Pneumonia can have both bacterial and viral etiology. There are many triggers that can be cited. But the main pests that cause pneumonia with complications are staphylococci, streptococci and pneumococci.
Untreated pneumonia at 2-3 weeks after the onset of the acute period often develops into pneumopleurisy - pleural pneumonia. Pleurisy is not an independent disease, but a symptom indicating an aggravation of inflammation.
Pleural pneumonia. Features
When inflammation affects both pleural membranes of the lungs, severe inflammation begins, which can easily turn into pleurisy. The pleural membranes are invented by nature so that after exhalation the lungs do not connect. The area of negative pressure that forms between the parietal and visceral pleura allows the lungs to expand unhindered during inhalation.
The pleura is a smooth serous membrane consisting of two layers that separates the lungs from the diaphragm. At the root of the lung, two layers of the pleura unite.
When a patient who has caught a virus or a bacterium does not go to the doctors with pneumonia for a long time, the inflammation goes to the lining of the lungs. This inflammation is called pleural pneumonia.
Complications
Nasal cilia, tonsils are natural barriers that should protect the respiratory tract from bacteria. But if the protective barrier is weak, the immune system is suppressed, the likelihood of developing pneumopleurisy is high.
Among the complications of pleural pneumonia are:
- lung abscess;
- dry pleurisy;
- purulent pleurisy;
- pneumothorax rupture of the lung and entry of air into the pleural cavity.
There are other equally dangerous non-pulmonary complications:
- impaired kidney or liver function;
- endocarditis or pericarditis - inflammation of the membranes of the heart;
- sepsis is a common blood poisoning.
Pneumothorax and sepsis are the most dangerous complications, often fatal. In order to prevent a fatal outcome, it is necessary to call an ambulance at the first symptoms of pneumonia. It is necessary to determine the causative agent of inflammation and the form of the disease.
Types of pneumonia
There are several classifications of pneumonia. According to the degree, severity, prevalence of the focus of infection, clinical and morphological signs.
By outbreak prevalence:
- left hand;
- right hand;
- double-sided;
- segmental;
- subsegmental.
By clinical and morphological features:
- bronchopneumonia;
- croupous, or pneumopleurisy.
Severity:
- mild inflammation;
- moderate;
- heavy.
According to the shape of the flow:
- spicy;
- long current.
The type of pneumonia is established after many tests. Mandatory after the doctor receives the results of bacteriological and histological examination.
Signs of pleurisy
It is difficult to determine the complication of ordinary pneumonia for a person without a medical education. And if pneumonia is treated at home, then when symptoms of pleurisy appear, you should immediately call an ambulance.
Obvious symptoms of pneumonia of the pleural cavity are:
- temperature 39° and above;
- chest pain aggravated by coughing;
- shortness of breath, weakness;
- pale skin and characteristic cyanotic triangle at the corners of the mouth;
- chest tightness;
- powerlessness;
- shallow breathing.
Pleurisy with purulent exudate is manifested by even more severe symptoms.
- Breathing very difficult.
- The person cannot move, the pain is unbearable. He lies or sits in a position in which he is comfortable inhaling air.
- Temperature is 40 °C, and it is impossible to bring down the usual antipyretics - antibiotics are needed.
- Strongaching muscles and joints.
- Cold and blue skin.
- Pressure reduced.
It is believed that if the usual inflammation has not passed after 3 weeks, then the pleural effusion has definitely begun to accumulate, which means that drainage is needed. But in each case, the development of pleural pneumonia takes place in different ways. It is not possible to predict the outcome of complications.
Danger of complications
If a complication of pneumonia has begun, effusion often begins to accumulate in the pleural cavity. Pleural effusion in pneumonia is an accumulation of fluid in the lung cavity with a volume of more than 4 mm. Exudate - fluid in the lung cavity depends on the nature of the inflammatory process and the cellular composition of the pleural effusion.
Pleural effusion complicates pneumonia caused not only by pneumococci and streptococci. There are a number of other factors:
- rupture of the esophagus;
- osteomyelitis;
- chest injury;
- diverticulosis;
- fungal pneumonia;
- pneumonia with tuberculous etiology.
However, as a result of infection with streptococci, the likelihood of developing pneumopleurisy is the highest - about 60%.
