Often a common disease that poses a real threat to life is pneumonia in children, in the treatment of which modern medicine has advanced far. Even 30–40 years ago, according to statistics, doctors managed to save only every 3-4 children with pneumonia.
Modern methods of therapy have reduced the mortality from this disease dozens of times, but this does not make the disease less serious. Forecasts in the treatment of each child always depend not only on the correct statement of the diagnosis and treatment plan, but also on the timeliness of referral to a doctor.
What is pneumonia?
Inflammation of the lungs, referred to as pneumonia, is a common disease that occurs not only in children of all ages, but also in adults.
The concept of pneumonia does not include other diseases of the lungs, for example, their vascular or allergic lesions, bronchitis and various disorders in their work caused by physical or chemical factors.
In children, this disease is common, as a rule, about 80% of all lung pathologies in babies occur in pneumonia. The disease is an inflammation of the lung tissue, but unlike other lung diseases such as bronchitis or tracheitis, with pneumonia, the pathogens penetrate the lower parts of the respiratory system.
The affected part of the lung cannot perform its functions, release carbon dioxide and absorb oxygen. For this reason, the disease, especially acute pneumonia in children, is much more serious than other respiratory infections.
The main danger of childhood pneumonia is that without adequate treatment, the disease progresses rapidly and can lead to pulmonary edema of varying severity, and even death.
In children with a weak immune system, the disease occurs in very severe forms. For this reason, pneumonia in infants is considered the most dangerous, since their immune systems are not yet sufficiently formed.
The state of the immune system plays an important role in the development of the disease, but it is important to correctly determine the cause of pneumonia, since only in this case its treatment will be successful.
Causes of pneumonia
For successful treatment of pneumonia in children, it is important to correctly diagnose the disease and identify the pathogen. The disease can be caused not only by viruses, but also by bacteria, as well as fungi.
Often the cause is a microbe pneumococcus, as well as mycoplasma. Therefore, the nature of the onset of pneumonia can be different, but it is precisely this point that is important for the organization of effective treatment, since the drugs to fight bacteria, viruses, and fungi are completely different.
Pneumonia can have a different origin:
- Bacterial origin. The disease can occur not only against the background of another illness of the respiratory system, as a complication, but also independently. Antibiotics for pneumonia in children are used precisely in this form of the disease, since it requires careful and urgent antibiotic therapy.
- Viral origin. This form of the disease is the most common (detected in about 60% of cases) and the easiest, but requires adequate treatment.
- Fungal origin. This form of pneumonia is rare, in children, it usually occurs after inadequate treatment of diseases of the respiratory system with antibiotics or abuse of them.
Inflammation of the lungs may have a unilateral form, when one lung or part of it is affected, or to be bilateral, covering both lungs at once. As a rule, in any etiology and form of the disease, the child’s temperature rises greatly.
Pneumonia itself is not a contagious disease, and even in viral or bacterial forms it is very rarely transmitted from one child to another.
The only exception is SARS, the cause of which was the activation of a certain type of mycoplasma. In this case, the disease in children is very difficult, accompanied by high temperatures.
Special mycoplasmas of pneumonia, causing respiratory mycoplasmosis and pneumonia, are easily transmitted by airborne droplets, causing diseases of the respiratory system of various forms, the severity of which depends on the state of the child’s immune system.
Most often, pneumonia in children up to a year or more occurs as a complication of other respiratory diseases, such as:
The inflammatory process begins at the moment when a large amount of mucus accumulates in the lungs and bronchi, which thickens and creates an obstacle to normal ventilation of the lungs.
A typical picture of the emergence and rapid development of pneumonia can be called a situation where a baby becomes ill with SARS or another respiratory disease, while the production of mucus begins to increase in the respiratory tract. But young children (especially up to a year, as well as up to 2–3 years old) still cannot independently clean the airways with the help of reflex cough due to insufficient development of the muscles of the respiratory system.
In the bronchi, accumulations of sputum are formed, due to which ventilation is disrupted at once in several areas of the lungs. The causative agents of the underlying disease from the area of the nasopharynx enter the lungs and settle in places where mucus accumulates, where they begin to multiply rapidly, causing the onset of the inflammatory process.
It is not difficult to treat the viral form, it, as a rule, does not require any special preparations and is cured in a week. But if a bacterial infection joins the inflammatory process and the disease becomes neglected, serious doses of antibiotics will be required.
Pneumonia in children, symptoms and signs of the disease
The symptoms of pneumonia in a child are very specific, which helps parents to suspect pneumonia in the crumbs.
