Chronic pneumonia in children

Chronic pneumonia in children is a chronic inflammatory non-specific bronchopulmonary process based on irreversible morphological changes in the form of bronchial deformation 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”.

The morphological substrate of chronic pneumonia is limited (segmental, polysegmental) pneumosclerosis and persistent deformations of the bronchi in its zone.

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Causes of Chronic Pneumonia in Children

Chronic pneumonia is formed under the influence of various factors:

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

Causes of chronic pneumonia

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Symptoms of chronic pneumonia in children

Symptoms of chronic pneumonia are characterized by repeated (several times a year) inflammatory processes in the lungs and depend on the volume and prevalence of the process, the degree of damage to the bronchi. Common symptoms include signs of intoxication: malaise, pallor, "shadows" under the eyes, loss of appetite. With extensive damage, flattening of the chest, a depression in the sternum or a keel-shaped bulge may develop. During an exacerbation - an increase in body temperature, moderate and short-term.

The most constant symptoms of chronic pneumonia are cough, sputum production and persistent wheezing in the lungs. During exacerbations, the cough is wet, "productive", with the discharge of mucopurulent or purulent sputum. Wet medium- and small-bubble wheezing is constantly heard in the affected areas. They persist during remission, and dry wheezing may also be heard.

Symptoms of chronic pneumonia

Diagnosis of chronic pneumonia in children

Chest X-rays of patients with chronic pneumonia show convergence of the pulmonary pattern elements in the affected area, increased airiness of adjacent segments, and shift of the median shadow toward the affected area. These signs of the affected area of the lung are expressed the better, the larger the volume of the lesion and the more pronounced the pneumosclerosis.

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

The bronchographic picture is characterized by heterogeneity of bronchial changes, the presence of both deformed and dilated bronchi in the affected section. 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

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Treatment of chronic pneumonia in children

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

• During periods of exacerbation, according to indications, sanitation bronchoscopies are performed with local administration of antibiotics and antiseptics.
• Of great importance is mucolytic therapy with vibration massage and postural drainage, taking into account the localization of the inflammatory process. Physical therapy is mandatory.
• Treatment of ENT diseases and oral cavity sanitation are necessary.
• 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 that develops during the course of cystic fibrosis, primary immunodeficiency, and Kartagener syndrome, as a rule, cannot be treated surgically.
• All children with chronic pneumonia must undergo 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
• Combating complications of acute pneumonia
• Physiotherapy, exercise therapy, breathing exercises for pneumonia
• Sanatorium and resort treatment and rehabilitation for pneumonia