Bronchopneumonia

Bronchopneumonia is an inflammatory disease that affects small areas of the lung. Let's look at the main symptoms, types, diagnostic methods, treatment and measures to prevent the disease.

The disease is called focal pneumonia, as it differs from the classic clinical symptoms 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 will have to undergo long-term treatment, which does not exclude relapses.

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

ICD-10 code

According to the International Classification of Diseases, 10th revision, bronchopneumonia is classified as:

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 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 agents, 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

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 pleura

J95-J99 Other diseases of the respiratory system

To identify the root cause of the disease and its pathogen, additional coding according to ICD 10 can be used.

Causes of bronchopneumonia

Inflammatory damage to the respiratory system has several causes, as a rule, they are associated with infectious agents.

Let's consider the main factors:

• An infection that originates in the bronchi and spreads to the lungs. Inflammation can be caused by pathogens such as Staphylococcus aureus, pneumococci, E. coli, and Klebsiella.
• Long-term exposure of the respiratory system to aggressive chemical or physical irritants.
• In most cases, this is a separate disease, but it can be a complication or symptom of other advanced and chronic illnesses that cause severe disruptions in the functioning of the immune system (bronchitis, bronchiolitis).
• External infections that develop against the background of a weakened immune system and other diseases. Thus, with the flu, the mucous membrane of the bronchi changes, because of this, bacteria and viruses begin to multiply, provoking focal inflammation.

If the disease has a bacterial form, it is caused by the invasion of bacteria into the parenchyma of the lung tissue. The immune system responds to the infection and inflammation occurs. This reaction provokes the filling of the alveolar sacs with exudate. The focal form has several isolated foci, so the replacement of air with liquid affects one or more pulmonary lobes.

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The causative agent of bronchopneumonia

In most cases, the causative agent of the inflammatory process is low-virulence microorganisms. These can be: streptococci, E. coli, staphylococci, fungi, Haemophilus influenzae. The spectrum of pathogens is quite wide and varies depending on the age category of patients.

• In small children, these are viruses; in older children and young patients, these are mycoplasmas (microorganisms similar to both viruses and bacteria, causing atypical inflammations). In any case, the symptoms of the disorder develop slowly.
• In adults, these are bacteria: streptococci, hemophilus, staphylococci.
• In elderly patients, those with cancer, weakened immune systems, after transplantation and those taking immunosuppressants - these are viral, bacterial and fungal infections. In this case, even Candida fungi, Pneumocystis carinii and tuberculosis can provoke the disease.

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Pathogenesis

The mechanism of development of respiratory system damage is closely related to bronchiolitis and acute bronchitis. Pathogenesis is hematogenous in nature, therefore it can occur with generalization of infection (septic pneumonia). Most often, inflammation spreads to the lung tissue in a descending manner (bronchiolitis, catarrhal bronchitis), i.e. intrabronchial, less often peribronchial (destructive bronchitis and bronchiolitis).

Of great importance in the development of the disorder are:

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

Usually, the basal parts of the lungs on each side are affected. Despite the differences in the cause and pathogens of the disease, the morphological changes have a number of common features.

1. Regardless of the etiology of the disease, the underlying cause is bronchiolitis or acute bronchitis, which can be presented in various forms: serous, mixed, mucous or purulent.
2. The mucous membrane swells, becomes full-blooded, which provokes abundant secretion of mucus by goblet cells and glands. Damage to the bronchial tree occurs due to exfoliation of the covering prismatic epithelium of the mucous membrane. Due to edema, the walls of the bronchioles and bronchi thicken.
3. The drainage function of the bronchi is impaired, which causes aspiration of infected mucus along the distal parts of the bronchial tree. The pathology usually occurs in the posterior lower and posterior segments of the lungs.
4. Depending on the size of the lesion, there are lobular, acyous, confluent lobular, segmental and polysegmental forms of the disease. Exudate with mucus, erythrocytes, neutrophils and macrophages accumulate in the alveoli. The fluid is distributed unevenly, while the interalveolar septa are also saturated with cellular infiltrate.

