Diagnosis of chronic pneumonia
Last reviewed: 23.04.2024
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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.
Bronchoscopy: as a rule, the changes are unilateral, depend on the phase of the disease, vary widely from local to widespread and from catarrhal to purulent endobronchitis.
FVD - in 70% of children there is a ventilation failure. In sputum with chronic pneumonia, two prevailing pathogens are found: hemophilic rod (60-70%) and pneumococcus (35-40%), both in monoculture and in associations. Moraxella catarrhalis is sown in 5-10%.
The course of chronic pneumonia is characterized by a change in the periods of remission and exacerbations (more often after ARI - in bronchitis with an increase in phlegm or purulent sputum).
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