Pulmonary pneumonia in children: symptoms and treatment. Some complications can have a negative impact on other organs and cause

Pneumonia is a serious disease, the essence of which is the inflammatory process in the lung area. This disease is not uncommon in both children and adults. But children get sick more often due to age characteristics body.

According to world statistics from 2016, among children under five years of age, the mortality rate from pneumonia is 15%. In most children, pneumonia is detected as a secondary disease. It occurs as a complication after another illness (for example, bronchitis, ARVI, mononucleosis, measles), which weakened the baby’s immunity and made the body susceptible to infections from the environment.

There are many causes and pathogens of pneumonia. The main group is bacteria. The study of the symptoms of pneumonia in children should be carried out taking into account both the pathogen and the age group.

The occurrence of pneumonia is directly related to the condition immune system body. Therefore, the main risk group is newborns, babies in the first year of life, children with pathologies of the immune system and chronic diseases.

The main channel of infection for all infectious diseases is the respiratory tract. Airborne The pathogen first enters the mucous membranes of the mouth and nose, after which it continues to move inside the body. Rhinitis, laryngitis, pharyngitis occur. As it spreads, the bronchi become infected - bronchitis. If at this stage the body cannot stop the infection, and therapeutic measures are taken, then the next stage is pneumonia.

Inflammation affects the area of ​​one or both lungs, as a result of which the functionality of the organ is impaired. With absence timely treatment Irreversible processes in the body are possible, which sometimes lead to the death of the patient.

The disease can also occur due to infection during injury or due to vomit entering the lungs.

The pathogens may be different, but the symptoms of the disease are classic version manifest themselves sufficiently actively that any parent has reason to seek medical help.

Routes of infection, risk group

The risk group includes premature babies, infants who have suffered hypoxia, asphyxia in the perinatal period, babies with vitamin deficiency, with pathology respiratory tract, immune system, cardiovascular system.

Among infants, congenital pneumonia is observed due to intrauterine infection. This is predominantly viral infection, the causative agents are: herpes, chickenpox, cytomegaloviruses. The risk increases significantly if a pregnant woman is sick for a long time.

Diseases during pregnancy are a fairly common occurrence, since the body of a pregnant woman is under stress from hormonal and physiological changes, increased stress on internal organs and many other processes accompanying pregnancy.

The next danger is intrahospital infection. The born baby is practically sterile inside and out. The intestines are not yet populated by lactic acid bacteria, the skin is not populated by the microflora familiar to an adult. At this moment, the appearance of pathogenic bacteria may not meet resistance from the infant’s immune system. The causes of this disease are Escherichia coli, staphylococcus, and streptococcus. Dangerous viruses include measles, influenza, and Human Respiratory Syncytial Virus.

In 70% or more of sick infants, the cause of pneumonia is pneumococcus.

Other common pathogens that cause pneumonia in children under 7 years of age include Haemophilus influenzae, Maraxella, and chlamydia.

Signs of pneumonia in a child

Pneumonia often begins as ARVI or flu, sometimes this is what they are, pneumonia begins later and is a consequence.

Pneumonia in a child as a result of incorrect treatment of influenza and ARVI

The main symptoms of influenza or ARVI are known to everyone and are of no interest to anyone. This is hyperthermia, fever, dryness skin, cough, runny nose, weakness and drowsiness.

A child’s body has a hard time coping with excess mucus in the respiratory tract. If you do not ensure that the patient drinks a lot and regularly irrigates the mucous membranes with expectorant syrups using inhalations, then mucus stagnation occurs. It begins to slowly descend to the level of the bronchi, the cough becomes muffled and deep.

This is followed by blockage and inflammation of individual parts or the entire lung. The alveoli fill with fluid or pus, shortness of breath, chest pain, and other symptoms of pneumonia appear.

Body temperature

An increase in body temperature is a natural reaction of the body to the invasion of infection. Helps inhibit many microorganisms and slow down the development of pathogenic flora.

Antipyretic medications are used when non-intervention can harm the body, because at a temperature close to 40 degrees, the protein of animal cells begins to coagulate, which threatens the death of not just the cells, but the entire body.

But the very presence of hyperthermia in a child is good; it indicates the presence inflammatory process and serves as a stimulator for parental visits to the doctor.

Pneumonia is characterized by a high temperature, which is almost uncontrollable by standard antipyretics.

In children with immune system disorders or severe chronic diseases, the temperature can only rise to 37.5.

Can pneumonia occur without fever?

This happens sometimes - it's enough to make you worry about how to recognize the symptoms of pneumonia in children.

Absence of temperature can be observed in a patient with the presence of chronic infection or pathology of the immune system. The baby may also have a mild cough due to general weakness of the body. Constantly observing the clinical picture of one disease, it can be difficult to distinguish between another, especially if the main signs are absent.

However, there are some symptoms that may indicate pneumonia. This

• labored breathing
• shortness of breath, chest pain
• blue discoloration of the nasolabial triangle.

These signs are present against a background of weakness, drowsiness, depression, general intoxication of the body, pallor of the skin, dry mucous membranes.

Baby's breathing

The main sign and, perhaps, the main danger of pneumonia is difficulty breathing. As a result of the accumulation of fluid in the alveoli and bronchi, these organs cease to perform their functions correctly. As the disease progresses, it becomes increasingly difficult for the patient to breathe, and characteristic signs appear:

• chest pain
• dyspnea
• cough
• wheezing

All symptoms or some of them are observed at once. If left untreated or improperly treated, increased symptoms can lead to respiratory failure, dangerous to the baby's life.

Only older children can indicate pain in the chest; parents of infants should be extremely careful.

Shortness of breath is rapid, intermittent and shallow breathing, which is accompanied by a whistle or other sound with each inhalation or exhalation. At the same time, you feel the load that the body overcomes when breathing.

The presence of this symptom indicates the risk of developing pulmonary edema.

Coughing is a natural mechanism for clearing the airways of foreign objects and mucus. If the cough is wet and loud, that’s good. With pneumonia, before treatment, the cough is dry, barking, mucus cannot separate from the walls, so the cough does not bring relief.

Wheezing occurs when mucus in the bronchi and lungs prevents air from passing freely; it moves, constantly encountering obstacles.

Cyanosis of the nasolabial triangle

This symptom is clearly visible in infants - it is manifested by blueness of the nasolabial triangle with any tension of the facial muscles: when crying, sucking.

In children under one year of age, due to immature immunity, symptoms of pneumonia may not include fever.

A characteristic indicator is a rapid pulse and rapid shallow breathing: in infants up to 3 months - above 60 breaths per minute, in babies from 4 to 12 months - above 50.

You should pay attention to cyanosis of the nasolabial triangle and pale skin.

Symptoms in a child over 1 year old

If a child between 1 and 5 years old takes more than 40 breaths per minute, this is a sure sign of pneumonia. At the same time, he tries to breathe with his whole body so that movements chest brought less pain.

In older children, pneumonia usually occurs with hyperthermia and fever, which lasts for several days, after which symptoms of damage to the alveolar tissue are added.