Particular attention should be paid to the fact that the disorder has some peculiarities in patients of different ages. Thus, in newborns, hyaline membranes of compacted fibrin are formed on the surface of the alveoli. In children aged 1-2 years, the pathology affects the posterior parts of the lungs adjacent to the spine and not fully straightened after birth. In patients over 50 years old, the process is slow, which is associated with age-related reduction of the lymphatic system.

Symptoms of bronchopneumonia

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

Patients complain of:

• High fever
• Chills
• Dry cough or cough with sputum production
• Pain in the chest
• Tachycardia
• Rapid breathing
• Wheezing in the lungs
• Leukopenia
• Leukocytosis
• Increase in ESR

If the disease has a secondary form, i.e. develops, for example, against the background of bronchitis, then the symptoms manifest as a sharp deterioration in health. Increased weakness, fatigue, headaches appear. The temperature rises to 38-39 degrees, cough and shortness of breath appear.

On 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 close location of the foci of inflammation or their fusion). Small bubbling or dry wheezing of an inconstant nature appears, breathing remains vesicular. Blood tests often reveal leukocytosis, but in rare cases there may also be a reduced number of leukocytes.

First signs

Inflammatory damage to the respiratory organs, like any other disease, does not manifest itself immediately. The first signs can be noticed when the disease begins to progress, spreading throughout the body. The process of determining the disease is complicated by the fact that it can develop against the background of other infections and lesions of the body.

Regardless of its form, it has the following characteristics:

• A sharp deterioration in 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 temperature, a feverish state, loss of appetite, muscle weakness, chills, and intoxication of the body are possible. The patient complains of painful sensations behind the breastbone, which manifest themselves when coughing and taking a deep breath.

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Temperature

Regardless of the form of the disease, there is a certain clinical picture that allows diagnosing it. Temperature is one of the symptoms indicating pathological processes in the body. If the disease develops against the background of bronchitis or catarrh of the upper respiratory tract, then it is difficult to suspect bronchopneumonia, since 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, usually in young patients. The temperature rises to 38-39 ° C, accompanied by chills, increased weakness, headaches, cough and pain in the chest area.

An elevated temperature indicates that the immune system is struggling with bacteria and viruses that affect the respiratory system. Against the background of the above symptoms, tachycardia appears, breathing becomes vesicular. A blood test may reveal neutrophilic leukocytosis. The temperature is especially acute in the first days, then it becomes subfebrile.

Cough

Against the background of various pathological symptoms accompanying bronchial damage, a number of signs are distinguished that appear regardless of the form of inflammation. Cough refers to such symptoms. It can be wet with mucopurulent sputum with streaks of blood or dry. Against its background, shortness of breath and rapid breathing appear, tachycardia and chest pain develop.

The cough reflex is a protective function of the body against various infectious agents entering the respiratory tract. If this reflex is suppressed, it will lead to a disruption of the drainage function of the bronchial tree. This will aggravate the course of the disease, since the body will not be able to get rid of the accumulated inflammatory exudate on its own.

As a rule, at first, the cough is dry and straining. Greenish sputum begins to be released gradually, later streaks of blood appear in it. Against the background of coughing and rapid breathing, serous-mucous discharge comes from the nose. When tapping the lungs, weak wheezing and vesicular increased breathing are determined. If the cough passes without fever, then X-ray 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 size in the pulmonary lobes.

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Bronchopneumonia without fever

Respiratory diseases have a certain set of symptoms, with the help of which the disease can be quickly diagnosed. But in some cases, differential diagnostics are used. One such example is bronchopneumonia without fever. This phenomenon is very rare and most often occurs in children. As a rule, the absence of fever is accompanied by the following symptoms:

• Tachycardia
• General intoxication of the body
• Anxiety
• Weakness and lethargy
• Cramps
• Paleness of the skin
• Chest pain when moving
• Unhealthy blush
• Drowsiness
• Decreased appetite

Atypical inflammation is associated with individual reactions of the body to infectious irritants. The reasons causing the latent course of the disease may be factors such as: impaired immune status, improper use of antibiotics. It is almost impossible to detect pathology without a medical examination and special diagnostic methods.

