Bronchopneumonia

Bronchopneumonia is an inflammatory disease that affects small areas of the lung. Consider the main symptoms, types, methods of diagnosis, treatment and measures to prevent the disease.

The disease is called focal pneumonia, as it differs from the classic clinical symptomatology of inflammation. There are several types and forms that differ in the nature of the course and complexity of therapy. The peculiarity of the disease is that the patient is waiting for a long treatment, which does not exclude relapses.

Most often, the disease occurs in elderly patients and in children in the first years of life. This is explained by the specific regulation of breathing, the structure of the respiratory system and the metabolic processes.

ICD-10 code

According to the international classification of diseases of the 10th revision, bronchopneumonia refers to:

Class X

Diseases of the respiratory system (J00-J99):

J00-J06 Acute respiratory infections of the upper respiratory tract

J10-J18 Influenza and pneumonia:

• J10 Influenza caused by an identified influenza virus
• J11 Influenza, virus not identified
• J12 Viral pneumonia, not elsewhere classified
• J13 Pneumonia caused by Streptococcus pneumoniae
• J14 Pneumonia caused by Haemophilus influenzae (Afanasyev-Pfeffer's stick)
• 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 specification of agent:
  • J18.0 Bronchopneumonia, unspecified
  • J18.1 Shared pneumonia, unspecified
  • J18.2 Hypostatic pneumonia, unspecified
  • J18.8 Other pneumonia, causative agent not specified
  • J18.9 Pneumonia, unspecified

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

To identify the root cause of the disease and its pathogen, it can use an additional encoding in μb 10.

Causes of bronchopneumonia

The defeat of the inflammatory inflammatory system has several causes, as a rule, they are associated with infectious agents.

Consider the main factors:

• Infection, originating in the bronchi and extending to the lungs. Inflammation can be triggered by such pathogens as: Staphylococcus aureus, pneumococci, Escherichia coli, Klebsiella.
• Long-term exposure to the respiratory system of aggressive chemical or physical stimuli.
• In most cases, this is a separate disease, but can act as a complication or symptom of other neglected and chronic ailments that cause severe disruption in the functioning of the immune system (bronchitis, bronchiolitis).
• External infections that develop against a weakened immune system and other diseases. So, with the flu, the bronchial mucosa changes, because of this, bacteria and viruses provoking focal inflammation begin to multiply.

If the disease has a bacterial form, then this is due to the invasion of bacteria into the parenchyma of the lung tissue. The immune system responds to infection and inflammation occurs. This reaction provokes the filling of exsudate alveolar sacs. The focal form has several isolated foci, so replacing air with a fluid affects one or more of the pulmonary lobes.

[1], [2]

Causative agent bronchopneumonia

In most cases, the causative agent of the inflammatory process are low-microbial microorganisms. It can be: streptococci, Escherichia coli, Staphylococcus, fungi, Haemophilus influenzae. The spectrum of pathogens is quite wide, and varies depending on the age category of the patients.

• In young children - a virus, in older children and young patients - mycoplasma (microorganisms are similar to viruses and bacteria, provoke atypical inflammation). In any case, the symptoms of the disorder develop slowly.
• In adults, these are bacteria: streptococci, hemophils, staphylococci.
• In elderly patients, with oncology, weakened immune system, after transplantation and those who take immunosuppressors are viral, bacterial and fungal infections. In this case, even fungi of the genus Candida, Pneumocystis carinii and tuberculosis, can be provoked by the disease.

[3], [4], [5], [6], [7], [8]

Pathogenesis

The mechanism of development of the defeat of the respiratory system is closely related to bronchiolitis and acute bronchitis. Pathogenesis has a hematogenous character, so it can occur when generalizing the infection (septic pneumonia). Most often, the inflammation spreads to the pulmonary tissue downward (bronchiolitis, catarrhal bronchitis), that is itrabronchial, less often peribronhial (destructive bronchitis and bronchiolitis).

Great importance in the development of the disorder have:

• aspiration pneumonia - autoinfection with aspiration;
• hypostatic pneumonia - congestion in the lungs;
• postoperative pneumonia - neuroreflex disorders;
• immunodeficiency pneumonia - immunodeficiency states.

Basal lungs on each side usually fall under the defeat. Despite the differences in the cause and causative agents of the disease, morphological changes have a number of common features.

1. With any etiology of the disease, bronchiolitis or acute bronchitis is the basis, which can be represented by various forms: serous, mixed, mucous or purulent.
2. The mucous membrane swells, becomes full-blooded, which provokes an abundant secretion of mucus with goblet cells and glands. Damage to the bronchial tree is due to sloughing of the prismatic epithelium of the mucous membrane. Because of the edema of the wall, bronchioles and bronchi thicken.
3. The drainage function of the bronchi is disturbed, which causes the aspiration of infected mucus along the distal parts of the bronchial tree. Pathology usually occurs in the posterior and posterior segments of the lungs.
4. Depending on the size of the lesion, there is a lobular, azyznaya, draining lobular, segmental and polisegmentent forms of the disease. In the alveoli accumulate exudate with mucus, erythrocytes, neutrophils and macrophages. The fluid is distributed unevenly, while the interalveolar septa are also impregnated with a cellular infiltrate.