Diagnosis of the disease

Diagnosis of pneumonia is carried out by a pediatrician, or initial examination carried out by an emergency doctor if, due to the child’s condition, it would be more appropriate to call her.

Differential diagnosis requires distinguishing pneumonia from acute respiratory viral infections, influenza, bronchitis, tuberculosis, and mycoviscidosis.

The final diagnosis is made on the basis of an x-ray of the lungs. In addition, a general blood test, a general urine test, and bacteriological and virological examinations of sputum to identify the pathogen are prescribed.

Kinds

By type of distribution it is divided into:

• Focal - with the formation of foci of infiltration, up to 1 cm in size, which are located in random order. Later they can grow and merge with each other (focal-confluent appearance).
• Segmental - affects the whole lung segment. Signs of pneumonia in children, such as fever, cough and wheezing, are initial stage diseases may be absent. The following come to the fore: weakness, nausea, dizziness, refusal to eat. Then tachycardia, pallor, and microcirculation disorders begin.
• Croupous – more often observed in patients over 5 years of age. It is characterized by the development of fibrinous inflammation of the lung lobe or 2–3 segments of the lobe, with pronounced symptoms. From the first days the following symptoms appear: fever, cough, shortness of breath, difficulty breathing, weakness, signs of general intoxication of the body (vomiting is possible), tachycardia, rapid breathing (in children over 5 years old - more than 40 breaths per minute), pallor.
• Interstitial - lesion connective tissue lung This species is dangerous due to the severe course of the disease, high percentage mortality. Characterized by a sharp, acute onset. The temperature rises up to 40 degrees and is almost not reduced by antipyretic drugs, and can last up to ten days. Shortness of breath and rapid breathing up to 60 breaths per minute. Myocarditis and pulmonary edema may occur.

Chlamydial

The name of the disease according to the type of pathogen, the main one is chlamydia pneumoniae or chlamydophila pneumonia.

By the end of the third week, signs of normal malaise include a rise in temperature to 38 degrees and a dry cough. Chronic diseases of the body become more active.

Features of chlamydial pneumonia are following symptoms: rash, neurological abnormalities, joint pain, gastrointestinal disorders.

Mycoplasma

A common type of disease, occurs in 20% of cases, typical for people under 15 years of age. The Mycoplasma pneumoniae virus is transmitted by airborne droplets.

The incubation period can last from one to three weeks. During this time, mycoplasmas actively multiply and spread between cells and on mucous tissues. The course of the disease itself clinical symptoms Pneumonia in children lasts about 2 weeks.

The first symptoms are an increase in temperature to non-critical levels, sore throat, runny nose, chills, dry cough, pain when swallowing. These symptoms are usually mistaken for the flu, which is why timely diagnosis this type of inflammation is difficult. Later, pain in the chest area and difficulty breathing appear.

Atypical

This term combines all types of diseases that are caused by rare pathogens. This disease often occurs latently, without pronounced symptoms. Therefore, diagnosis is difficult. True, most of these diseases proceed without complications, but there are exceptions; they are aggravated by the lack of adequate treatment due to diagnostic errors.

Therefore, you should be extremely careful and, if you have any suspicions, seek help from a medical facility.

You should pay attention to the duration and nature of the course of ARVI and influenza. If the patient's condition improves and then worsens again, it is time to consult a doctor. If the cough remains dry for a long time and does not go away, residual effects persist for a long time after illness - you need to seek advice from a medical institution.

If atypical pneumonia is viral in nature, then treatment methods may be sufficient even if the diagnosis is incorrect, since the therapy includes immune-modulating, antiviral, antipyretic drugs and mucolytics.

Acute bronchitis and bronchiolitis - differences from pneumonia

The bronchi are the main routes through which air enters the lungs. With bronchitis, mucus accumulates in them, which makes breathing difficult. Bronchiolitis is a blockage of small bronchial passages by mucus.

Bronchitis is considered less dangerous disease which is easier to treat. With bronchitis, the baby may not have a fever at all, he may feel relatively normal. And with the standard course of pneumonia, an inflammatory process with a strong reaction of the body is a standard set of clinical manifestations.

Pneumonia in children may be accompanied by coughing up blood; this does not happen with bronchitis.

A characteristic sign of any of these diseases is a cough with wheezing. When it appears, you should immediately contact a pediatrician who will listen to the child’s chest and determine the affected area of ​​the body. The diagnosis is confirmed by x-ray.

Which doctor should I contact?

In case of rapid progression of the disease, hyperthermia and difficulty breathing, it is advisable to call an ambulance. The doctor on duty will most likely be able to identify pathology in the respiratory system.

Children under 2 years of age are usually admitted to the hospital even with bronchitis, since the child’s body often cannot independently work to remove mucus from the bronchi, and at home there are not enough resources for qualified help. When admitted to the hospital, the baby undergoes a full range of examinations, making it most likely that the correct diagnosis and source of the disease will be established.

If you do not think it is necessary to call an ambulance, then the first point of reference for any questions about your health is your pediatrician. He will examine the child and, if necessary, prescribe additional tests and therapy.

Treatment of pneumonia in a child

Treatment of pneumonia in any conditions involves quarantine. Whatever causes pneumonia, it is contagious. Therefore, it is advisable for children, even with community-acquired pneumonia, which is often viral, to be allocated a separate room, personal dining rooms, bedding, and bath amenities.

Children under two years of age and patients with severe illness are subject to mandatory hospitalization. They also put you in the hospital if there is one in the house. small child who was not affected by the disease.

Basic principles of treatment

There are directional and symptomatic treatment. Both of them are used together to treat pneumonia.

Symptomatic treatment is aimed at reducing certain symptoms.

Targeted therapy is developed individually in each case and consists of destroying the causative agent of the disease.

Medicines

Antipyretics are used to reduce the temperature. To relieve pain, use painkillers.

To facilitate breathing, drugs for shortness of breath and mucolytics are used to thin the sputum. It is important to know that in case of pneumonia, bronchitis and other diseases of the respiratory tract, when the infection causes blockage of blood vessels with mucus, the use of drugs that stop coughing is contraindicated.

On the contrary, therapy is aimed at softening and removing mucus from the respiratory tract. To do this, patients are given plenty of fluids to drink and expectorant medications, for example, with ambroxol hydrochloride as the active ingredient. It can be taken orally or used as an inhalation solution.

Inhalations are very effective, they include several functions: medication administration, hydration mucous epithelium, restoration of water balance, dilution of sputum.

Antitussive medications are used in completely different cases, when it is necessary to prevent a cough of a different nature, for example, an allergic one. For better sputum discharge, special physical procedures are prescribed. For bacterial pneumonia, antibiotics are prescribed.

Is it possible to treat pneumonia in a child at home?