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Consequences

Inflammatory diseases of the respiratory system have a negative impact on the entire body, causing failures in the functioning of all organs and systems. The consequences of the disease directly depend on its form, complexity, correctness of diagnosis, chosen 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 to be fibrosis and lung abscess:

• An abscess is the decomposition of organ tissue due to pus forming in the inflammation site. It can form either singly or in groups, affecting several areas of the lung at the same time.
• Fibrosis – develops due to severe damage to organ tissue during inflammation. Connective tissue forms in the damaged areas. The disease causes severe chest pain due to insufficient oxygen supply to the affected areas. In this case, bronchopneumonia becomes chronic.

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

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

Incomplete or incorrect treatment in children leads to the following pathological results:

• Diuresis delay – many children who have had respiratory diseases experience urinary disorders. Various medications are used to eliminate them.
• Intoxication syndrome – the child’s body gradually accumulates waste products of viruses and bacteria, which aggravates inflammation. High temperature, lethargy, and loss of appetite persist for a long time. In addition, gastrointestinal disorders, exhaustion, and headaches are possible.
• Neurotoxicosis – the disorder has several stages. The first is characterized by a sharp increase in the child’s activity, hysterics. After this, a period of inhibition sets in, the baby becomes lethargic, loses appetite. At the last terminal stage, the temperature rises sharply, clonic convulsions appear and respiratory arrest is possible.
• Chronic pneumonia - has a negative impact on the development of the baby's body, causes frequent relapses of the disease, decreased immunity. In addition, deformation of the chest is possible.
• Exudative pleurisy - inflammatory exudate accumulates between the pleural layers. Without proper treatment, it leads to hydrothorax of the lungs, which is treated with pleural puncture.
• Adhesive pleurisy – fibrin appears in the pleural cavity, causing severe pain in the chest area. Abdominal surgery is required to eliminate the pathology.
• Sepsis is the most serious consequence of the disease. The pathology occurs due to the infection from the lungs getting into the blood, which spreads it throughout the body. It is characterized by a sharp increase in temperature, the appearance of abscesses in different parts of the body. It is almost impossible to cure this complication, so the fatal outcome is 100%.
• Asthenia - after a course of therapy, the child complains of increased weakness, decreased activity and performance, poor appetite and low body temperature. As a rule, the syndrome quickly passes and does not require medical care.

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Complications

Aggressive course of respiratory diseases or their improper treatment leads to negative results. Complications cause disorders in all organs and systems. Most often, the disease provokes the development of pleurisy, empyema, that is, suppuration of the pleura and abscesses. Very rarely, one of the life-threatening complications occurs - pneumothorax, that is, a rupture of lung tissue. In this case, if the patient is not provided with timely medical care, there is a risk of death.

There are two types of complications, let's look at them:

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

Severe inflammation leads to the development of multiple foci of infection and acute respiratory failure. If harmful microorganisms enter the blood, 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 doctor's task is to promptly identify complications and prescribe stronger therapy.

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Diagnosis of bronchopneumonia

The effectiveness of treatment of any disease directly depends on the methods used to detect it. Diagnosis of bronchopneumonia is a set of studies that allow you to determine the presence of the disease in the early stages. After examining the patient and collecting anamnesis, the doctor sends him for an X-ray. The X-ray image clearly shows the site of inflammation. After this, a microbiological study of sputum, mucus or a throat swab is carried out. This will help 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 to separate the inflammatory process from other pathological processes in the lungs, to determine the severity and complications. The development of pneumonia is indicated by characteristic symptomatic signs: intoxication of the body, cough with sputum, rapid development of fever and elevated body temperature.

Physical examination helps to determine the compaction of the pulmonary tissue and the auscultatory picture characteristic of the disorder - sonorous, fine-bubble, focal, moist crepitations or wheezing. Ultrasound examination of the pleural cavity and echocardiography help to identify pleural effusion. The patient undergoes a general blood test, in which the inflammatory process is reflected in the form of leukocytosis, increased ESR and band shift. Proteinuria or microhematuria may be detected in the urine anal.