Particular attention should be paid to the fact that the disorder has some peculiarities in patients of different ages. Thus, newborns on the surface of the alveoli form hyaline membranes from condensed fibrin. In children from 1 to 2 years old, pathology affects the posterior ones adjacent to the spine and incompletely spread out after the birth of the lungs. In patients older than 50 years, the process proceeds slowly, which is associated with the age-related reduction of the lymphatic system.

Symptoms of bronchopneumonia

All inflammatory diseases that affect the respiratory system have similar signs. Symptoms of bronchopneumonia develop slowly, especially if it appears against the background of another disease

Patients complain about:

• Strong fever
• Chills
• Dry cough or cough with sputum
• Painful sensations in the chest
• Tachycardia
• Rapid breathing
• Chroches in the lungs
• Leukopenia
• Leukocytosis
• Increase of ROE

If the disease has a secondary form, that is, develops, for example, against the background of bronchitis, then the symptomatology manifests itself as a sharp deterioration in the state of health. There is increased weakness, fatigue, headaches. The temperature rises to 38-39 degrees, there is a cough and shortness of breath.

With percussion, the sound does not always change (the focus is small or localized in the central lobes), but it can shorten or acquire a tympanic character (with a near location of the foci of inflammation or their fusion). Appear small bubble or dry rales of a non-permanent nature, breathing remains vesicular. In blood tests, leukocytosis is often detected, but in rare cases, there may be a decreased number of leukocytes.

First signs

Inflammatory lesions of the respiratory system, like any other disease, is not immediately apparent. The first signs can be seen when the disease begins to progress, spreading through the body. The process of determining the disease is complicated by the fact that it can develop against the background of other infections and damage to the body.

Regardless of its shape, it has such characteristics:

• Sharp deterioration of state of health
• Severe headaches, migraines
• Increased weakness
• Fatigue
• Increased body temperature
• Dry or wet cough

If it develops against the background of acute bronchitis, then in addition to high fever, feverish condition, loss of appetite, muscle weakness, chills, intoxication of the body. The patient complains of painful sensations behind the sternum, which are manifested when coughing and deep inspiration.

[9]

Temperature

Regardless of the form of the disease, there is a definite clinical picture that allows you to diagnose it. Temperature is one of the symptoms that indicate pathological processes in the body. If the ailment develops on the background of bronchitis or catarrh of the upper respiratory tract, then it is difficult to suspect bronchopneumonia, because apart from a slight increase in temperature, there are no other symptoms. But in some cases, the secondary form of the disorder manifests itself acutely, as a rule, in young patients. The temperature rises to 38-39 ° C, accompanied by chills, increased weakness, headaches, cough and pain in the chest.

Elevated temperature indicates that the immune system is struggling to fight bacteria and viruses that damage the respiratory system. Against the background of the above symptoms there is a tachycardia, breathing becomes vesicular. When analyzing blood, neutrophilic leukocytosis can be detected. Especially acute temperature is maintained in the first days, after it acquires a subfebrile form.

Cough

Against the background of various pathological symptoms accompanying the defeat of the bronchi, a number of signs that appear independently of the form of inflammation. Cough refers to such symptoms. It can be wet with phlegm-purulent phlegm with blood veins or dry. On its background there is shortness of breath and rapid breathing, tachycardia develops and pains in the chest area.

Cough reflex is a protective function of the body from various infectious agents that enter the respiratory tract. If this reflex is suppressed, it will lead to a disruption of the drainage function of the bronchial tree. This will exacerbate the course of the disease, since the body will not be able to get rid of the accumulated inflammatory exudate.

As a rule, at first, the cough is dry and nasal. Sputum greenish, begins to stand out gradually, later it appears veins of blood. Against the backdrop of coughing and rapid breathing, serous-mucous discharge comes from the nose. When rattling the lungs, weak wheezing and vesicular breathing are determined. If the cough passes without temperature, radiographic and fluorographic studies are used to identify the disorder. With the help of these methods it is possible to determine the foci of shading and their magnitude in the pulmonary lobes.

[10], [11]

Bronchopneumonia without temperature

Diseases of the respiratory organs have a certain set of symptoms, through which the ailment can be quickly and diagnosed. But in some cases, resort to differential diagnosis. One such example is bronchopneumonia without temperature. This phenomenon is very rare and most often in children. As a rule, the absence of temperature is accompanied by the following symptoms:

• Tachycardia
• General intoxication of the body
• Anxiety
• Weakness and lethargy
• Convulsions
• Pale skin
• Chest pain during movement
• Unhealthy blush
• Drowsiness
• Reduced appetite

Atypical form of inflammation is associated with individual reactions of the body to infectious stimuli. The causes that cause the latent course of the disease can be such factors as: violation of the immune status, improper intake of antibiotics. It is almost impossible to detect pathology without medical examination and special diagnostic methods.

