Segmental pneumonia is inflammation that affects one or more segments of the lungs. It is characterized by fever, significant fever, severe cough, chest pain. Segmental pneumonia is most often observed in children. According to statistics, in most cases, babies aged 3 to 7 years are susceptible to this disease, however, the development of segmental pneumonia is possible in other children’s age categories. This pathology is considered the most dangerous and difficult in newborns and infants up to a year.
About a quarter of all cases of this disease are segmental, second only to focal inflammation in frequency of occurrence. The disease can be both primary (occurs independently) and secondary (develops against the background of another disease, for example, ARVI).
Most often, this type of inflammation affects one of the lungs (95% of cases). Right-sided segmental pneumonia in a child occurs quite often, this is the most common type of course. If we take all cases of segmental pneumonia, left-sided lesions are more common in children than in adults.
Reasons for development
Segments are morpho-functional parts that make up the lobes of the lungs. The left lung consists of 2 lobes and 8 segments, and the right lung is formed by 3 lobes and 10 segments. Each segment is ventilated by a separate bronchus and fed by its own part of the pulmonary artery. The defeat of one of these areas is called segmental pneumonia. If two or more segments are involved in the process, then the disease is called polysegmental inflammation.
The most common causative agents are bacteria (Haemophilus influenzae, pneumococci, streptococci) and viruses (influenza, adenoviruses, viral respiratory infections). Inflammation may develop in a segment of the lung under the influence of fungi or protozoa.
Most often, pathogenic microflora enters the child’s body by inhalation. An aspiration route of infection is also possible, when microorganisms enter the respiratory tract from the nasopharynx. In some cases, infectious agents enter the lung tissue from distant foci with blood flow.
The development of inflammation of the lung segment is facilitated by a decrease in the immune status, hypothermia. Often this form of pneumonia is diagnosed in children prone to allergic reactions.
The disease begins acutely, the symptoms are rapidly increasing. The temperature rises to febrile values (38-39 degrees), intoxication of the body rapidly develops. Toxic waste products of pathogenic microflora are carried to all tissues, as a result, the following symptoms are observed:
- general malaise;
- increased sweating;
- sometimes convulsions begin, the child may have some confusion.
The cough, as a rule, joins on the second or third day. The child may complain of pain in the chest or in the stomach. The baby has no appetite, he becomes lethargic, does not show activity, refuses to play and run. The skin becomes pale, in the area of the nasolabial triangle it can cast blue.
If pneumonia does not end with recovery, it takes a protracted course, this can lead to the development of bronchiectasis , proliferation of connective tissue at the site of the inflammatory process (sclerosis).
This form of pneumonia can be complicated by the following pathologies:
- the development of pleurisy;
- abscess formation;
- empyema of the pleura;
- obstructive syndrome;
- cardiopulmonary failure.
The cause of complications in segmental pneumonia is untimely treatment of the disease, attempts at self-treatment. Also, a complicated course of pneumonia can be observed in children suffering from serious concomitant pathologies, immunodeficiency.
When a child develops signs of pneumonia, it must be immediately shown to a pediatric pulmonologist or pediatrician. The doctor will analyze the clinical symptoms, take a history, and conduct a physical examination that includes auscultation and percussion. After that, the following studies are assigned:
- general clinical studies of urine and blood;
- blood biochemistry;
- sputum culture ;
- serological tests (PCR, ELISA);
- X-rays of light.
The most informative method for making a diagnosis is radiography. In the pictures, you can see the shaded areas with clearly defined boundaries. These are the affected segments. If the x-ray data is insufficient, the doctor may order a CT scan of the lungs.
Differential diagnosis is carried out in relation to other forms of the disease, as well as tuberculous lesions, cancer, obliterating bronchiolitis , and pulmonary infarction.
Children with severe pneumonia, with complications, as well as those with serious concomitant diseases, are placed for treatment in a hospital. In other cases, it is possible to carry out therapy at home with outpatient supervision.
Treatment of this disease includes measures aimed at suppressing the activity of the causative agent of the infection, detoxifying the body, stopping the foci of the inflammatory process, and preventing or eliminating respiratory failure.
The main therapy is with antibiotics. The choice of the drug is carried out by the doctor on the basis of bacteriological analysis data. Sometimes you have to wait several days for the results of the study, and treatment must be started immediately. In such cases, the doctor prescribes one or two types of broad-spectrum antibiotics (penicillins, fluoroquinolones , cephalosporins). If there is no improvement within 1.5-2 days, then the drugs are replaced. The course of antibiotics is prescribed for about two weeks.
Additionally, the following medications are prescribed:
- bronchodilators ;
- mucolytics ;
- glucose solution, saline , administered by infusion to eliminate intoxication;
Also, therapy is carried out aimed at eliminating the disorders resulting from inflammation of the segmental lungs. According to the indications, funds are prescribed for the settlement of the cardiovascular system, antihistamines, corticosteroids, sedatives.
If the child develops respiratory failure, oxygen therapy is prescribed. Also shown are bronchial lavage with special solutions (bronchoscopy), inhalation.
After the removal of acute symptoms, physiotherapy is applied . Massage and breathing exercises are recommended.
As a rule, the affected segment collapses due to the fact that its alveoli collapse . This condition is called atelectasis, and if present, pneumonia can be protracted. With adequate treatment of uncomplicated forms of the disease, the main symptoms disappear after 10-12 days. On x-rays, changes can be seen throughout the month.
For prevention purposes, the child needs to be tempered from an early age, to strengthen his immunity. This requires a rational and nutritious diet, regular physical activity, adherence to the daily regimen. An effective preventive measure is to vaccinate a child against pneumococcal infection, influenza.
To prevent the development of this disease in a child, it is necessary to timely and correctly treat respiratory infections, to sanitize chronic infectious foci.
Segmental pneumonia is dangerous, like other forms of this disease. In order to prevent the severe consequences of pneumonia, you need to consult a doctor when the first symptoms appear, undergo an examination and strictly follow the recommendations of a specialist.