The phrase "pneumonia" is very frightening for parents. At the same time, it does not matter at all how many years or months the child is, this disease among mothers and fathers is considered one of the most dangerous. Is this really so, how to recognize pneumonia and how to treat it correctly, says the famous children's doctor, author of books and articles on children's health Yevgeny Komarovsky.
About the disease
Pneumonia (this is how doctors call what is popularly called pneumonia) is a very common disease, inflammation of the lung tissue. Under one concept, doctors mean several ailments at once. If the inflammation is not infectious, the doctor will write "pneumonitis" on the card. If the alveoli are affected, the diagnosis will sound differently - "alveolitis", if the mucous membrane of the lungs is affected - "pleurisy".
The inflammatory process in the lung tissue is caused by fungi, viruses and bacteria. There are mixed inflammations - viral-bacterial, for example.
Ailments that are part of the concept of "pneumonia" all medical reference books are classified as quite dangerous, since out of 450 million people from all over the world who fall ill with them a year, about 7 million die due to an incorrect diagnosis, incorrect or delayed treatment, and also from the speed and severity of the disease. Among the deceased, about 30% are children under 3 years of age.
According to the location of the focus of inflammation, all pneumonia are divided into:
- Focal;
- Segmental;
- Equity;
- Draining;
- Total.
Also, inflammation can be bilateral or unilateral if only one lung or part of it is affected. Quite rarely, pneumonia is an independent disease, more often it is a complication of another disease - viral or bacterial.
The most dangerous pneumonia is considered for children under 5 years of age and the elderly, among such patients the consequences are unpredictable. According to statistics, they have the highest mortality rate.
Yevgeny Komarovsky claims that the respiratory organs are generally the most vulnerable to various infections. It is through the upper respiratory tract (nose, oropharynx, larynx) into the child's body and most of the microbes and viruses penetrate.
If the baby's immunity is weakened, if the environmental conditions in the area where he lives are unfavorable, if the microbe or virus is very aggressive, then the inflammation does not linger only in the nose or larynx, but goes down into the bronchi. This condition is called bronchitis. If it cannot be stopped, the infection spreads even lower - into the lungs. Pneumonia occurs.
However, the airborne route of infection is not the only one. If we take into account that the lungs, in addition to gas exchange, perform several more important functions, it becomes clear why sometimes the ailment appears in the absence of a viral infection. Nature has entrusted the human lungs with the mission of humidifying and warming the inhaled air, purifying it of various harmful impurities (the lungs function as a filter), and also filtering the circulating blood in the same way, releasing many harmful substances from it and neutralizing them.
If the baby underwent surgery, broke his leg, ate something wrong and got severe food poisoning, burned himself, cut himself, this or that amount of toxins, blood clots, etc. gets into the blood in various concentrations. The lungs are patiently neutralized or taken out with using a protective mechanism - cough. However, unlike household filters, which can be cleaned, washed or thrown away, lungs cannot be washed or replaced. And if one day some part of this "filter" fails, becomes clogged, the very disease begins, which parents call pneumonia.
The causative agents of pneumonia can be a wide variety of bacteria and viruses.... If a child falls ill while in a hospital with another ailment, then in a huge degree of probability he will have bacterial pneumonia, which is also called hospital or hospital. This is the most severe of pneumonia, since under conditions of hospital sterility, the use of antiseptics and antibiotics, only the strongest and most aggressive microbes survive, which are not so easy to destroy.
The most common in children is pneumonia, which has arisen as a complication of a viral infection (ARVI, flu, etc.). Such cases of lung inflammation account for about 90% of the corresponding children's diagnoses. This is not even due to the fact that viral infections are "scary", but to the fact that they are extremely widespread, and some children get sick with them up to 10 times a year or even more.
Symptoms
To understand how pneumonia begins to develop, you need to have a good idea of how the respiratory system generally works. The bronchi constantly secrete mucus, the task of which is to block dust particles, microbes, viruses and other unwanted objects that enter the respiratory system. Bronchial mucus has certain characteristics such as viscosity, for example. If it loses some of its properties, then instead of fighting the invasion of foreign particles, it itself begins to cause a lot of "trouble".
For example, too thick mucus, if the child breathes dry air, clogs the bronchi, interferes with normal ventilation. This, in turn, leads to congestion in some parts of the lungs - pneumonia develops.
Often pneumonia occurs when the child's body is rapidly losing fluid reserves, bronchial mucus thickens. Dehydration of varying degrees can occur with prolonged diarrhea in a child, with repeated vomiting, high fever, fever, with insufficient fluid intake, especially against the background of previously mentioned problems.
Parents can suspect pneumonia in a child for a number of signs:
- Cough has become the main symptom of the disease... The rest, who were present before, gradually pass, and the cough only intensifies.
- The child became worse after the improvement... If the disease has already receded, and then suddenly the baby felt bad again, this may well indicate the development of a complication.