[12], [13]

Effects

Inflammatory diseases of the respiratory system adversely affect the entire body, causing disruptions in the work of all organs and systems. The consequences of ailment directly depend on its form, complexity, correctness of diagnosis, selected therapy and individual characteristics of the patient's body. Most often, the disease leads to the development of chronic bronchitis with inflammation of the bronchial mucosa, bronchial asthma.

More negative consequences are considered - fibrosis and abscess of the lung:

• Abscess is the decomposition of the organ tissues due to the pus formed in the inflammation focus. It can be formed either singly or in groups, hitting several sections of the lung at the same time.
• Fibrosis - develops due to severe damage to the tissues of the organ during inflammation. In places of damage, connective tissue is formed. The disease causes severe pain in the chest due to insufficient intake of oxygen to the affected areas. In this case, bronchopneumonia takes on a chronic form.

Another negative consequence of the pathology is infectious-allergic myocardium, acute cardiovascular insufficiency, dysbiosis, infectious-toxic shock. In elderly patients, most often there is respiratory failure due to disruption of gas exchange in the lungs and problems with the cardiovascular system.

The consequences of bronchopneumonia in children differ somewhat from similar processes in adults. The difference is that the total intoxication of the body is more pronounced than pulmonary pathological symptoms. Because of this, there are problems in diagnosis, which means that the wrong treatment is prescribed, which leads to serious complications.

Incomplete or incorrect treatment in children leads to such pathological results:

• Delayed diuresis - in many children who have had respiratory system diseases, urination disorders occur. To eliminate them, use various medications.
• Syndrome of intoxication - the child's body gradually accumulates the products of the vital activity of viruses and bacteria, which aggravates the inflammation. For a long time, high temperature, lethargy, lack of appetite. In addition, there may be a gastrointestinal disorder, exhaustion, headaches.
• Neurotoxicosis - the disorder has several stages. The first is characterized by a sharp increase in the activity of the child, hysterics. After this, there comes a period of inhibition, the baby becomes sluggish, loses appetite. At the last terminal stage, the temperature rises sharply, clonic convulsions appear and breathing stops.
• Chronic pneumonia - negatively affects the development of the baby's body, causes frequent relapses of the disease, a decrease in immunity. In addition, deformation of the chest is possible.
• Exudative pleurisy - an exudate of an inflammatory nature accumulates between the pleura sheets. Without proper treatment, leads to lung hydrothorax, which is treated with pleural puncture.
• Adhesive pleurisy - in the pleural cavity appears fibrin, causing severe pain in the chest. To eliminate the pathology requires a cicatricial operation.
• Sepsis is the most serious consequence of the disease. Pathology arises from the infection of the lungs in the blood, which carries it throughout the body. Characterized by a sharp increase in temperature, the appearance of abscesses in different parts of the body. To cure this complication is almost impossible, therefore the lethal outcome is 100%.
• Asthenia - after the course of therapy the child complains of increased weakness, there is a decrease in activity and performance, poor appetite and low body temperature. As a rule, the syndrome passes quickly and does not require medical care.

[14], [15], [16], [17], [18]

Complications

The aggressive course of respiratory diseases or their incorrect treatment leads to negative results. Complications cause violations by all organs and systems. Most often, the disease provokes the development of pleurisy, empyema, that is, the suppuration of the pleura and abscesses. Very rarely, one of the life-threatening complications arises - pneumothorax, that is, a rupture of the lung tissue. In this case, if the patient is not provided with timely medical assistance, then there is a risk of a lethal outcome.

There are two types of complications, consider them:

• Pulmonary
  • Pulmonary edema
  • Reactive pleurisy
  • Lung destruction
  • Abscess
  • Gangrene
  • Empyema of the pleura
  • Acute or chronic respiratory failure
• Extrapulmonary
  • Chronic and acute pulmonary heart
  • Intoxication psychosis
  • Impaired renal function
  • Meningitis
  • Hemolytic anemia
  • Meningoencephalitis
  • Sepsis

A severe course of inflammation leads to the development of multiple foci of infection and acute respiratory failure. If harmful microorganisms enter the blood, then this leads to sepsis, which leads to death. The presence of complications directly affects the course of the disease and the functioning of the body as a whole. The task of the doctor in time to identify complications and prescribe stronger therapy.

[19], [20], [21], [22], [23], [24], [25]

Diagnosis of bronchopneumonia

The effectiveness of the treatment of any disease directly depends on the methods used to detect it. Diagnosis of bronchopneumonia is a complex of studies that can determine the presence of the disease in the early stages. After examining the patient and collecting an anamnesis, the doctor sends it to the radiography. On the X-ray, the focus of inflammation is clearly visible. After that, a microbiological examination of sputum, mucus or a smear from the throat is carried out. This will determine the causative agent of the disease and select effective drugs to which the harmful microorganism is sensitive.

Particular attention is paid to differential diagnostic methods. This is necessary for separating the inflammatory process of other pathological processes in the lungs, determining the severity and complications. The development of pneumonia is indicated by characteristic symptomatic signs: intoxication of the body, cough with separation of sputum, rapid development of fever and elevated body temperature.