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Auscultation

When diagnosing respiratory diseases, special attention is paid to the study of sound phenomena occurring in the body. Auscultation is performed by applying an auscultation instrument to the chest. Direct, indirect and mediated auscultation are distinguished. The procedure is performed using a stethoscope and a phonendoscope. The patient should be in a standing or sitting position, breathing should be calm and even.

Comparative auscultation is used to detect pathological wheezing. This is due to the fact that more accurate data can be obtained by comparatively listening to symmetrical areas of the lung tissue. First, the anterior surface of the lungs is listened to, starting from the apex area, and then the posterior surface and checking symmetrical points. As a rule, 2-3 complete respiratory cycles are studied at each point, i.e. inhalation and exhalation.

Sounds heard over the lungs are divided into the following groups:

• Basic breath sounds are the various types of breathing heard over normal lungs.
• Side respiratory sounds are sounds that form above breathing, normal and pathological. They are heard simultaneously with the main respiratory sounds, these can be wheezing, pleural friction noise, pericardial noises.

Every healthy person has the following types of breathing heard over the lungs:

1. Vesicular – occurs over a large surface of lung tissue. Formed when the alveoli straighten out due to air entering them and the tension of their elastic elements.

• Increased vesicular breathing is possible both during inhalation and exhalation. As a rule, it occurs due to difficulty in the passage of air through the small bronchi, when they are swollen or in spasms.
• Weakened - occurs with pulmonary emphysema due to a decrease in the number of alveoli. This occurs as a result of the destruction of interalveolar septa and a decrease in the elasticity of their walls. Occurs with inflammation of the respiratory muscles and intercostal nerves, bruises and fractures of the ribs.

When the alveoli are filled with inflammatory exudate, this type of breathing may not be heard. Its disappearance is caused by complete blockage of a large bronchus and the development of atelectasis.

2. Bronchial breathing – occurs over limited areas of the airways and lungs. It is formed when air passes through the glottis, along the bronchial tree, spreading to the surface of the chest.

• Stenotic breathing – occurs due to narrowing of the trachea or main bronchus. Characterized by increased laryngotracheal breathing.
• Mixed breathing – occurs over areas of compacted lung tissue that are located deep within healthy tissue. The inhalation phase is similar to vesicular breathing, and the exhalation to bronchial breathing.
• Hard - heard when the lumen of the bronchi narrows due to inflammation or edema. It is characterized by a loud and long inhalation, but a normal exhalation.

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

Wheezing – can be dry and wet. Formed when air passes through the bronchial tree. Dry ones appear when there is viscous, thick secretion in the bronchi, and wet ones – when the bronchi are filled with wet secretion.

• Crepitation – occurs as a result of straightening of collapsed alveoli, which contain a small amount of exudate.
• Pleural friction noise – indicates the development of dry pleurisy. It differs from other noises in that it is heard both during inhalation and exhalation, but does not change after coughing.

During auscultation, there is an increase in the signs of bronchophony. Breathing is bronchial or vesiculobronchial with dry and moist rales. Crepitation is heard in the initial phase of the disease. If the inflammation spreads to the pleura, then pleural friction noise appears. In severe cases, tachycardia and arterial hypotension, collapse are possible.

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Tests

In the process of diagnosing respiratory tract damage, the patient is prescribed many procedures that allow determining the pathogen, severity and other features. Tests for bronchopneumonia are necessary to confirm it and establish its type. For these purposes, blood and urine are taken for testing. If the disease is mild, moderate leukocytosis and an increase in ESR are observed in the blood. With moderate severity - pronounced leukocytosis and increased ESR. Severe 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 carried out before starting to take antibiotics or 2-3 weeks after their cancellation. When taking urine tests, any deviations from the norm and changes indicate complications.

