Pneumonia is a disease that provokes the development of an inflammatory process in the lung tissue with significant damage to the respiratory sections. It can manifest itself or develop as a complication of other ailments. The patient is not contagious to others, the disease is not transmitted from person to person, but with all this there is an infectious breed in it.
Definition
Lobar pneumonia is a severe infectious-allergic lesion that captures one or more sides of the lung. Often manifested by chills, pleural and headache, fever, sweating, general weakness, wet cough and shortness of breath.
The incidence of patients is quite high, among all those infected, pneumonia accounts for 29.3% of cases. This pathology is characterized by the defeat of half of the lung and also the involvement of the pleura. The disease often affects adults, rarely children.
Etiology
Pathogenpneumococcus appears, or rather, its various strains, but the influence of other pathogenic bacteria is not excluded: chlamydia, staphylococci, mycoplasma, streptococci and Haemophilus influenzae. If it is impossible to identify the cause of the disease, the diagnosis is made as "unspecified lobar pneumonia". It should be noted that the virus can be in the nasopharynx for a long time without manifestation. It is also noteworthy that the disease often affects a perfectly he althy person, but under the influence of certain secondary factors.
Main penetration methods:
- through the bronchi;
- lymphogenic course;
- hematogenous pathway.
Pathogenetic picture of lobar pneumonia is described by immediate type hypersensitivity. Acute inflammatory changes in the parenchyma appear in the respiratory tract, and the disease is formed in one or many foci through Kohn's interalveolar pores, and then spreads significantly through the tissues of the lung. Damage to the lymphatic and small blood vessels leads to severe impairment of vascular permeability, as well as the formation of fibrinous exudate.
Classification
Divided by location:
- upper lobe;
- lower lobe pneumonia;
- average;
- interlobar;
- double-sided;
- left hand;
- right hand.
By the nature of the flow:
- protracted - lasts more than four weeks, often with symptoms licked off;
- sharp -formed rapidly and actively developed.
Symptoms
- The disease very rarely begins with a strong rise in temperature or a feverish state.
- Patients present with excruciating headaches, sweating and mild malaise accompanied by weakness.
- Initially, shortness of breath occurs, which then provokes the appearance of unpleasant sensations in the affected area, depending on the pleural state in the chest and on breathing. The pain is pronounced, has a clear localization, especially with active inspiration. If you try to bend the body into the source of the problem, then breathing will become superficial and weak.
- Crupaceous lobar pneumonia is accompanied by a severe cough and increased sputum production, but in the initial stages, the inherent dryness can cause painful breaths.
- Fever is often absent in the elderly and frail patients.
- Sputum is purulent-mucous, with a rusty color and blood.
- There is a clear feeling of lack of air, which can lead to problems with the cardiovascular system and blue nasolabial triangle.
- High intoxication with lobar pneumonia leads to sleep problems, neuralgic disorders, inability to move, arousal, as well as delusions and hallucinations, so these patients require constant care and monitoring.
- Icteric manifestations on the skin, whites of the eyes and mucous membranes.
- Isolation of fluid into the pleural cavity, the occurrence of signs of pleurisy.
- Aching pain in joints and muscles.
- Decreaseblood pressure.
- Intestinal problems.
Steps
Medics say that all morphological changes occurring in the lungs can be divided into 4 stages.
- The tidal stage at which microbial edema appears. It can develop as a result of the occurrence of right-sided and left-sided lobar pneumonia or its focal form. This period lasts only 1 day.
- It is characterized by red hepatization, in which the defeat of the entire lobe of the lung begins to appear. It significantly increases in size and acquires an airless and loose form. Pinpoint hemorrhages and a grayish-whitish coating appear on the pleura.
- From the 4th to the 6th day of the disease, changes in the red tint of the lung to gray occur. The tissues of the respiratory organs begin to become even harder and looser at the same time. This stage of lobar pneumonia is called "gray hepatization". The alveoli are completely filled with exudate. It is formed from neutrophilic leukocytes and filamentous fibrin particles.
- Only on the 9th day does the disease move to the stage of resolution.
Reasons
In most cases, various strains of pneumococcus are the causative agents, less often other microorganisms that enter the body in a variety of ways. The development of focal and lobar pneumonia is closely associated with the persistence of pneumococcus in the nasopharynx in a strong, he althy person and preliminary sensitization sick organism to its antigens.
The rapid onset of the disease may occuragainst the background of complete he alth and lack of contact with the sick.
Often lobar pneumonia appears along with diseases such as:
- tuberculosis;
- diabetes mellitus;
- ARVI (acute respiratory viral infection) or influenza;
- COPD (chronic obstructive pulmonary disease);
- malignant neoplasms in the respiratory system.
