An inflammatory process with damage to all structures of the lung and leading to dysfunction of external and tissue respiration or acute pneumonia is still one of the most common pathologies of the respiratory system. Despite modern methods of therapy, the disease is considered dangerous and often causes the death of debilitated patients, young children and the elderly. The outcome of the disease largely depends on the timely diagnosis and implementation of a set of therapeutic measures aimed at eliminating and localizing the inflammatory reaction, restoring lung function, and preventing complications.
Classification
Acute pneumonia is classified according to a number of features that are taken into account when making a diagnosis. The area of the lesion, the localization of inflammation, the severity of clinical manifestations, the conditions of development, the duration of the pathological process are reflected in the classification of the disease.
Conditions of occurrence
Depending on what triggered the development of pneumonia, pneumonia is classified according to 4 signs:
- The community-acquired form of the disease develops at home or not earlier than 48 hours after hospitalization and 4 weeks after discharge from the hospital. Differs in a fast course, a vivid clinical picture and a favorable outcome.
- The conditions for the occurrence of hospital pneumonia provide for the preliminary stay of the patient in the hospital. The cause of the disease is a violation of sanitary and epidemiological standards within a medical institution or contact with infected patients.
- Aspiration pneumonia develops as a result of prolonged presence of foreign objects in the respiratory tract. At risk are patients with impaired swallowing, breathing, who are on artificial ventilation.
- The immunodeficiency form of pneumonia occurs in people with chronic immunosuppression as a result of diseases or caused by taking immunosuppressants. Cancer patients, patients with HIV infection, autoimmune pathologies are most susceptible to the threat of infection, while the causative agent of pneumonia is often conditionally pathogenic microflora.
Lung infarction is considered one of the most dangerous forms of acute inflammation of the lung tissue and occurs as a result of circulatory disorders, in which the parenchyma area does not receive nutrition and a necrotic focus is formed in its place.
Establishing a diagnosis, taking into account this classification, is based on data from anamnesis, the analysis of which helps to establish the trigger mechanism of the disease.
Topographic features
The pathological anatomy of pneumonia indicates three main variants of lung damage:
- More often there is an inflammatory process localized in the right lobe, which is facilitated by the structural features of the respiratory system. The disease develops rapidly, responds well to conservative therapy and rarely leads to complications.
- Left-sided pneumonia is a serious pathology and requires compulsory hospitalization. The infectious process often takes a protracted nature and it takes a long time to completely eliminate the consequences of the disease.
- The most difficult option is bilateral pneumonia. Turning off a large volume of the parenchyma leads to profound impairment of respiratory and metabolic functions and often becomes the cause of death in debilitated patients.
The topographic classification of pneumonia helps to determine the medical tactics of patient management and to predict the possible development of the pathological process.
The severity of the current
The severity of clinical symptoms allows you to assess the severity of the course of the disease:
- The mild form is characterized by moderate symptoms with mild impairment of respiratory function and the absence of intoxication syndrome.
- Acute pneumonia of moderate severity occurs with pronounced signs of inflammation, intoxication and partial depression of the respiratory system.
- In severe cases, a vivid clinical picture of pneumonia is complemented by concomitant disorders of the heart and kidneys. Severe intoxication against the background of suppression of the immune defense often leads to the generalization of infection with the development of meningitis, sepsis and encephalitis.
Patients with a mild form of pneumonia can be treated at home, in all other cases, hospitalization in the department of pulmonology or intensive care is indicated.
Morphological signs
The localization of the inflammation focus is the basis of the classification in terms of morphology. The level of damage to the lung tissue indicates the prevalence of the infectious process and determines the tactics of treatment:
- Croupous pneumonia. An isolated inflammatory reaction in one of the lobes of the left or right lung with damage to the pleural membrane.
Focal and croupous pneumonia
- Focal pneumonia. Secondary inflammation of the lung tissue, which occurs in combination with bronchitis.
- Interstitial pneumonia. Extensive infectious and inflammatory lesions of the lung parenchyma, alveoli and pleural membrane.
The prognosis of the disease largely depends on the location, the wider the area of inflammation, the more difficult it is to cure acute pneumonia, avoiding irreversible changes.
Main reasons
The study of the etiology made it possible to compile a list of the most probable causes and risk factors that contribute to the development of the disease. The first place is occupied by pneumonia of bacterial origin, and among the main pathogens there are pneumococci, streptococci, staphylococci and Pseudomonas aeruginosa. Fungal pathogens are less common, and the viral nature of the disease indicates the development of complications after the infection.