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

• General blood and urine analysis
• Sputum bacterioscopy
• Sputum culture (quantitative assessment of flora and determination of sensitivity to antibiotics)

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X-ray of the lungs in two projections

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

Sputum in bronchopneumonia

One of the most important studies in respiratory diseases is the study of the coughed up material. Sputum in bronchopneumonia contains opportunistic bacteria, the analysis of which allows for a treatment plan to be drawn up. To confirm the inflammatory process, a culture study is performed on anaerobic microflora.

Material is obtained from the lower respiratory tract by aspiration through the trachea, protected brush biopsy or transtrochlear puncture. All procedures are invasive, so they are not used without appropriate indications. If the patient has a pronounced cough, then collecting sputum is not difficult. If the patient does not have a cough with sputum, then inhalations with a 3% solution of sodium chloride are required.

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

Instrumental diagnostics

Various methods of studying the symptoms of pneumonia make it possible to recognize the signs of pathology in a timely manner and make a treatment plan. Instrumental diagnostics of bronchopneumonia is represented by many methods, but the most valuable and informative are bronchoscopy and radiography. The second method is most often used, since it allows you to visually see the localization of inflammation foci on the radiograph.

Bronchoscopy is used in differential diagnostics. To do this, it is necessary to take bronchoalveolar lavage for examination and study the harmful microorganisms that caused the disorder. Instrumental methods help to identify the pathogen and the localization of inflammation. Thanks to this, the doctor can draw up an effective treatment plan that prevents complications of the disease and its relapses.

X-ray

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

Severe bronchopneumonia - the radiographic picture is clear, the focal nature of the inflammation is visible. The foci of infiltration can capture groups of pulmonary lobes or be limited to damage to several acini. On the radiograph, they have sizes from 1-15 mm in diameter, can merge into large spotted shadows, which causes continuous lobar darkening.

• Focal inflammation – foci have an irregular shape, which is explained by the projection fusion of individual elements. Through the shadow of a large focus, it is possible to trace the pulmonary pattern, which is enhanced due to vascular hyperemia and edema.
• Aciotic form - individual focal shadows do not differ from foci arising during hematogenous tuberculous dissemination. The radiograph shows an increase in the bronchovascular pulmonary pattern and expansion of the root shadows.
• Viral form - X-ray shows segmental nature of inflammation. Moderate darkening from the side of pulmonary roots. Sometimes a specific path appears that connects the expanded root with pneumonic darkening.

Differential diagnostics

Since respiratory diseases have many symptoms, the process of identifying the primary disease is significantly complicated. Differential diagnostics is necessary to distinguish the inflammatory process from other lung lesions. For this purpose, anamnesis, clinical, virological, parasitological, bacteriological and other research methods 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 explained by the fact that the infiltrate has the same localization and gives the same data during auscultation and percussion. In this case, X-ray examination and bronchoscopy are used.

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Treatment of bronchopneumonia

Any inflammatory diseases require immediate treatment, especially if it concerns the respiratory system. Treatment of bronchopneumonia involves taking effective measures to prevent the spread of infection throughout 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 products.
2. Antibiotics are used only after determining the sensitivity of the pathogen to them. Most often, broad-spectrum agents are prescribed, as well as drugs from different clinical groups. The duration of the course of therapy is determined by the attending physician, who monitors changes in the tests and the patient's status.
3. Medicines that thin and remove phlegm are used without fail. It is better to give preference to herbal remedies, as they are not addictive and have a minimum of contraindications and side effects.
4. It is necessary to use desensitizing drugs to reduce local inflammation and remove toxins from the body.
5. Vitamin therapy 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 macroelements.

Based on this, we can conclude that treatment is a rather long and complex process, which should only be carried out by a doctor.

Care for bronchopneumonia

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

Let's consider the main nuances of patient care:

• Ensuring bed rest until general well-being improves.
• Following a dairy-vegetable diet.
• Drink plenty of fluids.
• Taking thinning and expectorant medications.
• Compliance with symptomatic therapy prescribed by the doctor.

If the treatment is carried out in a hospital setting, the 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, the intake of medications and procedures prescribed by the doctor.

