influenzae, pneumococcus, staphylococcus and chlamydia. They can penetrate the body through 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 damage to the bronchi and upper respiratory tract.

Most pediatric pulmonologists believe that if the disease develops over a long period of time, the child should be examined immediately. Most likely, the immune functions of the body are impaired and an immunologist will help to cope with this. What was all this said for? The fact is that children with weak immunity have a very high probability of developing the disease. Their body is not able to resist pathogenic microorganisms penetrating it. Therefore, any disease can become acute and provoke complications, including bronchopneumonia.

The cause of the disease may be visiting children's institutions. Naturally, the child should not be left at home, but it is necessary to constantly monitor his condition. The main preventive measure is strengthening the immune system.

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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 respiratory disorders of varying degrees, including external and tissue. This may be respiratory failure, toxic effects of an infectious agent. Microcirculation disorders are often added to everything. This is the pathogenesis, it is characterized by the intensity and speed of development of the above processes.

The initial link in development is hypoxemia. It originates from an infectious agent that easily penetrates into the lung tissue. Gas perfusion is reduced due to bronchial obstruction and the formation of microatelectasis. The general toxic effect of the pathogen only aggravates hypoxemia. After all, this process disrupts the central and humoral regulation of respiration. Blood circulation is also negatively affected.

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 shortness of breath and expansion of the peripheral capillary network. Hypoxemia in an increasing form, as well as intoxication, can cause a decrease in the functional activity of tissue respiratory enzymes. As a result, the body becomes exhausted.

Symptoms of bronchopneumonia in children

It is not so difficult to recognize the inflammatory process in the lungs. However, many parents confuse it with a common cold or flu. Meanwhile, the disease begins to progress. Thus, in children, bronchopneumonia is characterized by the same symptoms as ARI.

First of all, a strong cough appears, then it is joined by paleness of the skin and weakness. The child quickly gets tired, he is lethargic, there is no desire to play and eat. A headache appears. Over time, the cough is characterized by the presence of sputum. Rapid breathing up to 30 beats per minute. The heartbeat also becomes rapid and reaches up to 110 beats per minute.

When listening to breathing, wheezing is clearly heard. Leukocytes in the blood begin to increase, causing the development of leukocytosis. The erythrocyte sedimentation rate is also increased. Body temperature can reach 39 degrees. Cases of the disease without an increase in temperature are extremely rare.

First signs

If the disease develops again, against the background of existing bronchitis, fatigue, headache and elevated body temperature are added to all the signs. The child begins to be bothered by a strong cough, including with mucopurulent sputum. This is the first sign of the onset of bronchopneumonia.

The main symptom is shortness of breath, as well as rapid breathing up to 30 beats per minute. The pulse rate increases significantly to 110 beats per minute. The child may complain of chest pain. When tapping, the sounds may not change. If the lesions are small or located in the central lobe, they decrease. When listening to small areas, you can determine the presence of fine-bubble dry wheezing. Wheezing can disappear or change its location. Blood tests show 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 be quite severe. 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 bacilli, staphylococci and streptococci.

It is not necessary to get a pathogenic microorganism from outside to become infected; a simple weakening of the immune system is enough. In newborns, the body's protective functions are not very well developed, which increases the risk of infection. Measles, whooping cough, and flu significantly reduce the body's protective functions, thereby facilitating the entry of pneumococcus into the body.

Treatment should be carried out from the first days of the disease. This will help to avoid complications and severe course of the disease. To eliminate bronchopneumonia, resort to the help of medications. The chronic form of the disease is supported by treatment aimed at general strengthening of the body.

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Consequences

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

Bronchopneumonia can lead to 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 respiratory tract lead to the development of tachycardia. Rapid heartbeat can bother a child in any condition.

The baby becomes extremely restless. He cannot concentrate on any task or even a game. The child most often refuses to eat, he is lethargic, there is no desire to do anything. The most severe consequence is convulsions. All this indicates that any disease must be eliminated in time, without provoking the development of complications.

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Complications

If proper treatment is not provided, the condition may worsen. Bronchopneumonia can cause a number of complications, including purulent otitis or serous pleurisy. All this worsens the child's condition. Nephritis 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, incorrect elimination of the disease leads to the baby withering. He remains weak, the desire to play, eat and do anything is completely absent. This is due to the weakening of the body.

Bronchopneumonia can often lead to general intoxication of the body. Tachycardia can also develop, which manifests itself both in motion and at rest. The baby is bothered by excessive anxiety, he begins to be capricious. The most severe complication is the development of seizures. Timely and correct treatment will help to avoid all possible consequences.

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Diagnosis of bronchopneumonia in children

Bronchopneumonia is diagnosed against the background of clinical symptoms. First of all, the doctor should familiarize himself with the signs, then examine the baby. Attention is paid to the nature of the percussion sound, wheezing. With the disease, signs of toxicosis and respiratory failure appear. These symptoms begin to increase as the disease develops. Diagnosis of bronchopneumonia in children is carried out in several stages.