With the help of physical research, it is possible to determine the consolidation of the tissue and the characteristic auscultatory pattern of the disorder-sonorous, small-bubble, focal, lax crepitations or wheezing. Ultrasound examination of the pleural cavity and echocardiography can reveal pleural effusion. The patient is taken an overall blood test, in which the inflammatory process is reflected in the form of leukocytosis, increased ESR and stab-shift. In the urinalysis can be detected proteinuria or microhematuria.

[26], [27], [28], [29], [30], [31]

Auscultation

When diagnosing diseases of the respiratory system, special attention is paid to the study of sound phenomena that arise in the body. Auscultation is carried out by applying to the chest a tool for listening. Distinguish direct, mediocre and mediated listening. The procedure is performed with a stethoscope and a phonendoscope. The patient should be in a standing or sitting position, breathing should be calm, even.

For the detection of pathological rales, comparative auscultation is used. This is due to the fact that more accurate data can be obtained by comparative listening to symmetrical areas of lung tissue. First, the front surface of the lungs is heard, beginning with the area of the apices, and then the back surface and checking the symmetrical points. As a rule, 2-3 full respiratory cycles are studied at each point, that is, inhaling and exhaling.

Sounds heard over the lungs are divided into groups such as:

• The basic respiratory noises are various kinds of breath which are listened to above normal lungs.
• Adverse respiratory noises are sounds that form over the breath, normal and pathological. They are listened to simultaneously with the main respiratory noises, these can be wheezing, pleural friction noise, pericardial noises.

Every healthy person over the lungs hears such kinds of breathing:

1. Vesicular - occurs over a large surface of the lung tissue. Formed by the expansion of the alveoli due to the intake of air in them and the tension of their elastic elements.

• Enhanced vesicular breathing is possible with both inspiration and exhalation. As a rule, it arises from the difficulty of passage of air through the small bronchi, with their puffiness or spasms.
• Weakened - occurs with emphysema due to a decrease in the number of alveoli. This occurs as a result of destruction of the interalveolar septa and a decrease in the elasticity of their walls. It occurs with inflammation of the respiratory muscles and intercostal nerves, bruises and fractures of the ribs.

When filling the alveoli with inflammatory exudates, this type of breathing may not be heard. To its disappearance leads to a complete blockage of the large bronchus and the development of atelectasis.

2. Bronchial respiration occurs over certain parts of the airways and lungs. Formed by the passage of air through the vocal chord, along the bronchial tree, extending to the surface of the chest.

• Stenotic breathing - arises from the narrowing of the trachea or the main bronchus. It is characterized by increased laryngotracheal breathing.
• Mixed breathing - occurs over the foci of compacted pulmonary tissue, which are located in the depth of a healthy tissue. The inspiratory phase is similar to vesicular breathing, and exhalation with bronchial.
• Rigid - is listened to when narrowing the lumen of the bronchi due to the inflammatory process or swelling. It is characterized by a loud and long breath, but a normal exhalation.

In addition to the above-described types of breathing, there are also secondary respiratory sounds:

Chryps - may be dry and wet. Formed by the passage of air through the bronchial tree. Dry appear when there is a viscous, thick secret in the bronchi, and wet - when filling the bronchi with a moist secret.

• Crepitation - occurs as a result of the spreading of the asleep alveoli, which contain a small amount of exudate.
• Noise of friction of the pleura - indicates the development of dry pleurisy. From other noises differs in that it is heard both during inspiration and exhalation, but does not change after a cough.

With auscultation, there is an increase in signs of bronchophonia. Breath bronchial or vesiculobronchial with dry and wet wheezing. Creption is heard in the initial phase of the disease. If the inflammation spreads to the pleura, then there is a noise of friction of the pleura. In severe course, tachycardia and arterial hypotension, collapse, are possible.

[32], [33], [34], [35], [36], [37]

Analyzes

In the process of diagnosing the defeat of the respiratory tract, the patient is prescribed a number of procedures to determine the causative agent of the disease, severity and other characteristics. Analyzes with bronchopneumonia are necessary for its confirmation and establishment of its variety. Blood and urine are used for this purpose. If the disease has a mild course, then in the blood there is a moderate leukocytosis and an increase in ESR. At moderate severity - pronounced leukocytosis and elevated ESR. Heavy form occurs with a large increase in leukocytes, high ESR, a decrease in lymphocytes and toxic granularity of neutrophils.

To obtain reliable results, blood is given on an empty stomach, the last meal should be at least eight hours before the test. The study is conducted before antibiotics are taken or 2-3 weeks after they are withdrawn. When passing urine tests, any deviations from the norm and changes indicate complications.

There is a specific research program used for inflammation of the respiratory system, which includes such analyzes as:

• General analysis of blood and urine
• Bacterioscopy of sputum
• Sputum culture (quantification of flora and determination of sensitivity to antibiotics)

[38], [39], [40],

Radiography of the lungs in two projections

If necessary, the above list is supplemented by a study of the function of external respiration and the study of blood gases, pleural punctures. With appropriate indications, a tomography of the lungs and serological tests, a biochemical blood test are performed. To determine bronchopneumonia of a chronic form, lung radiography is performed in three projections, lung tomography, sputum examination, spirography, biochemical blood analysis, bronchography and fibrobronchoscopy.