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

• Teaching a child to breathe correctly.
• Conducting vibration massage.
• Ensuring a drainage position (with the head down).
• Prevention to avoid complications.

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Treatment of bronchopneumonia at home

Simple forms of inflammatory lung diseases are usually not treated in a hospital setting, since the therapy is not complicated. Treatment of bronchopneumonia at home is most often carried out using 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 paid to organizing the patient's regimen; if home conditions do not allow this, then hospitalization is better.

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

It is extremely important to organize a dietary regimen with an increased content of vitamins B and C, since they play a leading role in the pathogenesis of respiratory failure. Since the disease causes increased vascular permeability, calcium chloride is used to eliminate this defect. The drug irritates connective tissue cells by increasing the tone of the vagus nerve. Ascorbic acid can be used for these purposes. The goal of home treatment is not only to eliminate structural changes in the lungs, but also to restore their normal functioning.

Medicines for bronchopneumonia

Treatment of inflammatory lesions of the respiratory system should begin at the first painful symptoms. Medicines are prescribed after the pathogen is identified, so broad-spectrum antibiotics are used at the beginning of therapy. Since many harmful microorganisms quickly develop resistance to such agents, their constant improvement is required.

The following antibiotics are used for treatment:

• Semi-synthetic penicillins
• Carbapenems
• Fluoroquinolones
• Cephalosporins
• Tetracyclines
• Macrolides
• Aminoglycosides
• Monobactams

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

Antiviral therapy is carried out with the following drugs:

• 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
• Ambrobene
• Bromhexine
• Bronchosan
• 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, contraction of smooth and skeletal muscles, blood clotting, functioning of the heart muscles and other organs. When the calcium content in the blood plasma decreases, a number of pathological reactions are observed, primarily severe hypocalcemia and tetany.

Indications for the use of calcium chloride:

• Parathyroid insufficiency
• Tetany
• Spasmophilia
• Dehydration
• Allergic complications associated with medications
• Pulmonary, nasal, gastrointestinal bleeding
• Before surgery to improve blood clotting

The drug is administered intravenously by drip/jet and orally. 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 in case of necrosis or severe tissue irritation. Calcium chloride is contraindicated in atherosclerosis, a tendency to thrombosis and high levels of calcium in the blood.

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Antibiotics for bronchopneumonia

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

When choosing medications, it is necessary to consider such factors as: the type of bronchopneumonia, contraindications, toxicity of medications, the spectrum of action of the drug, the speed of penetration into body fluids and the speed of reaching the therapeutic dose in the foci of inflammation. In some cases, antibiotics do not give the desired result. This occurs due to the incorrect selection of the drug, its dosage and duration of administration, the development of resistance of pathogens and frequent changes in drugs.

To eliminate the hospital form of the disease, the following means are used:

• First line – Amoxicillin, Ceftazidime, Penicillin, Cefepime. If there is intolerance to these medications, alternative means 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 when the first line drugs were ineffective. The following are used for therapy: Cefepime, Fluoroquinolone, Meropenem, Ticarcillin.
• The reasons for using the above mentioned agents are severe course of the disease, mixed type of infection, combinations of harmful microorganisms that are resistant to many drugs.
• To treat community-acquired inflammation, the following medications are used:
• Medium and mild stage – Fluoroquinolone, Aminopenicillin, Clarthromycin, Doxycycline.

• Severe stage – Azithromycin, Ceftriaxone, Cefotaxime.

If the patient is to take antibiotics for a long time, then probiotics and eubiotics are prescribed without fail - Linex, Lactobacterin, Bifiform, Bificol. They prevent intestinal dysbacteriosis, that is, they maintain the normal composition of microflora. Antibiotics are taken only according to medical indications. If in the first 2-3 days after the start of treatment the positive effect of therapy does not occur, then there is a risk of intoxication of the body and increased inflammation.

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Folk remedies

In the treatment of bronchopneumonia, many methods are used, which in combination give a positive result, accelerating the recovery process. Traditional treatment is effective because natural plant ingredients are used to eliminate inflammation. Such drugs have anti-inflammatory, vasodilatory, analgesic and other effects, but at the same time have a minimum of side effects and contraindications. If such means are combined with classical treatment, then the pathological process can be quickly eliminated.

