Inflammation of the lungs (pneumonia) is an infectious and inflammatory process with damage to the end sections of the respiratory tract, these include: terminal and alveolar passages, as well as alveoli.
In children, right-sided pneumonia is most common, which is confirmed by statistical data. For 1000 infants, 15-19 cases of the disease are recorded, from 1 to 3 years – 5-7 cases, from 3 to 6 years – 2-3 cases of pneumonia, 6-12 years – 1-2 cases.
Right-sided pneumonia in the picture
Features of the course of the disease
Frequent cases of community-acquired right-sided pneumonia are caused by provoking factors and structural features of the respiratory system. The right bronchus is wider and shorter in contrast to the left, which is narrower and longer, so inflammation from the upper sections easily spreads to the right sections. The child’s body is less strong, organs and systems are not sufficiently formed.
The child is rapidly developing symptoms of lung tissue damage with pneumonia, the following physiological functions deteriorate:
- gas exchange between atmosphere and blood;
- buffered with pH maintenance ;
- immune – the production of immunoglobulin, mucin, lactoferrin , lysozyme;
- protective – due to the movement of the ciliated epithelium;
- thermoregulatory (water evaporation);
- elimination of toxins.
High temperature in a child
With pneumonia, timely seeking medical care reduces the risk of severe consequences of the disease in a child, when urgent hospitalization is required.
Clinical manifestations
The symptoms of pneumonia directly depend on the stage of the disease, the prevalence of the process, the immunological status of the child and the type of pathogen. Pneumonia is conventionally divided into typical, atypical and secondary.
The typical form of pneumonia is characterized by an acute onset and an increase in intoxication syndrome. In children, the body temperature rises sharply to febrile numbers (over 38 ° C), a dry cough appears, which subsequently becomes moist and productive. After a series of cough shocks, purulent sputum is released. Children complain of pain in the right side of the chest when involved in the infectious-inflammatory process of pneumonia of the pleura.
The atypical form of pneumonia has a gradual onset and a blurred clinical picture. Muscle pains (myalgia), weakness, malaise, hyperthermia within subfebrile numbers (37.1-38 ° C) are noted. Headache and dizziness are expressed. The symptoms of pneumonia are similar to those of an acute respiratory illness.
The secondary form of pneumonia develops against the background of aspiration of gastric contents, amniotic fluid, foreign substances, congestion in the lungs with prolonged bed rest, after surgery on internal organs or immunodeficiency. Symptoms are similar to focal pneumonia, symptoms of toxicosis with apathy, weakness and lethargy prevail. Fever, heart palpitations, pallor of the skin, decreased or complete lack of appetite are noted.
Causes of occurrence
The main cause of pneumonia in the right lung is bacteria, viruses and fungi. They enter the body by aspiration after contact with a patient or a carrier of a certain type of pathogen.
In young children, a number of predisposing factors are distinguished:
Fetal hypoxia
- Insufficient oxygen supply during the prenatal period (hypoxia, asphyxia).
- Injury during childbirth.
- Pneumopathies , including malformations of lung tissue and mid-lobe syndrome.
- Hereditary disease – cystic fibrosis (cystic fibrosis).
- Chronic eating disorders (malnutrition, dystrophy, hypovitaminosis).
- Immaturity of the immune system and adaptive mechanisms.
In children of preschool and school age, the preceding factors of pneumonia can be:
- Self-treatment of acute respiratory viral infections, bronchitis, pharyngitis, laryngitis and tonsillitis at home with the wrong choice of therapy tactics.
- Chronic focus of infection in the nasopharynx.
- Propensity for allergies and atopy .
- Acquired heart muscle defects with overload of the pulmonary circulation.
- Immunodeficiency.
- Early hobby for smoking.
Scientific studies have shown a link between oral health and the incidence of pneumonia: regular debridement of dental caries reduces the risk of infection by half.
Is the disease contagious
Pneumonia is different and the pathways of infection are different. Children are more prone to contracting community-acquired pneumonia by airborne droplets and oral routes when the patient is in close proximity (coughing, sputum production, sneezing). The pathogen is in the air inhaled by the child, and also settles on household items, toys, food. Pneumonia is contagious if it comes from pathogenic bacteria.