Sputum during bronchopneumonia

One of the most important studies in the defeat of the respiratory system is the study of the coughing material. Sputum during bronchopneumonia contains conditionally pathogenic bacteria, the analysis of which makes it possible to draw up a treatment plan. To confirm the inflammatory process, a culture test for anaerobic microflora is carried out.

The material is obtained from the lower respiratory tract by aspiration through the trachea, protected by a brush biopsy or by a transcutaneous puncture. All procedures are invasive, so they are not used without appropriate indications. If the patient has a severe cough, then the collection of sputum is not difficult. If the patient does not have a cough with sputum, then inhalation with a 3% raster of sodium chloride is required.

Particular attention is paid to the study of the gas composition of the arterial blood. The analysis is performed in case of severe illness and complications. With its help, it is possible to identify various degrees of hypercapnia, decreased oxygen saturation, hypoxemia. All described signs are an indication for oxygen therapy.

Instrumental diagnostics

Various methods of studying the symptoms of pneumonia provide an opportunity to recognize the signs of pathology in a timely manner and make a treatment plan. Instrumental diagnosis of bronchopneumonia is represented by many methods, but the most valuable and informative is bronchoscopy and radiography. Most often, the second method is used, because with its help it is possible to visually see the localization of inflammatory foci on the roentgenogram.

Bronchoscopy is used for differential diagnosis. To do this, it is necessary to take bronchoalveolar flushing and to study the harmful microorganisms that caused the disorder. Instrumental methods help to identify the causative agent of the disease and the localization of inflammation. Due to this, the doctor can make an effective therapy plan that prevents complications of the disease and its relapse.

X-ray

X-ray examination of the organs of the respiratory system is one of the main diagnostic methods. X-ray is necessary for the recognition of atypical forms of inflammation, the symptoms of which are not sufficiently pronounced. Different types of bronchopneumonia differ both in etiology and in pathogenesis, but they can produce similar radiographic semiotics.

Expressed bronchopneumonia - the radiographic picture is clear, the focal nature of inflammation is seen. Foci of infiltration can capture groups of pulmonary lobules or be limited to the defeat of several acini. On the roentgenogram they have sizes from 1-15 mm in diameter, can merge into large spotted shadows, which causes a continuous shading.

• Focal inflammation - foci have an irregular shape, which is due to the projection fusion of individual elements. Through the shadow of a large hearth, it is possible to trace the pulmonary pattern, which, due to vascular hyperemia and puffiness, is strengthened.
• The aziotic form - individual focal shadows do not differ from the foci that arise with hematogenous tuberculosis dissemination. On the roentgenogram, there is an increase in the bronchoconstrictive pulmonary pattern and the widening of the root shadows.
• Viral form - X-ray indicates the segmental nature of inflammation. From the pulmonary roots, moderate darkening. Sometimes a specific path appears that connects the enlarged root with pneumonic dimming.

Differential diagnostics

Since diseases of the respiratory system have many symptoms, the process of identifying the primary ailment is significantly complicated. Differential diagnosis is necessary to distinguish the inflammatory process from other lung lesions. For this, anamnesis, clinical, virological, parasitological, bacteriological and other methods of investigation are used.

• Most often bronchopneumonia has to be differentiated from bronchitis, pleurisy. This is due to the fact that all the mentioned ailments are accompanied by similar symptoms. Since, pneumonic foci cause shortness of breath, cough, and sometimes cyanosis.
• Differentiation with tuberculosis is more complicated. This is because the infiltrate has the same localization and gives the same data for auscultation and percussion. In this case, X-ray and bronchoscopy are used.

[41], [42], [43], [44], [45], [46]

Treatment of bronchopneumonia

Any inflammatory disease requires immediate treatment, especially if it concerns the respiratory system. Treatment of bronchopneumonia involves taking effective measures to prevent the spread of infection through the body, the development of various complications and exacerbation of chronic infections.

To eliminate the inflammatory process, the following methods are used:

1. The patient is provided with bed rest, to minimize the load on the cardiovascular system and the body as a whole. Particular attention is paid to nutrition, which should consist of easily digestible foods.
2. Antibiotics are used only after determining the sensitivity of the pathogen to them. Most often, they are prescribed a wide spectrum of action, as well as drugs from different clinical groups. The duration of the course of therapy is determined by the attending physician, who monitors the changes in the patient's analyzes and status.
3. Medicines that dilute and excrete phlegm are used without fail. Advantage is better to give to means on a vegetative basis as they do not cause accustoming, have a minimum of contra-indications and side effects.
4. It is necessary to use desensitizing drugs to reduce local inflammation and remove toxins from the body.
5. Vitaminotherapy is needed to restore the protective properties of the immune system. As a rule, complex multivitamin preparations are used, which contain all the necessary vitamins, minerals and macro elements.