Let's look at the most popular folk recipes:

• The balm has anti-inflammatory properties. To prepare it, you will need: 250 g of aloe, 500 ml of Cahors wine and 350 g of liquid honey. Before cutting the aloe leaves, it is recommended not to water the plant for 14 days. After cutting, carefully wipe off the dust, chop and place in a glass jar. The plant is poured with honey and Cahors wine, mixed well and infused for 14 days in a dark, cool place. After the balm has infused, it must be filtered and squeezed out. The medicine is taken 1 spoon 2-3 times a day.
• Special inhalations have a good effect on the respiratory system. To do this, take a 10-15 cm piece of bandage, rub it thoroughly with onion and put it in a mug for inhalation. To achieve a therapeutic effect, you need to breathe over the mug for 10-15 minutes 5-6 times a day.
• The following remedies are particularly effective: linden honey, onion and garlic juice, dried lingonberries and raspberries, aloe juice, rose hips, oregano, linden blossom. From these ingredients, you can prepare decoctions and infusions to eliminate inflammation and strengthen the immune system.
• From a decoction of coltsfoot and violet or honey with marshmallow, you can prepare an excellent expectorant. All ingredients are taken in equal proportions. The medicine is taken 3-4 spoons 2-3 times a day.

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Herbal treatment

Traditional medicine methods are the use of only natural plant components that have a beneficial effect on the body. Herbal treatment is especially popular, as such products are safe to use, have a minimum of side effects and contraindications.

Let's look at effective herbal recipes for bronchopneumonia:

• Pour 750 ml of boiling water over 1 spoon of ground ivy and leave for 60 minutes. The infusion should be taken 2 spoons 3-4 times a day before meals. It is not recommended to exceed this dosage to avoid the toxic effect of the plant.
• Pour melted linden honey over a handful of viburnum berries and let it brew for 6-8 hours. Pour 250 ml of boiling water over a spoonful of the medicine and let it brew for 2 hours. The remedy should be filtered well and taken warm, 150 ml 1-3 times a day. Effectively eliminates severe cough and removes phlegm.
• Take linden flowers, mullein flowers and wild raspberry in a ratio of 2:3:3. Pour 1 liter of boiling water over the herbs and leave for 6-8 hours. Strain the cooled infusion and take 100 ml 3-4 times a day. Helps with dry, debilitating cough.
• To prepare an alcohol infusion for pneumonia, the following ingredients are required: aloe leaves, blueberry leaves, lingonberry, beet juice, rutabaga and wild rosemary roots (all components are taken in equal proportions). The herbal collection is poured with 1 liter of vodka and infused in a dark, cool place for 10-15 days. Before use, honey and butter must be added to the medicine. Take 1-2 spoons 2-3 times a day.
• Pour boiling water over 2 parts of coltsfoot leaves and raspberries, 1 part of oregano. The remedy should be infused for 2-4 hours, take 1 spoon diluted in a glass of water.

Homeopathy

To treat bronchopneumonia and restore normal functioning of the respiratory system, many methods are used to stop the inflammatory process. Homeopathy is one of the most popular remedies, as it is suitable for patients with intolerance to strong chemicals. Homeopathic remedies can effectively cure any kind of ailment and prevent relapses.

• At the initial stage of the disease, when high temperature, chills and other symptoms of fever appear, Aconite is taken in 3x and 3x dilutions. After a couple of days, this remedy is replaced with Bryonia or Belladonna in the same proportions.
• Further use of medications depends on the overall symptomatic picture. So, if there is a dry cough with the discharge of rusty sputum, then Sanguinaria is taken in 3 dilutions.
• To eliminate dry and wet wheezing, wheezing and expectoration, use Antimonium Tartaricum in 3 and 6 dilutions. If the cough is accompanied by chest pain, use Iodum or Kalium Iodatum in 3 and 6 dilutions.
• If the disease has a long course and antibiotics do not help, then the following homeopathic medicines can be used: Sulphur, Arsenicum Album, Hepar Sulphur and Arsenicum Iodatum in 3 and 6 dilutions.