If the symptoms of pneumonia are relatively mild and there are no very young children in the house, then treatment at home is permitted subject to the following conditions:

• quarantine, regular ventilation of the premises;
• strict adherence to the doctor’s recommendations, treatment with folk remedies - only after agreement with the doctor;
• carrying out therapeutic exercises and massage, which helps get rid of phlegm;
• purity;
• healthy diet, vitamin therapy.

Forecast and consequences

With timely seeking of medical help and timely initiation of treatment, with the right approach for the rehabilitation period, the prognosis is positive. The disease may pass without leaving any consequences for the body.

But it also happens differently. If therapy is not started in time, the inflammatory process may lead to tissue necrosis, sepsis, asthenic syndrome, exudative pleurisy, pleural empyema, etc.

Conclusion

There is nothing that is guaranteed to protect a baby from pneumonia. But there are preventive measures that significantly reduce the risk of becoming an unpleasant statistic.

1. Follow in a healthy way child's life. Daily routine, healthy eating, walks in the fresh air, conditioning, sports.
2. Timely vaccination against common diseases will prevent pneumonia, as a complication of these dangerous diseases.
3. Precautions for contact with infected people.
4. It is necessary to promptly consult a doctor for the treatment of all childhood ailments, from flat feet to holes in the teeth.

In 2017, Russia experienced several outbreaks of community-acquired pneumonia among the population. The mortality rate is about 5%, lower than in previous years. This may indicate progress in medicine and more Attentive attitude people to their health and the health of their children.

In Russia, pneumonia is diagnosed in 10 young children out of 1000. Signs of pneumonia in a child depend on the age and type of the disease. Infants and children under 4 years of age are most susceptible to this pathology. Pneumonia in young children can be diagnosed using fluoroscopy. After confirming the medical report, the doctor makes a decision on hospitalization of the patient and selects antibacterial therapy. The disease lasts on average 7-10 days.

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Types of childhood pneumonia

Depending on the location of the inflammation, pneumonia can be:

• shared;
• segmental;
• right-sided;
• left-handed;
• bilateral.

Based on their form, they distinguish between community-acquired (home-acquired), hospital-acquired and congenital pneumonia. The least common is atypical childhood pneumonia caused by mycoplasma. Pneumonia, characteristic of patients with immunodeficiency conditions, is classified separately.

The most common types of pneumonia are:

• focal bronchopneumonia;
• lobar pneumonia (pneumococcal);
• segmental (polysegmental) bronchopneumonia;
• interstitial acute.

Moreover, each type of pneumonia can be divided into uncomplicated and complicated. This form sometimes entails more serious diseases, such as effusion pleurisy, lung destruction, etc.

Depending on the duration of the disease, pneumonia can be:

• acute current (lasting up to 4 weeks);
• protracted (stated when the inflammatory process in the lungs continues for more than 4 weeks).

Any untreated pneumonia, especially in children under 3 years of age, becomes chronic. This form is characterized irreversible changes in the bronchial tree and constant relapses.

Types of childhood pneumonia

Causes of pneumonia

Pneumonia is a complication of diseases such as bronchitis and bronchial asthma, laryngitis, pharyngitis, tonsillitis, and ARVI.

In newborns, pneumonia is most often caused by streptococci and staphylococci. Sometimes pneumococci and Haemophilus influenzae can be the cause.

Congenital pneumonia manifests itself during the first 72 hours of a baby’s life. Infection with bacteria and chlamydia can occur during childbirth, then neonatal pneumonia manifests itself from the 6th to the 14th day of the child’s life.

Another reason for the occurrence of the disease is the presence intrauterine infection against the background of fragile immunity. Herpes viruses and cytomegalovirus can also be causative agents of the disease. Sometimes contribute to the disease birth defects development.

In children older than one year, the causes of pneumonia are:

• chronic infections;
• complicated sinusitis, adenoiditis, problems of the cardiovascular and central nervous systems;
• improper treatment of acute respiratory infections and acute respiratory viral infections (in the case of the use of cough suppressants).

Frequent use of vasoconstrictor drugs, or their use when there is a strong discharge from the nose, can contribute to the descent of the virus into the bronchi.

Despite the general misconception, it is extremely rare that the cause of pneumonia is severe hypothermia in a child.

Symptoms of pneumonia

The clinical picture depends on the following factors:

• forms;
• pathogen;
• degree of severity;
• child's age.

The main symptom of pneumonia is shortness of breath. A deep paroxysmal cough may occur. Possible chest cavity. If the disease is severe, the child may have attacks of suffocation during or immediately after coughing. Children's breathing quickens, becomes shallow, make deep breath becomes impossible. Pneumonia can also be recognized by wheezing in the lungs.

Additional symptoms:

1. Increased body temperature, swelling of the legs.
2. The face, especially the lips, turns pale or takes on a gray/bluish tint. As a rule, this is typical for bacterial pneumonia, and is caused by spasms of blood vessels.
3. Appetite decreases or disappears completely. The child may lose significant weight.
4. Lethargy, irritability, and increased fatigue appear.

In the video, the famous doctor talks about the symptoms of pneumonia. Video taken from the Doctor Komarovsky channel.

Signs in children of the first year of life

Pneumonia in newborns and babies in the first year of life is manifested by general lethargy and excessive drowsiness. The child refuses to eat, cries a lot, and behaves restlessly. Symptoms increase gradually. As soon as the baby's mother notices similar symptoms, you need to contact your pediatrician, even if normal temperature bodies. The chances of survival in young patients, especially infants, depend on the timeliness of medical care. Pneumonia in newborns, especially intrauterine pneumonia, often end in death.

Depending on the age of the child, signs of pneumonia are:

1. U one month old baby There is respiratory failure, which occurs due to the underdevelopment of the immune system of babies.
2. In a two-month-old baby, the disease is characterized by multiple small focal lesions of the lungs.
3. When three-month-old babies get sick, two lungs are affected at once.
4. U one year old child Segmental pneumonia develops more often, which can cause the most complications.

A doctor must identify the presence of pneumonia; the diagnosis is confirmed by x-rays and a blood test. The number of leukocytes, an increase in which is a sign of the development of pneumonia in children, helps to understand the presence of the disease.

First signals

The first signs of the disease in babies:

• behavioral disturbances in the direction of increased moodiness;
• frequent or loose stool;
• The cough is paroxysmal, worsens when crying, is accompanied by vomiting, yellow or green clots may be coughed up.
• the baby begins to spit up frequently between feedings;
• sleep is disturbed - it becomes intermittent, restless.

Body temperature

Body temperature in babies may remain unchanged or rise to subfibrile - 37.1-37.5 degrees. This is due to weak immunity and will not help determine the severity of the disease.

Baby's breathing

Breathing during pneumonia becomes rapid (more than 30 breaths per minute), heavy, with congestion at the site of the lung lesion. When a child gets sick, he begins to flare out his cheeks or nostrils, retract his lips and nod in time with the inhalation. Infants under 3 months of age may experience foaming at the mouth and nose, which may indicate impending respiratory arrest.