Proceeding from this, it can be concluded that treatment is a rather lengthy and complex process that should only be occupied by a doctor.

Care for bronchopneumonia

The process of recovery in any disease largely depends not only on the drugs used, but also on care. In bronchopneumonia, bed rest and a number of other procedures are indicated, the observance of which is necessary to prevent complications.

Consider the main nuances of care for patients:

• Providing bed rest before overall well-being.
• Compliance of milk and vegetable diet.
• Abundant use of liquid.
• Receiving diluting and expectorant drugs.
• Compliance with symptomatic therapy prescribed by a doctor.

If treatment takes place in a hospital, then intervention of medical personnel is required to conduct a dynamic assessment of the patient's condition. The nurse must monitor the patient's position in bed, taking medication and the procedures prescribed by the doctor.

If the treatment is assigned to a child, then in addition to the above procedures, the following are added:

• Teaching your child the right breathing.
• Carrying out a vibrating massage.
• Provide drainage position (with head down).
• Prevention to prevent complications.

Treatment of bronchopneumonia in the home

Simple forms of inflammatory lung diseases, as a rule, do not heal in a hospital environment, since therapy is not complicated. Treatment of bronchopneumonia at home is most often done with sulfonamides. But do not forget that even mild forms of inflammation have, although not pronounced, but pathological processes - respiratory failure, hypoxemia, anemia. Therefore, special attention should be given to the organization of the patient's regime, if the home conditions do not allow this, then hospitalization is better.

Therapy should be differentiated depending on the severity of the ailment and the characteristics of the patient's body. The use of sulfonamides quickly eliminates malaise, reduces fever and reduces toxic effects. In intoxication combined treatment with antibiotics with a wide spectrum of action is used.

It is extremely important to organize a dietary diet with a high content of B and C vitamins, since in the pathogenesis of respiratory failure they have a leading role. Since the disease causes an increased permeability of the vessels, calcium chloride is used to eliminate this defect. The medicine causes irritation of the cells of connective tissue by increasing the tone of the vagus nerve. For these purposes, you can use ascorbic acid. The task of home treatment is not only to eliminate structural changes in the lungs, but also to restore their normal functioning.

Medications for bronchopneumonia

Treatment of inflammatory lesions of the respiratory system should begin with the first painful symptomatology. Medication is prescribed after the determination of the causative agent, therefore at the beginning of the therapy, antibiotics of a wide spectrum of action are used. Since many harmful micro-organisms quickly develop resistance to such drugs, their constant improvement is required.

For treatment use such antibiotics as:

• Semisynthetic penicillins
• Carbapenems
• Fluoroquinolones
• Cephalosporins
• Tetracyclines
• Macrolides
• Aminoglycosides
• Monobactams

Modern antibacterial agents have high bioavailability and an extended spectrum of action. They have minimal toxic effect on the kidneys, central nervous system, liver.

Antiviral therapy is carried out with such medicines:

• Saquinavir
• Arbidol
• Acyclovir
• Foscarnet
• Ganciclovir
• Valaciclovir
• Zidovudine
• Zalcitabine
• Didanosine

Bronchodilators in inhalation form:

• Anticholinergics
• β-2-agonists
• Methylxanthines
• Expectorants and mucolytic drugs:
• Acetylcysteine
• Amroxol
• Lazolvan
• Ambroben
• Bromhexine
• Bronhosan
• Sinupret
• Gedelix.

Calcium chloride

Calcium is very important for the normal functioning of the body. The thing is that the ions of this substance contribute to the transmission of nerve impulses, the reduction of smooth and skeletal muscles, blood clotting, the functioning of the heart muscles and other organs. With a decrease in the calcium content in the blood plasma, a number of pathological reactions are observed, primarily expressed by hypocalcemia and tetany.

Indications for use of calcium chloride:

• Insufficiency of parathyroid gland function
• Tetany
• Spasmophilia
• Dehydration
• Allergic complications associated with taking medications
• Pulmonary, nasal, gastrointestinal bleeding
• Before surgery to increase blood clotting

The drug is administered intravenously drip / spray and inside. When using the medication, side effects may occur: heartburn, bradycardia, pain in the epigastric region, a feeling of heat. The drug is not used intramuscularly with necrosis or severe tissue irritation. Calcium chloride is contraindicated in atherosclerosis, a tendency to thrombosis and a high level of calcium in the blood.

[47], [48], [49], [50], [51], [52], [53], [54], [55], [56]

Antibiotics for bronchopneumonia

Therapy of pneumonia is a long process that involves the use of different medications. Antibiotics for bronchopneumonia fight with harmful microorganisms that cause disease. To select an effective drug, a number of tests are performed, one of which is sputum analysis. This study allows you to adjust the therapy scheme for a speedy recovery.

When choosing medicines, it is necessary to take into account such factors as: the type of bronchopneumonia, contraindications, toxicity of medicines, the spectrum of the drug's action, the speed of penetration into body fluids, and the speed of reaching a therapeutic dose in inflammatory foci. In some cases, antibiotic drugs do not give the proper result. This is due to improper selection of the drug, its dosage and duration of administration, development of resistance of pathogens and frequent changes of drugs.