Airborne droplet
Diagnostics
To diagnose pneumonia, the pulmonologist performs examination, auscultation and percussion. You will need to follow the mandatory methods:
- X-ray of the chest cavity organs in frontal and lateral projection;
- clinical blood test and general urine analysis;
- microscopic analysis of sputum with Gram stain to establish the type of pathogen;
- determination of the gas composition of blood;
- sowing sputum on a nutrient medium in order to establish resistance to antibacterial agents.
Chest X-ray
In the case of a questionable clinical picture of pneumonia and a differential diagnosis, it may be required: bronchoscopy, computed tomography of the OGK, ultrasound.
Treatment methods
With moderate and severe course, the treatment of right-sided pneumonia in children is indicated only in a hospital. To prevent the disease, an integrated approach is needed using several methods:
Oxygen therapy for a newborn
- Taking medicines.
- Oxygen therapy in the event of respiratory failure and hypoxia.
- Physiotherapy procedures.
- Correct and regular nutrition.
Infants (up to 1 year old), children with chronic diseases of internal organs, diabetes mellitus, kidney and liver diseases, and oncohematological pathologies are subject to compulsory hospitalization for pneumonia .
The course of taking medications
Treatment of pneumonia begins with the appointment of etiotropic and symptomatic drugs. Until the results of bacteriological culture are obtained, the child is prescribed broad-spectrum antibiotics:
Suspension Augmentin
- Penicillin group: Augmentin , Tymentin .
- Cephalosporins: Ceftriaxone , Cefepime .
- Macrolides: Azithromycin, Rovamycin .
- Fluoroquinolones : Levofloxacin , Gatifloxacin , Moxifloxacin .
In order to reduce intoxication with pneumonia, alkaline drinking, saline and detoxification solutions are indicated intravenously ( Trisol , Reopolyglyukin ). With a wet cough, expectorant syrups, tablets, solutions are prescribed: Ambroxol, Mukaltin, Acetylcysteine. To reduce edema, inflammation and reflex spasm of bronchioles, antihistamines are required: Tavegil, Erius , Suprastin.
Physiotherapy
Physiotherapy procedures for pneumonia are carried out 2-3 days after the start of etiotropic treatment, include ultraviolet irradiation of the chest cavity organs, breathing exercises (physical exercises with raising hands, inflation of balls), massage, and physiotherapy exercises.
Nebulizer inhalation
With a pronounced paroxysmal cough, a nebulizer is prescribed with inhalation of antiseptic ( Dekasan ), mucolytic (Ambroxol) or bronchodilator (Atrovent) drugs.
ethnoscience
Radish with honey
It is unacceptable to treat pneumonia with traditional medicine. Doctors allow folk methods only as a secondary and auxiliary therapy.
At home, a decoction with bergenia is used to gargle the throat, radish with honey to increase the body’s resistance, inhalation with fir oil to moisturize and warm the respiratory tract.
During the recovery period after pneumonia, a compress with plantain is used on the right chest area, an infusion of pine buds, oak bark, lavender, St. John’s wort, as well as propolis for oral administration.
Preventive measures
Primary prevention includes measures to prevent the development of pneumonia:
- adherence to a healthy lifestyle;
- proper and balanced nutrition during the period of bearing a child;
- rational feeding;
- introduction of complementary foods and artificial mixture;
- strengthening of immunity, hardening.
Secondary prevention is aimed at timely treatment of respiratory diseases, rehabilitation of chronic foci of infection (tonsillitis, sinusitis, caries), seeking medical help in case of a general deterioration in the child’s condition and suspected pneumonia.
The clinics regularly carry out vaccination against pneumococcal infection in children over 2 years old.
Possible consequences
Serious complications of pneumonia can include:
Lung gangrene
- abscess formation and gangrene of the lung tissue;
- inflammation of the pleural membrane with the development of empyema;
- acute hypoxia with obstruction;
- pulmonary edema.
Against the background of pneumonia, endocarditis, meningitis, and sepsis also develop.
Pneumonia refers to infectious and inflammatory diseases that affect all age groups. Pneumonia in children should be closely monitored by a pediatrician and pulmonologist. Individualized and timely started treatment reduces the risk of complications.