Cyanosis of the nasolabial triangle

For babies in the first year of life, blue discoloration of the nose and lips is typical. This sign can be noticed during feeding, when the baby is tense. Cyanosis can also be discernible in a relaxed state, which indicates the spread of bacteria and vasospasm.

This is what cyanosis of the nasolabial triangle looks like in a baby

Signs in preschool children

The first sign of pneumonia in children 3-5 years old is an increase in body temperature from the 3rd to the 5th day of acute respiratory viral infection.

Additional symptoms:

1. Intoxication of the body increases significantly, the child becomes irritable.
2. Problems with sleep are noted - the baby tosses and turns, wakes up, behaves restlessly, while lethargy and loss of appetite are expressed.
3. Another sign of the development of pneumonia is a body temperature that is difficult to reduce. The drugs that helped before stop working.
4. There is chest pain and increased sweating.
5. The cough appears from the 5th day of illness or is absent.
6. Sometimes skin rashes and muscle pain appear.
7. Tachycardia may develop. Breathing becomes more frequent - more than 50 breaths per minute.

Signs in schoolchildren

In children 7-12 years old, symptoms are expressed as follows:

• breathing is heavy and harsh, quickens up to 60 times per minute;
• against the background of the development of pneumonia, fine wheezing appears in the lungs, muffled tones can be heard at the site of inflammation;
• body temperature rises to 39-40 degrees and lasts for 3 days, as a rule, without further increase;
• sputum does not come out well, the child suffers from a dry cough;
• there is pallor or blueness of the lips.

Segmental pneumonia

Segmental pneumonia affects entire segments of the lungs, causing them to become deformed. It can develop at any age; children aged 3-7 years are most susceptible to the disease. It is characterized by severe intoxication of the body with an increase in body temperature above 38.5 degrees. During the course of the disease, respiratory failure develops. Segmental pneumonia is treated for a long time, usually in inpatient conditions. Cough is rare. Recovery of lung cells lasts for 2-3 months. Bronchiectasis may form - enlargement of individual areas.

This is what the lungs of a child with segmental pneumonia look like on an x-ray

Indications for hospitalization

Newborns and children under 3 years of age must be hospitalized. Children over 3 years old are admitted to the hospital if the disease is severe or complicated by other chronic diseases. The decision to keep the child in the hospital or at home is made by the attending physician after assessing the condition of the sick baby and the results of the analysis.

Indications for hospitalization of younger and older children school age are lesions of several lobes of the lung, an abscess or sepsis. If the pressure drops, the child faints or feels excessively weak, it is advisable to hospitalize him for constant monitoring. Any disturbance of consciousness is a reason for emergency hospitalization. At any age, children with obstructive syndrome or pleurisy.

Treatment of the disease

The principles of treating pneumonia depend on the causative agent of the disease. Viral pneumonia resolve on their own within 7 days and do not require additional treatment. Bacterial infections can only be cured with antibiotics. It is very important to ensure sufficient quantity fluids, even if the child refuses to drink on his own.

Standards of treatment for childhood pneumonia include the use of the following medications:

1. Cough. Drugs are used to thin sputum and facilitate its removal. It can be used in the form of tablets or syrups; the composition can be chemical or natural. Well-proven ones are Ambroxol (from birth), Bromhexine (from 3 years).
2. Temperature. Antipyretic medications are used if the body temperature is above 38.5 degrees. The most popular are Paracetamol (from birth) and Nurofen (from birth).
3. Antibiotics. First of all, appoint penicillin series, but the choice depends on the form of pneumonia. Popular ones are Amoxicillin (from birth), Erythromycin (from 4 months).
4. Probiotics - Linex (from birth), Bificol (from 6 months).

If pneumonia occurs against the background of an acute respiratory viral infection, it is important to treat a runny nose. For swelling of the mucous membrane, be sure to use vasoconstrictors— Otrivin (from 6 years), Nazivin (from 1 year). Rinse with saline solutions - Aqua Maris, Quick, Spritz, all of them can be used from birth.

For bronchial obstruction, treatment with Berodual or Eufillin is prescribed. The drugs can be used from birth under medical supervision.

The types of medications for pneumonia, dosage and method of administration are shown in the table:

Type of medication	Drug name	Age	Dosage	Method of administration
Mucus thinners	Ambroxol Bromhexine	from birth	up to 6 years - 1/2 tsp, up to 12 years - 1 tsp, over 12 years - 2 tsp. 3-6 years - 2.5 ml, 6-10 years - 5-10 ml, over 10 years - 10-20 ml	2-3 times a day, during meals 3 times a day
Antipyretics	Paracetamol	from birth from birth	15 mg per 1 kg	3-4 times a day 3 times a day
Antibiotics	Amoxicillin Erythromycin	from birth from 4 months	20 mg per 1 kg 50 mg per 1 kg	divided into 3 doses divided into 4 doses
Probiotics	Linex	from birth from 6 months	up to 7 years old - 1 sachet, over 7 years old - 2 sachets up to 12 months - 1 dose, over a year - 5-10 doses	1 time per day 3 hours after the antibiotic Dissolve 1 dose in 1 tsp. water, apply 20-30 minutes before meals
Vasoconstrictors	Otrivin	from 6 years	1 injection up to 6 years - 0.025% - 1-2 drops, over 6 years - 0.5% - 1-2 drops	3-4 times a day 2-3 times a day
Wash solutions	Aqua Maris	from birth from birth	1-2 irrigations 1-2 irrigations	3 times a day 3 times a day
For bronchospasm	Berodual Atrovent	from birth from birth	2 drops (0.1 mg) per 1 kg per 1 dose, no more than 1.5 mg per day individually Linex - 536 rubles Otrivin - 164 rubles Paracetamol - 55 rubles Basic rules for treating pneumonia at home As soon as the child begins to get sick, the temperature in his room should be 18-19 degrees, since cool air prevents the mucus in the lungs from drying out quickly. It is advisable to remove all dust collectors and carpets; if this is not possible, wet cleaning should be done more often. It is better to do this once a day, but at least twice a week without using detergents with fragrances. The room where the child is located must be regularly ventilated and moistened. For this you can use special Appliances, air ionizers or any other items (towels on a radiator, a bowl of water). Ventilate every 10 minutes for an hour. How long treatment of pneumonia at home will last will depend on the child’s compliance drinking regime and diets. Meals should be light, without fatty and fried foods. Perfect fit vegetable soups and steamed meat. If the child does not want to eat, you can limit yourself to decoctions of dried fruits, compote or tea. The disease is treated faster if you adhere to bed rest. You can walk outside from the 6th-7th day of illness when feeling good and favorable weather conditions. Disease Prevention Prevention is important in the treatment of pneumonia. It begins during pregnancy, when expectant mothers should avoid smoking and inhaling tobacco smoke. It is necessary to monitor your health and nutrition. The following measures to prevent pneumonia are distinguished: Hardening the body. The stronger a child’s immunity, the lower the risk of developing pneumonia. Frequent long walks in the fresh air. Avoid damp, moldy or poorly ventilated areas. Timely treatment of acute respiratory infections and acute respiratory viral infections, especially in children of the first year of life.