To eliminate the sickness form of the disease, such means are used:

• The first line is Amoxicillin, Ceftazidime, Penicillin, Cefepime. With intolerance of these drugs, alternative drugs can be used: Ticarcillin, Cefotaxime, Ciprofloxacin. In some cases, a combination of medications is used to quickly improve the patient's condition.
• The second line - is used in the case when the drugs of the first line were ineffective. For therapy apply - Cefipim, Fluoroquinolone, Meropenem, Ticarcillin.
• The grounds for using the above mentioned means are a severe course of the disease, a mixed type of infection, combinations of harmful microorganisms that are resistant to many drugs.
• For the treatment of the out-of-hospital type of inflammation, use such medications:
• Medium and easy stage - Fluoroquinolone, Aminopenicillin, Clartromycin, Doxycycline.

• Severe stage - Azithromycin, Ceftriaxone, Cefotaxime.

If the patient has a long-term use of antibiotics, then mandatory appoint probiotics and eubiotics - Lineks, Lactobacterin, Bifiform, Bifikol. They prevent the intestinal dysbacteriosis, that is, maintain the normal composition of the microflora. Antibiotics are taken only for medical reasons. If the first 2-3 days after the start of treatment, the positive effect of therapy does not occur, that is, the risk of intoxication of the body and increased inflammation.

[57], [58], [59], [60], [61], [62]

Alternative treatment

In the therapy of bronchopneumonia, a lot of methods are used, which together give a positive result, speeding up the healing process. Alternative treatment is effective in that plant natural ingredients are used to eliminate inflammation. Such drugs have anti-inflammatory, vasodilating, analgesic and other actions, but they have a minimum of adverse reactions and contraindications. If such a combination is combined with classical treatment, the pathological process will be quickly eliminated.

Consider the most popular alternative recipes:

• Anti-inflammatory properties have a balm, for the preparation of which you will need: 250 g of aloe, 500 ml of cahors and 350 g of liquid honey. Before cutting aloe leaves, the plant is recommended not to water for 14 days. After cutting, carefully wipe off dust, grind and place in a glass jar. The plant is flooded with honey and Cahors, mixed well and infused for 14 days in a dark, cool place. After the balsam has been brewed, it must be filtered and wrung out. The medicine is taken for 1 spoon 2-3 times a day.
• Good inhalation effects on the respiratory system. To do this, take a piece of bandage 10-15 cm, carefully rub onion and put in a mug for inhalation. To achieve a therapeutic effect, over a mug you need to breathe 10-15 minutes 5-6 times a day.
• Particularly effective are such tools as: lime honey, onion and garlic juice, dried berries cranberries and raspberries, aloe juice, rose hips, oregano, lime color. Of these ingredients, you can prepare decoctions and infusions to eliminate inflammation and strengthen the immune system.
• From the decoction of mother-and-stepmother and violet or honey with althea, you can prepare an excellent expectorant. All ingredients are taken in equal proportions. The medicine is taken 3-4 times a day 2-3 times a day.

Herbal Treatment

Methods of alternative treatment - is the use of only natural plant components, which favorably affect the body. Treatment with herbs is very popular, because such products are safe to use, have a minimum of side effects and contraindications.

Consider effective recipes on herbs from bronchopneumonia:

• 1 spoonful of buds, ivy, pour 750 ml of steep boiling water and insist for 60 minutes. Infusion should be taken on 2 tablespoons 3-4 times a day before meals. Exceed this dosage is not recommended to avoid toxic effects of the plant.
• A handful of berries of viburnum fill with melted linden honey and let it brew for 6-8 hours. Spoon the medicine pour 250 ml of boiling water, and insist for 2 hours. The drug should be well filtered and taken warm 150 ml 1-3 times a day. Effectively eliminates a strong cough and sputum.
• Take the flowers of linden, mullein and raspberry flowers in the proportion of 2: 3: 3. Pour the herbs 1 liter of boiling water and leave for 6-8 hours. Cooled infusion should be filtered and take 100 ml 3-4 times a day. Helps with a dry, debilitating cough.
• For the preparation of alcoholic infusion with pneumonia, the following ingredients are required: aloe leaves, blueberry leaves, cowberry, beet juice, rutabaga and rosemary roots (all components are taken in equal proportions). Herbal collection pour 1 liter of vodka and insist in a dark cool place for 10-15 days. Before use, honey and butter should be added to the medicine. Take 1-2 spoons 2-3 times a day.
• Pour boiling water 2 parts of leaves of mother-and-stepmother and raspberry fruits, 1 part of oregano. The agent should be infused for 2-4 hours, take 1 spoon, diluted in a glass of water.

Homeopathy

For the treatment of bronchopneumonia and the restoration of normal functioning of the respiratory system, many methods are used to stop the inflammatory process. Homeopathy refers to one of the most popular means, since it is suitable for patients with intolerance to potent chemicals. Homeopathic remedies can effectively cure an ailment of any kind and prevent the development of relapses.