To confirm the presence of bronchopneumonia, an X-ray examination is performed. When the lungs are affected, darkening is observed in the places where the infection is localized. Laboratory tests are performed along with instrumental diagnostics. They allow you to track the level of leukocytes in the blood and the ESR indicator. For this, a general blood test is taken. In a child, material is taken from a finger. To make a correct diagnosis, the data from the instrumental and differential studies are combined.

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Tests

First, the child's skin is examined. In case of bronchopneumonia, it takes on a pale shade. After that, the main tests are taken. This includes a general blood and urine test.

Blood tests can determine the level of leukocytes. If there is an inflammatory process in the body, the level of leukocytes begins to increase significantly, thereby provoking the development of leukocytosis. In some cases, leukocytes decrease. The ESR indicator is also determined in the blood. It measures the sedimentation time of erythrocytes. Urine analysis shows the acid content. No changes are observed in peripheral blood tests. To detect a bacterial infection, secreted sputum is taken for testing.

These indicators make it easy to determine the presence of an inflammatory process in the body. Instrumental methods can be prescribed as additional tests. They are X-ray examinations. This method will be discussed below.

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Instrumental diagnostics

Often, X-ray examination is performed to diagnose the disease. X-ray is one of the most important methods of instrumental diagnostics. At the initial stage, it is possible to detect an increase in the pulmonary pattern on the affected segments. At the same time, the transparency of the lung tissue may be completely normal or partially reduced.

The consolidation stage is characterized by intense darkening of the lung areas affected by inflammation. When the lesion covers most of the lung, the shadow is uniform, and in the central areas 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 may remain dilated for a long time.

In particularly difficult cases, computer tomography is used. This is important if differential diagnostics are performed, which involves examining pleural effusion and changes in lung tissue.

Differential diagnostics

This method of research includes a number of measures aimed at correct diagnosis of the problem. First of all, attention is paid to changes in blood parameters. In the inflammatory process, an increased number of leukocytes is observed. Differential diagnostics also include a biochemical blood test, although it is not able to provide 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, it is necessary to conduct a study to determine blood gases. Microbiological studies play an important role. They allow you to identify the bacteria that led to the development of the disease. Simultaneously with sputum culture, smears are also made, followed by bacterioscopy. If the condition is extremely severe, it is necessary to culture venous blood.

Immunological studies and antigen determination are often used. They allow the presence of a specific soluble antigen to be determined in urine. However, this method is not available in every clinic.

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Treatment of bronchopneumonia in children

Therapy of the disease is a difficult and consistent process. This includes combating the infectious origin, as well as eliminating cardiovascular and respiratory failure. It is important to restore all body functions and eliminate morphological changes in the lungs. Thus, in children, the treatment of bronchopneumonia is a complex process that includes a number of specific actions. Elimination of the disease should be carried out in accordance with the phase of pathogenesis.

Hospitalization is possible only if there is an unfavorable premorbid background, severe course of the disease, as well as 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 ward. In the general ward, children are given interferon in their noses, this will help to avoid re-infection or worsening of the situation.

All diagnostic procedures should be gentle. This condition also applies to future treatment. The main condition for successful treatment is individual care. It is necessary to ensure thorough nasal hygiene, sleep in the fresh air or with an open window, and regular ventilation. Quartzization of the room should be carried out. The optimal air temperature is considered to be no more than 20 degrees.

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

Medicines

Antibacterial therapy should be urgent. It is prescribed immediately after diagnosis. It is important that the medications exactly match the child's age. Antibacterial therapy is carried out for 2 weeks. Preference should be given to the antibiotic to which the microflora isolated from the patient's bronchial secretion is sensitive.

In severe stages of the disease, it is necessary to use broad-spectrum antibiotics. These may be Erythromycin, Azithromycin, Augmentin and Zinnat. They can be taken either separately or in combination with each other. If there is no positive dynamics within 2 days, the medications should be replaced with others. Most often, children are prescribed Nystatin and Levorin. These drugs are antifungal and are taken together with antibiotics. Euphyllin is used to stabilize blood pressure.

• Erythromycin. The drug is used internally, 20-40 mg per kilogram of weight. The dose depends on the severity of the child's condition. The drug should not be used in case of hypersensitivity, liver or kidney failure. Nausea, vomiting, tinnitus and urticaria may develop.
• Azithromycin. The drug is taken orally one hour before meals, or 2 hours after. The dosage is prescribed by the doctor depending on the individual course of the disease. The drug should not be taken by children under 12 years of age. It can lead to the development of allergic reactions, dizziness, diarrhea, nausea, vomiting.
• Augmentin. The dose is prescribed individually, depending on the person's condition, age and weight. The drug should not be used in case of hypersensitivity, as well as impaired liver function. Nausea, dyspeptic symptoms and leukopenia may develop.
• Zinnat. The drug is used one tablet 2 times a day. The duration of therapy is on average 10 days. The drug should not be used in case of hypersensitivity, as well as for children under 3 years of age. It can cause gastrointestinal disorders and allergic reactions.
• Nystatin. The drug is prescribed at 250,000 IU 3-4 times a day. The dosage can be adjusted by the attending physician. He also prescribes the duration of therapy. The drug is not used in newborns under one year old. It 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 in case of hypersensitivity and at the age of up to 2 years. May cause disorders of the digestive tract.
• Euphyllin. The drug is used 4 times a day, at a rate of 7-10 mg per kilogram of weight. The drug is not used at the age of up to 3 years, as well as in case of hypersensitivity. May lead to the development of gastrointestinal disorders.