One of the most common diseases respiratory tract is pneumonia. It often occurs in young children. Pneumonia can be very dangerous for children, since it affects not only the lungs, but can also affect the entire body in the process of complications. Of course, all parents begin to panic when their child is diagnosed with pneumonia and immediately rush to the hospital. But don't be so scared. Of course, pneumonia is serious illness, but if it is detected in time and treated correctly and completely, then everything will be fine and there will be no consequences. The difficulty is that sometimes it is not easy to recognize the disease, and the symptoms are different for everyone. Also, children from childhood to adolescence have viral and latent pneumonia.

Types of pneumonia in children

Pneumonia has several varieties, depending on the area of ​​damage to the lung and the principle of the disease. IN general outline The structure of the lungs consists of lobes, which are divided into segments. Depending on the damaged parts, the following types are distinguished:

• Focal pneumonia is a lesion of a small area of ​​the lung mucosa. The lesion is approximately one centimeter in diameter.
• Segmental and polysegmental pneumonia. Segmental is the result of damage to a segment of the lungs by an inflammatory process. If several segments are inflamed, then it is polysegmental.
• Lobar pneumonia is when an entire lobe of the lung is inflamed. The larger part of the lung inflamed, accordingly, the more difficult the disease progresses, and the child’s well-being becomes worse.

There are also right-sided and left-sided pneumonia, depending on which side the inflammatory process developed, right or left.

Causes of the disease

The causative agents of the disease are different at each age. They also differ in children who are on inpatient treatment those who have a weakened body, and children suffering from low immunity.

Most cases of pneumonia are the result of activation of the nasopharynx's own bacterial flora; there is also the possibility of exogenous infection. The bacterial flora is activated during acute respiratory diseases or other stress factor, and as a result, pneumonia develops.

Children from 6 months to 5 years often develop pneumonia due to pneumococcus and Haemophilus influenzae. Schoolchildren and preschool children can get sick during epidemic periods from late summer to mid-autumn. It is during this time period that the importance of mycoplasma, which is the causative agent of pneumonia, increases. Among adolescents, pneumonia may be a factor.

Pneumonia kills an estimated 1.4 million children under five each year—far more than malaria, measles and AIDS combined.

Viral pneumonia affects mainly children in their first year of life.. If the child is weak, regurgitates, and has aspiration of gastric contents, the most likely cause is Escherichia coli or Staphylococcus aureus, rarely Moraxella (Branchamella) catharalis. Pneumonia, which is caused by the microorganism Legionella, is extremely rare.

We should not forget about forms of pneumonia caused by microbacteria and tuberculosis fungi. Children under one year of age are more likely to suffer from viral pneumonia.

Oddly enough, you can catch pneumonia while being treated in a hospital. There is a whole group of such types of diseases. They are caused by hospital pathogens that are highly resistant to antibiotics: for example, Pseudomonas aeruginosa, Proteus, staphylococci, Klebsiella, or the autoflora of the patient himself. If a child is given antibacterial therapy, this can suppress the microflora of the lungs, thereby making the organs of the lower respiratory tract vulnerable to bacteria.

How does pneumonia manifest? (Video)

The symptoms of the disease can be different, it all depends primarily on the pathogen, the age of the child and his condition. Pneumonia often develops against the background of an acute respiratory disease, but it also occurs independently.

For acute pneumonia Characterized by a high temperature - 38 - 39? C, due to which the whole body suffers, appetite disappears, general weakness is observed, the child becomes inactive, he is not interested in games, there is no mood, and he has a headache. If treatment is not started, a high fever can last for about a week or even longer.

The child soon develops a very unpleasant dry cough, which quickly turns into a productive wet cough with wheezing. If the disease is advanced, purulent mucous sputum may come out with a cough, sometimes even with blood. Often there is pain in the side, which becomes stronger when inhaling and coughing. There is a lack of oxygen, and therefore the child can breathe quickly and shallowly.

Bacterial pneumonia, if it is not very advanced, can be easily treated with properly selected antibiotics. But, unfortunately, only 30% of all sick children in the world receive the necessary medications.

There is also chronic pneumonia, which developed as a result chronic sinusitis or bronchitis. Its result may be allergic diseases. The disease goes through remissions and exacerbations. Symptoms are similar to acute pneumonia, which gradually disappear and full recovery as a result, it may never happen.

Features of the course of the disease in infants

Even the youngest children can get pneumonia. Among possible reasons early illness or complications after influenza or measles. The main thing is to know and be able to recognize the symptoms of pneumonia and always closely monitor the child.

In infants, symptoms of the disease may manifest as follows::

• cough that is long and does not go away;
• the child “groans” while breathing;
• high temperature, above 38;
• refusal to eat and drink;
• unstable stool;
• the child is not gaining weight.

You should also pay attention to the fact that with pneumonia, infants often burp and may have bloating. Very rarely, of course, but there are intestinal spasms and cardiovascular failure. Again, everything is individual and depends on the body. If parents simply suspect that the child may have pneumonia, they should consult a doctor and have an examination.

Pneumonia can be prevented if vaccination is carried out on time, the child is fed properly and the optimal temperature and humidity parameters are maintained in the home.

If, nevertheless, the child gets sick and the doctors discover pneumonia, it is necessary to begin treatment immediately, because pneumonia is a serious disease, and the body of a small child may not be able to cope with it. Unfortunately, there are known cases fatal outcome caused by this disease. Pneumonia does not go away on its own, it is not, it only gets worse and can cause complications.

Pneumonia or pneumonia is one of the most common acute infectious and inflammatory diseases in humans. Moreover, the concept of pneumonia does not include various allergic and vascular diseases of the lungs, bronchitis, as well as dysfunction of the lungs caused by chemical or physical factors (trauma, chemical burns).

Pneumonia occurs especially often in children, the symptoms and signs of which are reliably determined only on the basis of X-ray data and a general blood test. Pneumonia among all pulmonary pathologies in children early age is almost 80%. Even with the introduction of progressive technologies in medicine - the discovery of antibiotics, improved diagnostic and treatment methods - this disease is still one of the ten most common causes of death. According to statistical data in various regions of our country, the incidence of pneumonia in children is 0.4-1.7%.

When and why can pneumonia occur in a child?

The lungs in the human body perform several essential functions. The main function of the lungs is gas exchange between the alveoli and the capillaries that envelop them. Simply put, oxygen from the air in the alveoli is transported into the blood, and carbon dioxide from the blood enters the alveoli. They also regulate body temperature, regulate blood clotting, are one of the filters in the body, help cleanse, remove toxins, breakdown products that arise when various injuries, infectious inflammatory processes.

And when it occurs food poisoning, burn, fracture, surgical interventions, with any serious injury or illness, there is a general decrease in immunity, and it is more difficult for the lungs to cope with the load of filtering toxins. That is why very often a child develops pneumonia after suffering or against the background of injuries or poisoning.