Symptoms of pneumonia in children are considered to be:
- Permanent and very strong cough, arising from long-term attacks, with an acute form of the disease, cough can turn into attacks of suffocation.
- Protracted course of a cold when it remains in the active phase for longer than 7 days.
- The sharp deterioration of the child after recent acute respiratory viral infection or flu.
- High temperature, persisting for several days and not falling down with antipyretic drugs, and if the temperature can be slightly reduced, it quickly rises to its previous levels.
- Inability to take a deep breath. When you try to breathe deeply in a child, an attack of strong cough begins.
- Pale skin. Pallor of the skin suggests that developing pneumonia is bacterial and is explained by the fact that the active reproduction in the body of bacteria leads to the appearance of spasms of blood vessels, as this results in poisoning by toxins, which are the metabolic products of harmful bacteria. The bluish tint of the skin requires immediate medical attention.
High temperatures tend to occur depending on the age of the child. In children under one year old, and sometimes in children up to 2–3 years old, the temperature may be low, within 37.5 °, which is explained by the underdevelopment of the immune system and the inability to give an adequate response during the development of the disease. Older children can reach temperatures as high as 38 ° –40 °.
Almost always, pneumonia is accompanied by signs of general intoxication, manifested by weakness, lack of appetite, drowsiness, and excessive sweating.
Diagnosis of the disease
Even if the child has all the symptoms of pneumonia, he does not need to be diagnosed independently, since the real disease may be quite different. An accurate diagnosis can only be made by a specialist after conducting a full set of studies and examinations.
Therefore, the discovery of such symptoms should be a reason for an urgent appeal to specialists who either confirm the anxieties of the parents and take appropriate measures or disprove them.
Diagnostics includes the following activities:
- Full inspection and listening to the lungs. An experienced doctor can determine if a child has pneumonia even by ear.
- Assessment of the general condition of the baby.
- X-ray examination, which is carried out simultaneously in two projections, taking pictures from the side and front for more accurate diagnosis and assessment of the lung condition.
- A blood test, which will establish not only the inflammatory process in the lungs, but its nature and specific type of infection, which is necessary for the appointment of an effective treatment.
Atypical pneumonia in children
Inflammation of the lungs caused by chlamydia or mycoplasma is called atypical. The difference between this type of pneumonia and typical species is that the disease begins and proceeds, like a common cold, but then drastically changes into a completely different form. It is important to remember that the disease can be hidden for a long time, without showing itself much. Read more about mycoplasmosis →
The symptoms of this type of pneumonia are somewhat different:
- At the very beginning of the disease, the child’s temperature rises sharply, the values of which reach 40 °, but after that it decreases and becomes subfebrile with persistent indicators of 37.2–37.5 °. In some cases, there is a complete normalization of indicators.
- In some cases, the disease begins with the usual signs of SARS or a cold, such as sore throat, frequent sneezing, and a bad cold.
- Then there is shortness of breath and a very strong dry cough, but acute bronchitis also has the same symptoms, this fact complicates diagnosis. Often children begin to be treated for bronchitis, which greatly complicates and aggravates the disease.
- Listening to the lungs of a child, the doctor cannot identify pneumonia by ear. Rattles are rare and of different nature, there are practically no traditional signs when listening, which greatly complicates the diagnosis.
- In the study of blood tests, as a rule, there are no pronounced changes, but an increase in ESR is detected, as well as neutrophilic leukocytosis, supplemented by leukopenia, anemia and eosinophilia.
- When X-rays are performed, the doctor sees in the imagery foci of heterogeneous pulmonary infiltration with an enhanced pulmonary pattern.
- Mycoplasmas, like chlamydia, causing atypical pneumonia, can exist for a long time in the epithelial cells of the lungs and bronchi, and therefore the disease is usually protracted and, once appeared, can often recur.
- Treatment of atypical pneumonia in children should be macrolides, which include clarithromycin, josamycin and azithromycin, because it is to them that the pathogens are most sensitive.
Indications for hospitalization
Only a doctor can decide where and how to treat a child with pneumonia. Treatment can be carried out not only in stationary conditions, but also at home, however, if the doctor insists on hospitalization, it is not worth to prevent it.
Children must be hospitalized:
- with severe disease;
- with pneumonia complicated by other diseases, such as pleurisy, cardiac or respiratory failure, acute impairment of consciousness, lung abscess, a drop in blood pressure, sepsis, or infectious-toxic shock;
- in which there is a lesion of several lobes of the lung or a lobar variant of pneumonia;
- up to a year. In infants up to one year old, the disease proceeds in a very severe form and poses a real threat to life, therefore, their treatment is carried out exclusively in stationary conditions, where doctors can provide emergency help to them in a timely manner. Children under 3 years of age undergo inpatient treatment, regardless of the severity of the disease. Older children can receive home treatment, provided that the disease is not in a complicated form;
- who have chronic diseases or severely weakened immunity.
