Polysegmental pneumonia differs from other types of the disease in a predisposition to a severe form of course. In this regard, it can be called one of the most dangerous. Polysegmental pneumonia requires immediate medical attention and quick recognition of symptoms.
Clinical picture
The respiratory organs in the body consist of various functional parts: the lung consists of two lobes, which are subdivided into segments. They, in turn, are composed of alveoli. The name of the disease has a transparent etymology: “poly” + “segment”. The disease is characterized by the fact that the inflammatory processes occurring in the respiratory organs simultaneously cover several functionally important areas of both lungs.
The main hazards in polysegmental pneumonia:
Lung segments
- expansive path of disease development;
- gradual spread of extensive destruction of lung structures;
- high risk of complications, destructive effects on the body.
Varieties of the disease according to the location of the inflammation:
- right-sided polysegmental pneumonia – occurs in the upper lobes of the lungs;
- left-sided pneumonia;
- bilateral pneumonia;
- outpatient (community-acquired) pneumonia: occurs gradually in connection with prolonged respiratory illness. Affects the lower segments of the lungs, difficult to diagnose.
There are two complexes of polysegmental pneumonia with varying degrees of complexity.
Bronchopulmonary syndrome
It arises as a complication due to the excessive accumulation of pathogens in the airways and lungs. Symptoms of the syndrome:
Moist cough with chest pain
- wheezing when breathing or talking. The reason is inflammation of the respiratory system, swelling of the walls of the bronchi;
- severe moist cough, accompanied by sputum production. During illness, the lungs are filled with a specific secret of a viscous consistency. Cough – the body’s defense mechanism, allows the lungs to get rid of unnecessary substances;
- unpleasant or painful sensations in the chest when coughing, breathing, moving. The sensations are caused by the spread of inflammation to the pleural sheets;
- dyspnea. Observed during physical exertion, it occurs as a result of the contraction of healthy tissue of the respiratory tract and lungs, which leads to a lack of oxygen and the need for frequent inhalation and exhalation.
Intoxication syndrome
Its symptoms:
- a sharp, rapid development of inflammation, provoked by pneumococcal pneumonia. Obvious detection of signs of illness by the general condition of the body. Stable high temperature up to 40 ° C. It does not go down throughout the disease, it gradually decreases only due to treatment;
- palpable chills, turning into fever. It occurs periodically, lasts several hours, provokes profuse sweating in the patient;
Heat
- severe dizziness, migraine, headache. Reason: an increase in the number of harmful pathogens in the body. Achieved by damaging the epithelium of the lungs. It leads to a dysfunction of the blood supply to the body, hence the painful sensations;
- incessant fever in children, which can run continuously for several days, recurs throughout the illness;
- pain, weakness, aches in muscles and joints. They are explained by impaired blood circulation. The reason is insufficient oxygen saturation of the body.
Causes
The disease is complex, multifactorial, it develops due to groups of pathological causes. They are divided into 2 directions:
- Bacterial infections in the body:
Pneumococci
- pneumococci are the cause of 80% of cases. Factors for their appearance are a decrease in general immunity before the disease, the effect on the lungs, internal burns. Complicated by the presence of proteins in the structure of organisms, similar in composition to humans. The immune system is unable to distinguish between these proteins during illness, so it destroys both species. Inflammatory processes in the body are accelerated;
- staphylococci – treatment is complicated by the fact that these organisms are able to create many internal structures, being in the body and provoking disease. Antibiotics remove only the outer layers, so the procedure is imperfect;
- streptococci – give a relatively mild course of the disease.
- Atypical causes (viruses, parasites, fungi) of the disease:
- chlamydia (a mild form of the disease, but difficult and costly treatment);
- legionella (cause of severe interstitial form, high probability of death);
- mycoplasmas (provoke extended, but less dangerous forms).