The main factors are:
- prolonged exposure to cold temperatures on the body;
- suffered severe injuries, most often of the chest;
- bad habits, smoking comes first;
- decrease in immune system resistance;
- strong physical activity;
- emotional instability and the impact of stressful situations;
- bad microclimate;
- production hazards.
Lobar pneumonia in children
The body of a child is much weaker than that of an adult, so the course of the disease is even more acute and sudden. Throughout the entire time, an extremely high, unstoppable temperature can be traced. In the nasolabial triangle, in addition to blue, a herpetic rash can also form. Toddlers are exposed to severe muscle weakness and headaches.
The main signs of the course of the disease are the same as in adults, although complications can leave their mark on the nervous system, cause acute psychosis in the child during and after illness, as well as serious impairment of brain activity. This may further affectchild development.
Diagnosis
Difficulties in early detection of the disease in modern conditions are associated with a rather diverse clinical picture and the blurring of symptoms.
To confirm left-sided or right-sided lobar pneumonia, the doctor arranges a questioning of the patient (presence of complaints, concomitant diseases, risk factors) and his physical examination. Suspicion of the disease involves the presence of such signs as severe fever, symptoms of intoxication, cough, shortness of breath, pleural pain, cyanosis of the tip of the nose and lips.
The main factors for the presence of an ailment during the examination are:
- lagging chest at the time of breathing on the affected side;
- increased bronchophony and voice trembling;
- the presence of tachycardia, as well as more frequent shallow breathing;
- limited chest tenderness;
- percussion stupidity.
During auscultation at the time of community-acquired lobar pneumonia, characteristic inspiratory crepitus is heard, as well as pleural grazing noise. Further, pathological bronchial breathing, sonorous small bubbling or moist muffled rales may be revealed.
Important for confirming the diagnosis are the results after radiography, which is done in 2 projections. It shows an increase in the pulmonary pattern and at the beginning of the disease there is no structure of the root in the affected area. And also there are homogeneous segmental foci of infiltration on the lung fields after passing 4–6days of defeat.
Laboratory blood tests of the patient indicate the presence of leukocytosis with a shift of the formula to the left, and in very severe situations - leukopenia, hyperfibrinogenemia and an increase in ESR (erythrocyte sedimentation rate). To detect the pathogen, doctors diagnose sputum culture to determine the microflora with the detection of sensitivity to antibiotics.
Treatment
Therapy of the disease is carried out only in a hospital, especially when it comes to children, with severe and mandatory bed rest. The use of antibiotics should take place immediately after the establishment of the conclusion, without waiting for the results of the culture test for sensitivity to drugs. Additionally, antipyretic and antiallergic drugs, immunostimulants and agents that help improve sputum discharge are prescribed.
Treatment of lobar pneumonia should not take place without physiotherapeutic procedures, because thanks to them, the patient's recovery is accelerated. Sometimes patients are connected to a ventilator, blood pressure is stabilized, drug bronchoscopy, oxygen barotherapy and other useful procedures are performed.
Rehabilitation after the disease is quite difficult, since most of the complications that can be obtained end with the amputation of part of the lung. To a greater extent, it is based on folk methods and hardware procedures.
Physiotherapy
In order to defeat the disease, you must use the following methodstreatment:
- UHF (Ultra High Frequency Therapy);
- drug electrophoresis;
- exercise therapy (therapeutic physical culture);
- chest massage;
- drug inhalation.
Traditional medicine
As an auxiliary technique, non-traditional methods are used for treatment. The most effective herbs for therapy are:
- leaves of a young birch;
- chamomile and oregano;
- coltsfoot;
- knotweed;
- aloe leaves;
- raisins and blueberries;
- buckwheat honey;
- thyme and thyme.
Complications
Lobar pneumonia is described by a huge number of serious problems that often lead to further disability or death.
- Acute respiratory failure can be associated both with the disease itself and remain after irreversible changes that have occurred in the lung matter.
- Development of abscesses, namely purulent formations with tissue death, which are removed only by surgery.
- Gangrene of the lung - purulent putrefactive necrosis spreads very quickly.
- Empyema of the pleura - inflammation of the pleural sheets with fluid exudate between the lining of the lung, which contains pus.
- Pleurisy is a lesion of the serous cover of internal organs.
- Various purulent complications at the time of infection in the blood: purulent pericarditis, meningitis, brain abscesses and other similar complications.
- Cardiac disorders, development of heart failure and aortic valve.
Forecast
Lobar pneumonia is considered a dangerous and serious disease with a huge number of severe consequences and complications. Although with a timely visit to the attending physician, a lot of problems can be avoided. This ailment refers to diseases that are characterized by a bright and strong, but relatively transient course, so if you follow all the necessary measures, it proceeds quite quickly. The prognosis for the risk group is not very encouraging, immunocompromised patients, the elderly and children under 5 years of age do not tolerate this disease well, and the consequences are also serious.