In most cases, the basis of therapy for pneumonia is the use of antibiotics, and if the doctor has prescribed them to the child, in no case should one refuse to use them.
No folk remedies, homeopathy and even traditional methods of treatment of acute respiratory viral infections can not help with pneumonia.
Parents, especially in outpatient treatment, must strictly follow all the prescriptions of the doctor and strictly follow all the instructions in terms of medication, diet, drinking, rest and caring for a sick child. In the hospital, all necessary measures should be carried out by medical personnel.
It is necessary to treat pneumonia correctly, and it means that you should follow some rules:
- Reception of antibiotics prescribed by a physician should be strictly in accordance with the established schedule. If, according to the prescription of a doctor, it is necessary to drink antibiotics 2 times a day, then an interval of 12 hours should be observed between doses. When appointing a three-time reception, the interval between them will be 8 hours, and this rule cannot be violated. It is important to comply with the timing of medication. For example, cephalosporin and penicillin antibiotics are taken no longer than 7 days, and macrolides should be used within 5 days.
- It is possible to evaluate the effectiveness of the treatment, expressed in improving the general condition of the child, improving the appetite, reducing shortness of breath and reducing the temperature, only after 72 hours from the start of therapy.
- The use of antipyretic drugs will be justified only when the temperature indicators in children from a year exceed 39 °, and in children up to a year – 38 °. High fever is an indicator of the immune system’s fight against the disease, with the maximum production of antibodies that destroy pathogens. For this reason, if the baby normally tolerates heat, it is better not to churn it, since in this case the treatment will be more effective. But, if the baby has had febrile convulsions at least once against the background of an increase in temperature, it should be given antipyretic already when the indicators rise to 37.5 °.
- Nutrition. Lack of appetite for pneumonia is a natural condition. To force a child to eat through force is not necessary. During the period of treatment, baby should prepare light meals. The optimal food will be liquid cereals, steam cutlets from lean meat, soups, boiled potatoes or mashed potatoes, as well as fresh fruits and vegetables rich in vitamins.
- It is necessary to follow the regime of drinking. The child should consume in large quantities pure non-carbonated water, green tea with raspberries, natural juices. If the child refuses to use the liquid in the required amount, you should give him small portions of special pharmacy solutions to restore the water-salt balance, for example, Regidron.
- In the child’s room, it is necessary to carry out wet cleaning every day, as well as monitor the humidity of the air, for this you can use humidifiers or put a container with hot water in the room several times a day.
- It should be remembered that in the treatment of pneumonia can not use immunomodulators and antihistamines. They will not help, but they can lead to side effects and aggravate the child’s condition.
- The use of probiotics is necessary for pneumonia, since the use of antibiotics causes a disturbance in the bowels. And to remove toxins formed from the vital functions of pathogens, the doctor usually prescribes sorbents.
If all the prescriptions are followed, the sick child is transferred to the normal mode and allowed to walk in the fresh air from about 6–10 days of therapy. With uncomplicated pneumonia, a child is given relief from physical exertion for 1.5–2 months after recovery. If the disease is severe, sports will be allowed only after 12-14 weeks.
It is necessary to pay special attention to preventive measures, especially after the illness of the child. It is important to prevent sputum in the lungs because of the development of the disease.
Maintaining sufficient moisture in the baby’s room will not only help to provide easier breathing, but also will be an excellent measure to prevent the sputum from drying out and drying in the lungs.
Sports and high mobility of children are excellent preventive measures that help eliminate sputum from the lungs and respiratory tract and prevent the formation of its accumulations.
Drinking plenty of water helps not only keep the baby’s blood in good condition, but also helps to thin the mucus in the airways and lungs, which facilitates its elimination in a natural way.
Effectively treat pneumonia can only be subject to all doctor’s prescriptions. But, of course, it is much easier to prevent it, and for this you should promptly and completely eliminate any diseases of the respiratory system.
It must be remembered that pneumonia in most cases becomes a complication if the catarrhal or other diseases of the respiratory system are neglected, as well as if the therapy is not timely or the treatment is stopped early. Therefore, in order to avoid possible complications and the development of pneumonia, one should not engage in self-treatment of colds, but seek medical attention for any manifestations.
Author: Irina Vaganova, doctor, especially for