Features of the disease for children
At an early age, the disease is more severe, especially in infants. This is due to the instability of their immune system. The child’s body and respiratory organs are not fully formed: thin, small, with sensitive mucous membranes. As a result of the disease, severe swelling of the organs develops and there is a difficulty in the passage of air. In adults, the disease is most often milder.
Diagnostics
The main method for diagnosing the disease is X-ray. The images obtained objectively display the affected segments, their localization. Conclusions are made on the darkening in the images – this is one of the main signs of the disease. A spatial classification of polysegmental pneumonia is carried out : right-sided / left-sided / bilateral, upper-lobe / lower-lobe. Data on the volume of lesions are displayed.
Additional methods:
Physical examination
- physical examination reveals wheezing, weak breathing, airway defects;
- a clinical blood test will indicate pronounced symptoms of the course of inflammatory processes in the body;
- fluorography;
- bacteriological examination of secretions (sputum);
- diagnostics of the state of the immune system;
- in the case of severe forms of the disease, serological and virological procedures are additionally carried out.
All information received is taken into account when determining the type and dosage of medicines. The diagnosis is determined only in conjunction with the external manifestations of the disease, in order to avoid confusion with other types of similar ailments.
Treatment activities
After all the necessary tests and diagnosis have been made, the patient is prescribed a course of antibiotics. The choice is based on the individual characteristics of the patient: age category, tolerance, allergies, type of infectious agent.
Antibiotic groups:
Antibiotics
- pharmacological group of penicillins. Properties: low toxicity, wide dosage range;
- carbapenems . Possess effective antimicrobial activity;
- fluoroquinolones . Show antimicrobial activity, are used as antibacterial agents.
The duration of treatment is from 2 weeks to 20 days. Several stages of administration: in severe cases of the disease, antibiotics are initially administered intravenously, then taken orally. Additionally, antiviral substances are prescribed in case of a previous acute viral infection.
Treatment of bronchopulmonary syndrome
Special drugs are used – glucocorticosteroids . Additionally – inhalation. In parallel, the patient is prescribed a course of taking vitamins to restore immunity. For patients of retirement age, medications for the cardiovascular system are additionally prescribed, since pneumonia has a significant negative effect on it . Treatment involves bed rest, no stress.
After relieving symptoms and improving the condition, patients are prescribed physiotherapy, physiotherapy exercises, breathing exercises and massage (contributes to the final cleansing of the body from phlegm).
Symptoms can be relieved at home with infusions, teas, and warming.
Forecast
For almost all cases of polysegmental pneumonia, the outcome is positive, the disease can be cured. This does not mean that the disease will disappear by itself, without visible effort. To get rid of pneumonia, you must strictly follow the doctor’s instructions, follow the regimen and perform all procedures. If all conditions are met, recovery is possible in 30-40 days. If the disease continues to develop, the consequences are unpredictable.
Prophylaxis
For people over 65, pneumococcal vaccination is recommended. The vaccine is also useful for those who smoke for a long time, have cardiovascular disease, or have poor immunity. It does not give a 100% guarantee, but it significantly reduces the risk of disease.
General recommendations for prevention:
Vaccination against pneumococcal infection
- avoiding contact with people with pneumonia or infectious diseases (measles, flu, tonsillitis, chickenpox);
- compliance with the rules of personal hygiene;
- systematic strengthening of immunity;
- regular scheduled medical examinations;
- breathing exercises, hardening;
- minimization of stressful situations and hypothermia.
Complications
If symptoms or indications for treatment are ignored, the following consequences develop:
- chronic pneumonia;
- local pneumosclerosis – proliferation of connective tissue in the structure of the lungs, this leads to deformation of the bronchi and lungs;
- bronchiectasis – irreversible expansion of the walls of the bronchi, changes in their structure.
Pneumosclerosis
Polysegmental pneumonia is a complex and dangerous disease, its clinical picture is not always obvious. The risks in the absence of therapy are too great, therefore, timely diagnosis and thoughtful treatment are required.