Folk remedies

At this stage, the child needs to be provided with maximum care. Parents should be with the baby all the time and surround him with the necessary care and warmth. Treatment with folk remedies will help with this.

It is necessary to start eliminating the disease with the help of effective means. Thus, birch buds and honey have a good effect. You should take 750 grams of honey and mix it with 100 grams of buds. All ingredients are heated on the stove and boiled for 7 minutes. When the decoction is ready, it needs to be cooled. It is taken one dessert spoon, diluted with a small amount of liquid, before bedtime.

Tar water has proven itself well in this case. You need to take a clean three-liter glass jar and pour 500 ml of medical tar into it. Then fill the vessel to the brim with water, preferably boiling water. Then hide the jar in a warm place for 9 days. When the remedy is infused, you can begin to treat the child. It is necessary to use one spoon before bedtime. Tar water tastes quite disgusting, so the baby should be given something tasty to eat after the remedy. These two recipes are the most popular and effective of their kind.

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Herbal treatment

Who would have thought that a common plantain can cope with even such a serious disease. Thus, herbal treatment has proven itself since ancient times. With the help of plantain, you can overcome many diseases, including bronchopneumonia.

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

You can also try garlic. To do this, wash it and put it in a plastic cup. Before doing this, the cup needs to be pierced. It is enough to make several holes with an awl. Finely chop the garlic and place it in the prepared cup. Then let the baby smell this remedy. The procedure is repeated several times a day.

Homeopathy

Today, homeopathic treatment is very popular. Thus, homeopathy is perfect for people with intolerance to strong chemicals. For many patients, this is really a way out of a difficult situation. Homeopathic remedies allow for high-quality and final cure of bronchopneumonia.

At the initial stage, it is recommended to resort to the help of Aconite in 3 dilutions. After which the remedy Bryonia is used in the same dilution. Belladonna helps to cope with the disease perfectly. Over time, they begin to prescribe drugs depending on the clinical manifestations. If there is blood in the sputum, Phosphorus in 6 dilution or Ipecacuanha in 3 dilution is used. If moist rales are observed, Antimonium Tartaricum in 3 and 6 dilutions is used. Iodum in 3 and 6 dilutions and Kalium Iodatum in 3 and 6 dilutions help to cope with coughing fits. Veratrum Viride in 3 and 3 dilutions is used for heart failure.

It is important to understand that a child's body does not require any experiments. Therefore, you should not start treatment with homeopathic remedies on your own. Everything is done under the supervision of an experienced specialist.

Surgical treatment

Surgical intervention is not performed very often. Surgical treatment is started if the inflammation of the respiratory tract has led to a violation of bronchial patency. The fact is that the mechanism of bronchiectasis has not been fully studied.

The violation of bronchial patency is characterized by blockage of the bronchus, which leads to its significant expansion. The end result of this process is the exclusion of the entire lung or a separate part of it from the act of breathing. This condition requires immediate surgical intervention. Otherwise, the baby simply will not be able to breathe.

Surgical intervention involves the removal of a lung or its individual segments. Such an operation is performed extremely rarely. If a child under 7 years of age has not suffered from the formation of bronchiectasis, there is still hope that they will not occur. It is worth noting that surgical intervention is performed only in the case of a severe course of chronic bronchopneumonia.

Prevention

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

Secondary preventive measures include preventing recurrent diseases. It is important to start treatment on time, its effectiveness plays an important role. It is impossible to allow a protracted or chronic form of the disease. It is necessary to carefully prevent reinfection. This is especially important in cases where no more than 2 months have passed since acute pneumonia. It is also necessary to treat concomitant diseases, including rickets, dystrophy and anemia. Active general strengthening and stimulating therapy should be carried out. This will prevent the emergence of new foci of inflammation.

Forecast

If the treatment was carried out on time and gave positive results, then there is nothing to worry about. In this case, the prognosis will be favorable. When the first symptoms appear, you should immediately seek help from a doctor. This will reduce the risk of developing serious complications. After all, they can significantly worsen the situation and make the prognosis unfavorable.

Insufficient treatment, the presence of viral or bacterial reinfection can cause the formation of a protracted or even chronic process. In the case of a destructive process or severe pneumonia, the prognosis becomes unfavorable.

The child's body is too susceptible to various infections. The baby's immune system is not able to resist many diseases. Therefore, they begin to actively progress in the body. If high-quality treatment is not prescribed, a negative development of the situation is possible. This indicates that the baby's health must be constantly monitored and taken to the doctor in time.

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