Pneumonia with a high temperature for more than 7 days leads to a sharp loss of body weight and anemia - anemia. Therefore, therapy should be started as soon as the causative agent of the infection becomes known.
Phases of exudate formation in the lungs
Pleurisy develops in several stages. And the sooner action is taken, the better the diseasebeing treated.
The stages of fluid accumulation in the pleural cavity are as follows:
- inflammation from the lungs goes to the pleura;
- the vessels dilate and the release of body fluids increases;
- fluid outflow is disturbed;
- Lung adhesions appear;
- fluid, if it stays in the pleural cavity for a long time, it will thicken.
- purulent exudate is formed.
The result of an abnormal process in the lungs is the formation of pleural empyema. This is a very dangerous complication, the treatment of which does not always end well. Another danger of a large accumulation of fluid is mediastinal skew. When fluid, for example, in the right lung presses on the mediastinum, it is strongly tilted to the left, and vice versa.
Pneumonia in children
Children suffer from pneumonia harder, if you suspect you need to call an ambulance so that the doctor takes an x-ray and accurately diagnoses. Many parents, not knowing the diagnosis, begin to give the child advertised antibiotics. This only blurs the symptoms and makes it more difficult for the doctor to determine the cause of the ailments.
Pleural pneumonia in children is severe. Their immunity is weak. And the body's defenses cannot withstand the attack of pneumococci for a long time. If a small child develops purulent pleurisy and acute respiratory failure during pneumonia, delay in qualified medical assistance can cost the baby's life.
Is pneumonia contagious?
Some believe that pneumonia develops after hypothermia. Otherclaim that inflammation can be transmitted by airborne droplets. Is it worth it to protect a child from other children if he has pleural pneumonia? Is she contagious? When the results of the study confirm that the disease is of a viral or bacterial nature, then yes - the child is contagious.
Diagnosis
A patient with pneumonia - ordinary or pleuropneumonia - needs a high-quality multilateral examination. What research needs to be done?
- X-ray of the lungs in two projections: frontal and lateral;
- complete blood count;
- pleural fluid puncture and its histological and biochemical analysis;
- when listening with a stethoscope, wheezing and characteristic sounds are heard from the movement of the inflamed pleura;
- videothoracoscopy;
- computed tomography if the x-ray picture is not clear enough.
Left-sided pleural pneumonia often causes myocardial infarction. When diagnosing such a disease, the doctor will require an ECG of the heart.
How to remove fluid from the lung cavity?
Drainage is performed to remove exudate from the pleural cavity. The puncture is carried out in the II-III intercostal space, necessarily along the anterior surface of the chest. The fluid is pumped out through the puncture using a special drainage apparatus. During pumping, a negative pressure equal to 0.98-1.5 kPa must be maintained in the pleural cavity.
Timely pumping of fluid serves as a prevention of pneumothorax and pleural empyema. However, this must be donethoracic doctor.
If the exudate is not pumped out, the substance will turn into pus, and it will be more difficult to pump it out.
Treatment with drugs
In the case of pleurisy, treatment with folk methods should by no means be carried out. The doctor, after determining the cause of inflammation, prescribes the necessary drugs.
If pleural pneumonia is diagnosed, treatment is:
- A third-generation course of antibiotics, if the cause of pneumopleurisy is bacteria. Among antibiotics, macrolides and cephalosporins are most effective in various types of inflammation. For example, "Ceftriaxone" from cephalosporins. From macrolides of semi-synthetic origin - "Azithromycin".
- Puncture of the pleural cavity to drain fluid.
- Diuretics have also been taken for a while.
- Painkillers.
- Anti-inflammatory drugs.
- Course of vitamins to maintain immunity.
If the reasons for the reproduction of the fungus in the lungs, antifungal drugs are prescribed.
At the end of treatment, when the inflammation is almost gone, only a little sputum remains, then breathing exercises are prescribed.
Prevention
During the autumn-winter decrease in immunity, it is recommended to walk more often, not to stay too long in stuffy rooms. When there are patients with infectious diseases at home, separate them from the rest of the family. Pneumonia can indeed be contagious. Pneumonia is especially dangerous for the elderly, children and girls.with low body weight who are on diets.
It is advisable to take vitamins in winter, actively exercise and eat well. All this will strengthen the body's ability to fight bacteria and viruses.