At high risk are newborns, people with immunodeficiency diseases and the elderly. Pneumonia can be provoked by occupational hazards, inhalation of supercooled air, high humidity, prolonged bed rest, stressful situations, as well as a weakened immune defense after a cold or flu.
The cause of pneumonia can be allergic reactions, in which, as a result of prolonged damage to the mucous membranes of the respiratory tract, conditions are formed for the active development of pathogens.
Manifestations of acute pneumonia
The symptomatology of the disease indicates the presence of inflammation and depends on its localization, prevalence and degree of involvement of lung tissues in the pathological process. Typical symptoms of pneumonia in adults are:
- Heat.
- Excessive sweating.
- General weakness.
- The presence of a cough.
- Difficulty shallow breathing.
- Dyspnea.
- Symptoms of general intoxication.
Changes in the work of the heart, kidneys and the clinic of neurological disorders are manifested in the middle and severe course of the disease. In children, manifestations of pneumonia are characterized by severe respiratory dysfunctions and increasing intoxication. In addition, there are two main options for the development of the disease:
The acute inflammatory response is characterized by rapid onset, rapid progression, and complete recovery within 3-4 weeks without serious complications.
With prolonged pneumonia, the pathological process develops sluggishly, inflammation, which lasts from 2 to 3 months, often leads to chronic lung diseases and is accompanied by the formation of connective tissue structures in the lung tissue.
It can be difficult to distinguish between the two variants of the course of the disease at an early stage, and differentiation is based on the history data and the results of dynamic X-ray observation.
Diagnostics
A complex of diagnostic procedures allows you to diagnose the disease, determine the risks and prescribe the necessary treatment at home or in a hospital.
Which doctor should you contact
Diagnostics is carried out by a local therapist or a doctor of the pulmonology department. Signs of pneumonia in a child are found on examination by a pediatrician, and gerontologists carry out examination of elderly patients in specialized centers. If pneumonia is suspected, the doctor prescribes X-ray and functional tests, prescribes directions for tests and evaluates the results, taking into account the history data.
What tests need to be passed
The study of urine, blood and sputum allows you to assess the severity of the inflammatory process, conduct the necessary tests to detect the causative agent of the infection and establish the range of suitable medications for treatment. Laboratory tests help not only to determine the diagnosis, but also to differentiate with tuberculosis, cancer and other respiratory diseases.
Treatment methods for acute pneumonia
Patients with pneumonia are subject to hospitalization, although in some cases, with a mild course of the disease, it is allowed to treat pneumonia at home. The conservative therapy regimen involves the use of antibacterial, antiviral or antifungal drugs, the appointment of symptomatic agents, and the use of medications to remove sputum. Alternative methods and physiotherapeutic techniques are used as auxiliary procedures after the elimination of acute symptoms of inflammation. During the period of pneumonia treatment, the patient requires special care and diet. Bed rest, special diet and treatment procedures can help to cope faster with inflammation and reduce the likelihood of complications.
Forecast
The outcome of the disease depends on a number of factors, the main of which are the patient’s age, the severity of the course, the prevalence of inflammation and the degree of involvement of other organs in the pathological process. Provided timely diagnosis and correct treatment, pneumonia in adults is cured without complications in 4-6 weeks. The disease has an unfavorable prognosis in children under one year old and in old age, as well as with a complicated course in debilitated patients.
Preventive measures
The prevention of pneumonia is one of the most important public health concerns. Disease prevention includes giving up bad habits and reducing occupational risks, timely diagnosis, remediation of chronic foci of infection and general measures to strengthen immunity – proper nutrition, sports, adherence to the daily routine, hardening. The recommendations of doctors on a healthy lifestyle help reduce the risk of colds and viral diseases, which are the main risk factor in the development of pneumonia.
Complications of acute pneumonia
The consequences of pneumonia are often associated with impaired respiratory function due to extensive inflammation of the lung tissue. With the generalization of the infection, there is a danger of developing sepsis, meningitis, encephalitis, as well as inflammatory diseases of the heart, kidneys and joints. Septic complications of pneumonia are most likely in children under one year old, and at an older age, functional disorders come to the fore.
Postponed acute pneumonia requires medical supervision for 6-9 months. This measure is aimed at preventing long-term consequences and helps to reduce the risk of relapse. During this period, special attention should be paid to preventive measures and work to strengthen the immune system.