- The child cannot take a deep breath. Every attempt to do this leads to a violent attack of coughing. Breathing is accompanied by wheezing.
- Pneumonia can manifest itself through severe pallor of the skin against the background of the above symptoms.
- The child has shortness of breath and antipyretic drugs, which used to always quickly help, have ceased to have an effect.
It is important not to engage in self-diagnosis, since the absolute way to establish the presence of inflammation in the lung is not even the doctor himself, but an X-ray of the lungs and bacterial sputum culture, which will give the doctor an accurate idea of which pathogen is the cause of the inflammatory process. A blood test will show the presence of antibodies to viruses, if the inflammation is viral, and the Klebsiella found in the feces, will lead to the idea that pneumonia is caused by this very dangerous pathogen. At home, the doctor will definitely listen and tap out the lungs of a small patient, listen to the nature of wheezing when breathing and during coughing.
Is pneumonia contagious?
Whatever the cause of pneumonia, it is in almost all cases contagious to others. If these are viruses, they are easily transmitted to other family members by air, if the bacteria - by contact, and sometimes by airborne droplets. Therefore, a child with pneumonia should be given a separate dish, towel, bedding.
Treatment according to Komarovsky
After the diagnosis is made, the doctor will decide where the child will be treated - at home or in the hospital. This choice will depend on how old the child is and how severe his pneumonia is. Pediatricians try to hospitalize all children under 2 years old, since their immunity is weak, and the treatment process must therefore be constantly monitored by medical personnel.
All cases of obstruction during pneumonia (pleurisy, blockage of the bronchi) are the basis for hospitalization of children of any age, since this is an additional risk factor, and recovery from such pneumonia will not be easy. If your doctor says you have uncomplicated pneumonia, then he will most likely allow you to treat it at home.
Most often, pneumonia is treated with antibiotics, while it is not at all necessary that many sick and terrible injections will have to be done.
The doctor will determine antibiotics that can quickly and effectively help based on the results of a sputum test for bacterial culture.
Two-thirds of cases of pneumonia, according to Evgeny Komarovsky, are perfectly treated with pills or syrups. In addition, expectorants are prescribed, which help the bronchi to clear accumulated mucus as soon as possible. At the final stage of the child's treatment, physiotherapy and massage are shown. Also, children who are undergoing rehabilitation are shown walks and taking vitamin complexes.
If the treatment takes place at home, then it is important that the child is not in a hot room, drinks a sufficient amount of liquid, vibration massage is useful, which promotes the discharge of bronchial secretions.
Treatment for viral pneumonia will be similar, with the exception of taking antibiotics.
Prevention
If a child is sick (ARVI, diarrhea, vomiting and other problems), you must make sure that he consumes a sufficient amount of liquid... The drink should be warm so that the liquid can be absorbed faster.
A sick baby should breathe clean, moist air. To do this, you need to ventilate the room, humidify the air with a special humidifier device or with wet towels hung around the apartment. It should not be allowed to be hot in the room.
The best parameters for maintaining a normal level of mucus viscosity are as follows: air temperature 18-20 degrees, relative humidity 50-70%.
If a child is sick, you need to try to free his room as much as possible from everything that can accumulate dust - carpets, soft toys, upholstered furniture. A large amount of inhaled dust particles only accelerates the thickening of sputum and increases the risk of developing pneumonia. Wet cleaning should be carried out 1-2 times a day; it is strictly forbidden to add chlorine-based detergents!
If the child is coughing, you do not need to give him all kinds of cough remedies at home.
A cough is needed to flush out excess waste sputum. If the cough reflex is stopped at the very peak of the disease with antitussive drugs, then there will be no sputum release, and the risk that pneumonia will begin will increase significantly. Mucolytic (expectorant) agents (plant-based), the task of which is to liquefy phlegm, are welcome, but, according to Komarovsky, with strict observance of all of the above points.
With ARVI, in no case should you take antibiotics. Even if your doctor advises you to start doing it to prevent pneumonia. Even the latest antibiotic is not able to destroy all the microbes that are in the human body, while antimicrobial agents do not act on viruses at all. But it has been proven that taking them for flu or ARVI increases the likelihood of developing pneumonia by 9 times!
With a runny nose caused by a viral infection, do not immediately start dripping vasoconstrictor drops into the child's nose. So it is more likely that viruses, bypassing the nose, go straight to the lungs and cause an inflammatory process there.
An excellent way of prevention is pneumococcal vaccination. It is pneumococcus that causes the most severe forms of pneumonia. A child of the first year of life is given a vaccine as part of the Vaccination Schedule, which helps the body develop antibodies to pneumococcus. Even if infection occurs, the disease will be easier. The vaccine is given several times. In the first months of life, at 2 years old, at 4 years old, at 6 years old and at 12 years old. In no case should you refuse to vaccinate, says Evgeny Komarovsky.
See Dokor Komarovsky's show for more details.