Most often, the causative agent of the disease is pathogenic bacteria - pneumococci, streptococci and staphylococci, as well as Lately cases of the development of pneumonia from pathogens such as pathogenic fungi, legionella (usually after staying in airports with artificial ventilation), mycoplasma, chlamydia, which are often mixed and associated, have been recorded.

Pneumonia in a child, how independent disease, which occurs after serious, severe, prolonged hypothermia, is extremely rare, since parents try to prevent such situations. As a rule, in most children, pneumonia does not occur as a result of primary disease, but as a complication after ARVI or influenza, less often than other diseases. Why is this happening?

Many of us believe that acute viral respiratory diseases in last decades became more aggressive and dangerous due to their complications. This may be due to the fact that both viruses and infections have become more resistant to antibiotics and antiviral drugs, which is why they are so difficult in children and cause complications.

One of the factors in the increase in the incidence of pneumonia in children in recent years has been the general poor health of the younger generation - how many children today are born with congenital pathologies, developmental defects, and lesions of the central nervous system. Especially severe course pneumonia occurs in premature or newborn babies, when the disease develops against the background of an intrauterine infection with an insufficiently formed, immature respiratory system.

At congenital pneumonia often the causative agents are herpes simplex virus, cytomegalovirus, mycoplasma, and in case of infection during childbirth - chlamydia, group B streptococci, opportunistic fungi, Escherichia coli, Klebsiella, anaerobic flora, in case of infection hospital infections, pneumonia begins on the 6th day or 2 weeks after birth.

Naturally, pneumonia most often occurs in cold times, when the body already undergoes a seasonal adjustment from heat to cold and vice versa, overloads occur for the immune system, at this time there is a lack of natural vitamins in foods, temperature changes, damp, frosty, windy weather contribute to hypothermia of children and their infection.

In addition, if a child suffers from any chronic diseases - tonsillitis, sinusitis, dystrophy, rickets (see), cardiac vascular disease, any heavy chronic pathologies, such as congenital lesions central nervous system, developmental defects, immunodeficiency states - significantly increase the risk of developing pneumonia and aggravate its course.

The severity of the disease depends on:

• Extensiveness of the process (focal, focal-confluent, segmental, lobar, interstitial pneumonia).
• The age of the child, the younger the baby, the narrower and thinner the airways, the less intense gas exchange in the child’s body and the more severe the course of pneumonia.
• Places where and for what reason pneumonia occurred:
  — community-acquired: most often have more mild course
  — hospital: more severe, since infection with bacteria resistant to antibiotics is possible
  - aspiration: when it enters the respiratory tract foreign objects, formula or milk.
• The most important role is played by the general health of the child, that is, his immunity.

Improper treatment of influenza and ARVI can lead to pneumonia in a child

When a child gets sick common cold, ARVI, influenza - the inflammatory process is localized only in the nasopharynx, trachea and larynx. If the immune response is weak, and also if the pathogen is very active and aggressive, and the child’s treatment is carried out incorrectly, the process of bacterial reproduction descends from the upper respiratory tract to the bronchi, then bronchitis may occur. Further, inflammation can also affect lung tissue, causing pneumonia.

What happens in a child's body when viral disease? In most adults and children, various opportunistic microorganisms - streptococci, staphylococci - are always present in the nasopharynx, without causing harm to health, since local immunity inhibits their growth.

However, any spicy respiratory disease leads to their active reproduction and correct action parents during the child’s illness, immunity does not allow their intensive growth.

What should not be done during ARVI in a child to avoid complications:

• Antitussives should not be used. Coughing is a natural reflex that helps the body clear the trachea, bronchi and lungs of mucus, bacteria, and toxins. If, to treat a child, in order to reduce the intensity of a dry cough, you use antitussives that affect the cough center in the brain, such as Stoptusin, Bronholitin, Libexin, Paxeladin, then an accumulation of sputum and bacteria in the lower respiratory tract may occur, which ultimately leads to pneumonia.
• You cannot carry out any preventive therapy antibiotics for colds, viral infection(cm. ). Antibiotics are powerless against the virus, but the immune system must cope with opportunistic bacteria, and their use is indicated only if complications arise as prescribed by a doctor.
• The same applies to the use of various nasal vasoconstrictors; their use promotes faster penetration of the virus into the lower respiratory tract, therefore Galazolin, Naphthyzin, Sanorin are not safe to use for a viral infection.
• Drinking plenty of fluids is one of the most effective methods relieving intoxication, thinning sputum and quick cleansing the respiratory tract is served by drinking plenty of fluids; even if the child refuses to drink, parents should be very persistent. If you don't insist that your child drinks enough large quantity liquid, in addition, there will be dry air in the room - this will help dry out the mucous membrane, which can lead to a longer course of the disease or a complication - bronchitis or pneumonia.
• Constant ventilation, the absence of carpets and rugs, daily wet cleaning of the room in which the child is located, humidification and purification of the air using a humidifier and air purifier will help to quickly cope with the virus and prevent pneumonia from developing. Since clean, cool, moist air helps thin mucus, rapid elimination toxins through sweat, cough, and wet breath, which allows the child to recover faster.

Acute bronchitis and bronchiolitis - differences from pneumonia

ARVI usually has the following symptoms:

• High temperature in the first 2-3 days of the disease (see)
• Headache, chills, intoxication, weakness
• Qatar of the upper respiratory tract, runny nose, cough, sneezing (does not always happen).

At acute bronchitis against the background of ARVI, the following symptoms may occur:

• Slight increase in body temperature, usually up to 38C.
• At first the cough is dry, then it becomes wet, there is no shortness of breath, unlike pneumonia.
• Breathing becomes harsh, various scattered wheezes appear on both sides, which change or disappear after coughing.
• The radiograph shows an increase in the pulmonary pattern, and the structure of the roots of the lungs decreases.
• There are no local changes in the lungs.

Bronchiolitis occurs most often in children under one year of age:

• The difference between bronchiolitis and pneumonia can only be determined by x-ray examination, based on the absence of local changes in the lungs. According to the clinical picture acute symptoms intoxication and increasing respiratory failure, the appearance of shortness of breath - very similar to pneumonia.
• With bronchiolitis, the child’s breathing is weakened, shortness of breath with accessory muscles, the nasolabial triangle becomes bluish, general cyanosis and severe pulmonary heart failure are possible. When listening, a boxy sound and a mass of scattered fine-bubble rales are detected.

Signs of pneumonia in a child

With high activity of the infectious agent, or with a weak immune response of the body to it, when even the most effective preventive therapeutic measures do not stop the inflammatory process and the child’s condition worsens, parents can guess from some symptoms that the child needs more serious treatment and urgent examination by a doctor. At the same time, in no case should you start treatment with any traditional method. If it really is pneumonia, not only will this not help, but the condition may worsen and time will be lost for adequate examination and treatment.

