Chronic pneumonia in children

Chronic pneumonia in children is a chronic inflammatory nonspecific bronchopulmonary process, which is based on irreversible morphological changes in the form of deformation of the bronchi and pneumosclerosis in one or more segments of the lungs and accompanied by relapses of inflammation in the bronchi and lung tissue.

In foreign literature, this disease is referred to as "bronchiectasis (bronchiectasis)", "chronic bronchopulmonary inflammation."

Morphological substrate of chronic pneumonia - limited (segmental, polysegmentary) pneumosclerosis and persistent deformities of the bronchi in its zone.

[1], [2], [3], [4], [5]

Causes of chronic pneumonia in children

Chronic pneumonia is formed under the influence of various factors:

• adverse outcome of acute pneumonia;
• atelectasis of various genesis, including congenital;
• Aspiration of foreign bodies;
• chronic aspiration of food;
• congenital malformations of the tracheobronchial tree;
• congenital microdefects of bronchial structures;
• immunodeficiency;
• ciliary dysfunction, etc.

Causes of Chronic Pneumonia

[6], [7], [8]

Symptoms of Chronic Pneumonia in Children

Symptoms of chronic pneumonia are characterized by repeated (several times a year) inflammatory processes in the lungs and depends on the volume and prevalence of the process, the degree of bronchial involvement. Of the common symptoms are signs of intoxication: malaise, pallor, "shadows" under the eyes, a decrease in appetite. With extensive lesions, flattening of the thoracic, zapping in the sternum or keeled bulging may develop. During an exacerbation - an increase in body temperature, moderate and short.

The most persistent symptoms of chronic pneumonia are cough, sputum and persistent wheezing in the lungs. With exacerbations cough moist "productive", with the withdrawal of mucopurulent or purulent sputum. Wet medium and small bubbling rales are heard constantly in the affected areas. They persist even during remission, dry wheezing can also be heard.

Symptoms of Chronic Pneumonia

Diagnosis of chronic pneumonia in children

On chest radiographs in patients with chronic pneumonia, the approach of the elements of the pulmonary pattern in the affected area is determined, the airiness of adjacent segments is increased, the midline is shifted to the side of the lesion. These signs of the affected area of the lung are expressed the better, the larger the lesion volume and the more pronounced the pneumosclerosis.

Bronchography is the main method that reveals the localization and volume of pulmonary involvement, the degree and nature of bronchial deformities. In the affected area, bronchial convergence, loss of their conicity, a decrease in the depth of contrast, deformation of the lumen and bronchiectasis, which in case of chronic pneumonia are only cylindrical, are determined.

For the bronchographic picture is characterized by heterogeneity of bronchial changes, the presence in the affected department of both deformed and enlarged bronchi. This distinguishes chronic pneumonia from changes in congenital malformations of the lungs, in which there is a more or less uniform lesion of the bronchi.

Diagnosis of chronic pneumonia

[9], [10], [11], [12]

Treatment of chronic pneumonia in children

Treatment of chronic pneumonia in children should be long, stage, individual, depending on the period of the disease, the frequency of exacerbations, the presence of concomitant diseases.

• In the period of exacerbation, according to the indications, sanative bronchoscopies are performed with local administration of antibiotics and antiseptic agents.
• Of great importance is mucolytic therapy with vibration massage and postural drainage, taking into account the localization of the inflammatory process. It is obligatory to conduct exercise therapy.
• It is necessary to treat diseases of the ENT organs, sanation of the oral cavity.
• The question of surgical treatment is decided strictly individually depending on the severity of the disease, the effectiveness of conservative therapy, the age of the child and the presence of complications
• Bronchiectasis, formed during the course of cystic fibrosis, primary immunodeficiency, Kartagener's syndrome, surgical treatment, as a rule, are not subject.
• All children with chronic pneumonia should undergo a sanatorium treatment.

Treatment of chronic pneumonia

• Pneumonia - Treatment regimen and nutrition
• Antibacterial drugs for the treatment of pneumonia
• Pathogenetic treatment of pneumonia
• Symptomatic treatment of pneumonia
• Fighting complications of acute pneumonia
• Physiotherapy, exercise therapy, respiratory gymnastics with pneumonia
• Sanatorium treatment and rehabilitation for pneumonia