• At the initial stage of the disease, when there is a fever, chills and other symptoms of fever, take Aconite in 3 and 3 dilutions. A couple of days, this tool is replaced by Brion or Belladonna in the same proportions.
• The further use of medicines depends on the overall symptomatic pattern. So, if there is a dry cough with sputum discharge rusty shade, then take Sanguine in 3 dilutions.
• To eliminate dry and wet wheezing, wheezing and separation of phlegm, Antimonium Tartaricum is used in 3 and 6 dilutions. If the cough is accompanied by pain in the chest, then use Iodum or Kalium Yodatum in 3 and 6 dilutions.
• If the disease has a long course, and antibiotic drugs do not help, then homeopathic medicines can be used: Sulfur, Arsenicum Albumum, Gepar Sulfur and Arsenicum Iodatum in 3 and 6 dilutions.

All homeopathic preparations should be prescribed by a homeopath physician, after a thorough examination. It is contraindicated to take such medicines independently.

Operative treatment

Prolonged and chronic forms of bronchopneumonia entail many serious complications. Surgical treatment is indicated for pathological lesions of the respiratory system, when a prolonged inflammatory process led to irreversible changes in the lung tissue. Most often, the operation is necessary for chronic abscesses, the formation of primary lung cancer or bronchogenic cancer.

Patients may be scheduled for lung resection to improve general condition and save life. Most often, segmental resection, pneumectomy and lobectomy are used. All procedures are performed by the method of separate ligation of the lobe, segment or elements of the lung root.

If pathology is bilateral, seizing individual segments of several lobes, then segmental resection is shown, which allows to radically cure a patient who was previously considered hopeless. If the inflammation is the cause of purulent intoxication, then in addition to general restorative therapy, postural drainage is carried out to facilitate the withdrawal of sputum and exudate.

Prevention

In addition to the main treatment used to eliminate bronchopneumonia, methods of preventing disease are important. Prevention is indicated to patients of all ages, regardless of the form of the disease.

Let's consider the basic preventive recommendations:

• Elderly patients are recommended to vaccinate against streptococcal infection, which is the most common causative agent of the disease. For children at risk, vaccination against pneumonia is carried out.
• To prevent pathology, it is necessary to undergo an annual vaccination against influenza. Since very often this disease causes complications in the form of bronchopneumonia.
• Observance of elementary rules of hygiene, that is, washing hands with soap, the use of individual towels and dishes, also prevent infection by pathogens.
• Particular attention should be paid to strengthening the immune system. For these purposes, they use vitamin therapy, various complexes of microelements and minerals. A healthy full-fledged diet also refers to prevention methods, as it enhances the immune status.
• Refusal from such harmful habits as smoking and alcoholism, in which the resistance of bronchi and lungs to infections decreases, is an important method of preventing not only diseases of the respiratory system, but also the body as a whole.

Singular for the prevention of bronchopneumonia

Singular is a medicine for the treatment of bronchi and lungs, from the pharmacological group of leukotriene receptor antagonists and antiasthmatics. It is prescribed, as a rule, to children of child age. The active component of the drug is Montelukast. It inhibits leukotriene receptors of the epithelium of the bronchi and lung tissue, making them resistant to the effects of cysteinyl leukotrienes. Tablets prevent bronchial spasms, increased eosinophils and sputum production. The agent causes bronchial relaxation within 2 hours from the time of administration and reduces the content of intracellular and inflammatory factors of the respiratory system.

• For patients older than 15 years, appoint 10 mg once a day before bedtime. Children from 2-5 years, 4 mg once a day, and for patients 6-14 years, 5 mg per day. The tablet should be thoroughly chewed and washed down with plenty of liquid.
• Side effects occur when the rules for the use of medicines are not observed. As a rule, the patient complains of thirst, increased anxiety, headaches, allergic reactions to the skin. In especially severe cases, anaphylaxis, increased bleeding, paresthesia, tachycardia and swelling are possible.
• In case of an overdose epigastric pain, drowsiness, severe thirst, vomiting appear. Treatment is symptomatic, hemodialysis is not carried out.
• Tablets are contraindicated for patients younger than 2 years. Prohibition of use is hypersensitivity to the active ingredient and other components of the drug.

Forecast

The course and effectiveness of treatment of inflammatory lesions of the bronchi and lungs largely depends on the type of disease, severity and individual characteristics of the patient's body. The prognosis is based on the state of the cardiovascular system, as it is closely related to bronchopneumonia. In addition, there is a dependence of the outcome of the disease on the age of the patient. That is, the older the patient, the more difficult the malaise and the worse the prognosis may be, because the disease often recurs.

Bronchopneumonia has a serious prognosis (up to a lethal outcome) in patients with circulatory insufficiency, various diseases of the cardiovascular system, in dystrophy, avitaminosis and diseases accompanied by cachexia. With timely diagnosis and treatment, the prognosis is positive.

[63], [64], [65], [66], [67], [68], [69], [70], [71]