All homeopathic medicines should be prescribed by a homeopathic doctor after a thorough examination. Taking such medicines on your own is contraindicated.

Surgical treatment

Protracted and chronic forms of bronchopneumonia entail many serious complications. Surgical treatment is indicated for pathological damage to the respiratory organs, when a long-term inflammatory process has led to irreversible changes in the lung tissue. Most often, surgery is necessary for chronic abscesses, the formation of primary cancerous lung lesions or bronchogenic cancer.

Patients may be prescribed lung resection to improve their general condition and save their lives. The most common types of resection are segmental resection, pneumonectomy, and lobectomy. All procedures are performed by separate ligation of a lobe, segment, or root elements of the lung.

If the pathology is bilateral, affecting individual segments of several lobes, then segmental resection is indicated, allowing a radical cure for a patient who was previously considered hopeless. If inflammation has caused purulent intoxication, then in addition to general strengthening therapy, postural drainage is performed to facilitate the removal of sputum and exudate.

Prevention

In addition to the main treatment used to eliminate bronchopneumonia, methods of disease prevention are of great importance. Prevention is indicated for patients of all ages, regardless of the form of the disease.

Let's look at the main preventive recommendations:

• Elderly patients are recommended to be vaccinated against streptococcal infection, which is the most common causative agent of the disease. Children at risk are vaccinated against pneumonia.
• To prevent pathology, it is necessary to undergo annual vaccination against influenza, since this disease very often causes complications in the form of bronchopneumonia.
• Compliance with basic hygiene rules, i.e. washing hands with soap, using individual towels and utensils, also prevents infection with pathogenic microorganisms.
• Particular attention should be paid to strengthening the immune system. For these purposes, vitamin therapy, various complexes of microelements and minerals are used. Healthy, nutritious nutrition also refers to prevention methods, since it increases the immune status.
• Giving up bad habits such as smoking and alcoholism, which reduce the resistance of the bronchi and lungs to infections, is an important method of preventing not only diseases of the respiratory system, but also the body as a whole.

Singulair for the prevention of bronchopneumonia

Singulair is a medicine for the treatment of bronchi and lungs, from the pharmacological group of leukotriene receptor antagonists and anti-asthmatic agents. It is usually prescribed to pediatric patients. The active component of the drug is montelukast. It inhibits leukotriene receptors of the epithelium of the bronchial and lung tissue, making them resistant to the effects of cysteinyl leukotrienes. The tablets prevent bronchial spasms, an increase in eosinophils and sputum secretion. The drug causes relaxation of the bronchi within 2 hours of administration and reduces the content of intra- and extracellular factors of inflammation of the respiratory system.

• For patients over 15 years old, 10 mg is prescribed once a day before bedtime. For children aged 2-5 years, 4 mg once a day, and for patients aged 6-14 years, 5 mg per day. The tablet must be thoroughly chewed and washed down with plenty of liquid.
• Side effects occur when the rules for using the medication are not followed. As a rule, patients complain of thirst attacks, increased anxiety, headaches, allergic reactions on the skin. In particularly severe cases, anaphylaxis, increased bleeding, paresthesia, tachycardia and swelling are possible.
• Overdose causes pain in the epigastrium, drowsiness, intense thirst, and vomiting. Treatment is symptomatic, hemodialysis is not performed.
• The tablets are contraindicated for patients under 2 years of age. Hypersensitivity to the active substance and other components of the drug is a contraindication to use.

Forecast

The course and effectiveness of treatment of inflammatory lesions of the bronchi and lungs largely depend 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 associated with 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 severe the malaise and the worse the prognosis may be, since the disease often recurs.

Bronchopneumonia has a serious prognosis (up to and including death) in patients with circulatory failure, various cardiovascular diseases, dystrophy, vitamin deficiency and diseases accompanied by cachexia. With timely diagnosis and treatment, the prognosis is positive.

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