Symptoms of pneumonia in a child 2 - 3 years old and older

How can attentive parents determine if they have a cold or viral illness that they should urgently call a doctor and suspect pneumonia in their child? Symptoms that require x-ray diagnostics:

After an acute respiratory infection or flu, there is no improvement in the condition for 3-5 days, or after a slight improvement, a jump in temperature and increased intoxication and cough reappear.

• Lack of appetite, lethargy of the child, sleep disturbances, and moodiness persist for a week after the onset of the illness.

The main symptom of the disease remains a severe cough.

• The body temperature is not high, but the child has shortness of breath. At the same time, the number of breaths per minute in a child increases, the norm of breaths per minute in children aged 1-3 years is 25-30 breaths, in children 4-6 years old - the norm is 25 breaths per minute, if the child is in a relaxed, calm state. With pneumonia, the number of breaths becomes greater than these numbers.
• With other symptoms of a viral infection - cough, fever, runny nose - pronounced pallor of the skin is observed.
• If the temperature is high for more than 4 days and antipyretics, such as Efferalgan, Panadol, Tylenol, are not effective.

Symptoms of pneumonia in infants, children under one year old

The mother can notice the onset of the disease by changes in the baby’s behavior. If a child constantly wants to sleep, becomes lethargic, apathetic, or vice versa, is capricious a lot, cries, refuses to eat, and the temperature may rise slightly, the mother should immediately consult a pediatrician.

Body temperature

In the first year of life, pneumonia in a child, the symptom of which is considered to be a high, unbroken temperature, is distinguished by the fact that at this age it is not high, does not reach 37.5 or even 37.1-37.3. However, temperature is not an indicator of the severity of the condition.

The first symptoms of pneumonia in an infant

This is causeless anxiety, lethargy, loss of appetite, the baby refuses to breastfeed, sleep becomes restless, short, loose stools appear, there may be vomiting or regurgitation, runny nose and paroxysmal cough, which intensifies while the baby is crying or feeding.

Baby's breathing

When breathing and coughing.
Sputum - with wet cough purulent or mucopurulent sputum (yellow or green) is released.
Shortness of breath or increased number breathing movements in young children - a clear sign of pneumonia in a child. Shortness of breath in infants may be accompanied by nodding of the head in time with breathing, and the baby also puffs out his cheeks and stretches out his lips, sometimes foamy discharge appears from the mouth and nose. A symptom of pneumonia is considered to be exceeding the normal number of breaths per minute:

• In children under 2 months, the norm is up to 50 breaths per minute; over 60 is considered a high frequency.
• In children from 2 months to a year, the norm is 25-40 breaths, if 50 or more, then this is exceeding the norm.
• In children over one year of age, more than 40 breaths are considered shortness of breath.

The texture of the skin changes when breathing. Attentive parents may also notice retraction of the skin when breathing, usually on one side of the diseased lung. To notice this, you should undress the baby and observe the skin between the ribs; it retracts when breathing.

At extensive lesions there may be lag on one side of the lung when deep breathing. Sometimes you can notice periodic stops in breathing, disturbances in the rhythm, depth, frequency of breathing, and the child’s desire to lie on one side.

Cyanosis of the nasolabial triangle

This most important symptom pneumonia, when blue skin appears between the baby’s lips and nose. This sign is especially pronounced when the baby is breastfeeding. With severe respiratory failure, slight blue discoloration may appear not only on the face, but also on the body.

Chlamydial, mycoplasma pneumonia in a child

Among pneumonias, the causative agents of which are not common bacteria, but various atypical representatives, mycoplasma and chlamydial pneumonia are distinguished. In children, the symptoms of such pneumonia are somewhat different from the course of ordinary pneumonia. Sometimes they are characterized by a hidden, sluggish course. Signs of atypical pneumonia in a child may be as follows:

• The onset of the disease is characterized by a sharp rise in body temperature to 39.5C, then a persistent low-grade fever-37.2-37.5 or even the temperature normalizes.
• It is also possible that the disease begins with the usual signs of ARVI - sneezing, severe runny nose.
• Persistent dry debilitating cough, shortness of breath may not be constant. This cough usually occurs with acute bronchitis, not pneumonia, which complicates the diagnosis.
• When listening, the doctor is most often presented with scant data: rare wheezing of various sizes, pulmonary percussion sound. Therefore, it is difficult for a doctor to determine atypical pneumonia based on the nature of wheezing, since there are no traditional signs, which greatly complicates the diagnosis.
• There may be no significant changes in the blood test for SARS. But usually there is an increased ESR, neutrophilic leukocytosis, combination with anemia, leukopenia,.
• A chest x-ray reveals a pronounced increase in the pulmonary pattern and heterogeneous focal infiltration of the pulmonary fields.
• Both chlamydia and mycoplasma have the ability to exist for a long time in epithelial cells bronchi and lungs, so most often pneumonia is of a protracted, recurrent nature.
• Treatment of atypical pneumonia in a child is carried out with macrolides (azithromycin, josamycin, clarithromycin), since the pathogens are most sensitive to them (to tetracyclines and fluoroquinolones, too, but they are contraindicated for children).

Indications for hospitalization

The decision about where to treat a child with pneumonia - in a hospital or at home - is made by the doctor, and he takes into account several factors:

• Severity of condition and presence of complications- respiratory failure, pleurisy, acute disorders consciousness, heart failure, drop in blood pressure, lung abscess, pleural empyema, infectious-toxic shock, sepsis.
• Damage to several lobes of the lung. Treatment focal pneumonia in a child at home it is quite possible, but with lobar pneumonia Treatment is best done in a hospital setting.
• Social readings– poor living conditions, inability to carry out care and doctor’s orders.
• Age of the child - if sick infant, this is grounds for hospitalization, since pneumonia in an infant poses a serious threat to life. If pneumonia develops in a child under 3 years of age, treatment depends on the severity of the condition and most often doctors insist on hospitalization. Older children can be treated at home, provided that the pneumonia is not severe.
• General health- in the presence of chronic diseases, weakened general health a child, regardless of age, the doctor may insist on hospitalization.

Treatment of pneumonia in a child

How to treat pneumonia in children? Antibiotics are the mainstay of treatment for pneumonia. At a time when doctors did not have pneumonia in their arsenal, pneumonia was a very common cause of death in adults and children, so in no case should one refuse to use them, no folk remedies are not effective for pneumonia. Parents are required to strictly follow all doctor’s recommendations, implement proper care for the child, compliance with the drinking regime, nutrition:

• Taking antibiotics it must be carried out strictly on time, if the drug is prescribed 2 times a day, this means that there should be a break of 12 hours between doses, if 3 times a day, then a break of 8 hours (see). Antibiotics are prescribed - penicillins, cephalosporins for 7 days, macrolides (azithromycin, josamycin, clarithromycin) - 5 days. The effectiveness of the drug is assessed within 72 hours - improvement in appetite, decrease in temperature, shortness of breath.
• Antipyretics are used if the temperature is above 39C, infants above 38C. At first, antipyretic antibiotics are not prescribed, since it is difficult to assess the effectiveness of therapy. It should be remembered that during high temperature produced in the body maximum amount antibodies against the causative agent of the disease, so if a child can tolerate a temperature of 38C, it is better not to bring it down. This way the body can quickly cope with the microbe that caused pneumonia in the baby. If the child has had at least one episode, the temperature should be brought down already at 37.5C.
• Nutrition for a child with pneumonia- lack of appetite in children during illness is considered natural and the child’s refusal to eat is explained increased load on the liver when fighting infection, so you cannot force feed the child. If possible, you should prepare for patient's lung food, exclude any ready-made chemical products, fried and fatty, try to feed the child simple, easily digestible food - porridge, soups in a weak broth, steamed cutlets from lean meat, boiled potatoes, various vegetables, fruits.
• Oral hydration- in water, natural freshly squeezed diluted juices - carrot, apple, weakly brewed tea with raspberries, add water-electrolyte solutions (Rehydron, etc.).
• Ventilation, daily wet cleaning, the use of air humidifiers alleviate the baby’s condition, and the love and care of parents works wonders.
• No general strengthening (synthetic vitamins), antihistamines, or immunomodulatory agents are used, since they often lead to side effects and do not improve the course and outcome of pneumonia.

Taking antibiotics for pneumonia in a child (uncomplicated) usually does not exceed 7 days (macrolides 5 days), and if you follow bed rest, follow all the doctor’s recommendations, in the absence of complications, the child will quickly recover, but within a month there will still be residual effects in the form cough, slight weakness. With atypical pneumonia, treatment may take longer.

When treated with antibiotics, the intestinal microflora in the body is disrupted, so the doctor prescribes probiotics - Bifidumbacterin, Normobakt, Lactobacterin (see). To remove toxins after completion of therapy, the doctor may prescribe sorbents such as Enterosgel, Filtrum.

If the treatment is effective, the child can be transferred to a general regimen and walks from the 6-10th day of illness, and hardening can be resumed after 2-3 weeks. At mild course pneumonia large physical exercise(sports) are allowed after 6 weeks, with complications after 12 weeks.

Pneumonia is an acute infectious disease, the causative agent of which is most often bacteria. The disease occurs with focal lesion lung tissues.

In a sick child at 4 years old, the signs of the disease may differ significantly from the manifestations of the disease in an infant. Helps differentiate pneumonia from bronchitis X-ray, in which the darkening of the respiratory part of the respiratory organs is clearly visible.

Among 1 thousand children in the first year of life, pneumonia, or pneumonia, occurs in 15–20 cases, and among preschool children – in 36–40. In school-age children and adolescents, the incidence is much lower and amounts to only 7–10 cases. The highest mortality rates from pneumonia are recorded under the age of 4 years.

The pathogen enters the alveoli of the lungs, where it provokes the development of the inflammatory process. Liquid (exudate) accumulates here, which interferes with physiological air exchange. The amount of oxygen entering the body is sharply reduced, so hypoxia is a sign of pneumonia in a child. Lack of oxygen often causes disruption of the circulatory system. This condition poses a danger not only to health, but also to life, so treatment must begin immediately.

COMMON SIGNS IN CHILDREN

It is quite difficult to detect signs of pneumonia in a child. early stage. At the first stages, the symptoms of pneumonia are difficult to distinguish from the manifestations of acute bronchitis.

General symptoms:

• Increased body temperature. Infection of lung tissue is accompanied by an inflammatory process that causes febrile symptoms. Unlike common viral infectious diseases, the temperature during pneumonia does not decrease on days 2–3, but remains at 37–38 degrees for a long time, despite competent therapy for ARVI.
• The cough may vary in nature or be absent altogether. It can be dry, wet, paroxysmal or similar to whooping cough symptoms. It is also likely that its character will change from dry to wet. It is possible to produce mucous or purulent sputum; if traces of blood are detected in it, you must immediately inform your doctor.
• Chest pain may occur during coughing or when inhaling. Pain syndrome concentrated on the right or left, and also radiates under the shoulder blade.
• Change in breathing sounds. When listening, the doctor may detect wheezing or harsh breathing.
• Lack of oxygen.

External manifestations:

• fast fatiguability;
• pallor and bluishness of the skin in the area of ​​the nasolabial triangle;
• swelling of the wings of the nose;
• rapid shallow breathing (more than 40 times per minute in children from 1 to 6 years old);
• increased sweating without physical and emotional stress;
• decreased appetite due to intoxication.

The described symptoms make it possible to timely identify the first signs of pneumonia in children.

From point of view laboratory diagnostics, valuable information can be obtained from the results clinical analysis blood. It reflects the total amount of inflammatory metabolic products in its liquid fraction.

May indicate the presence of pneumonia increased content band and segmented leukocytes (more than 15 thousand in 1 cubic mm), as well as a significant increase in the erythrocyte sedimentation rate.

A timely consultation with a pediatrician will help determine which signs actually indicate pneumonia and differentiate them from symptoms of other pulmonary diseases.

SIGNS IN A CHILD IN THE FIRST YEAR OF LIFE

In children under one year of age, pneumonia occurs 10 times more often than in schoolchildren. The highest incidence is observed among children 3-9 months.

The danger of pneumonia in infants is the rapid spread of the pathological process in the lung tissue and disruption of the functions of digestion and urination.

Features of symptoms:

• Symptoms of pneumonia in children under one year of age develop gradually. First, there is a general malaise, which is manifested by weakness, loss of appetite, regurgitation, and sleep disturbances. Next, symptoms similar to a viral infection occur: dry cough, sneezing and nasal congestion.
• The disease occurs at a relatively low and stable body temperature. As a rule, it does not exceed 38 degrees or may not rise at all.
• Cyanosis of the nasolabial triangle and fingertips intensifies when screaming, during strong crying or breastfeeding.
• Retraction of skin between ribs.
• With the development of respiratory failure, the two halves of the chest participate differently in the act of breathing.
• Later, increased breathing and disruption of its rhythm are noted. The wings of the nose are tense, they become pale and motionless.
• In infants under three months of age, it is possible to experience foamy discharge from mouth. Such signs of pneumonia in a child under one year old may be a harbinger of frequent and prolonged respiratory arrest.

Symptoms of pneumonia in children under 6 months of age may be atypical, so if pneumonia is suspected, an x-ray examination is required.

SIGNS IN PRESCHOOL CHILDREN

The symptoms of pneumonia in a 1-year-old child and in older children have some differences. Preschoolers have developed a more stable immune system, so pneumonia manifests itself with clear typical symptoms.

Features of symptoms:

• In a child from 2 to 5 years old, signs of pneumonia at the initial stage may include: general symptoms viral infections that occur in combination with other diseases.
• Most often, in children of preschool and school age, pneumonia occurs as a type of bronchopneumonia.
• When at 3 year old child pneumonia, then his breathing rate is more than 50 respiratory movements per minute.
• A cough may appear only on the 5th–6th day of illness, but may be absent altogether.
• Preparations based on ibuprofen and paracetamol cannot reduce body temperature.
• Sputum during coughing occurs only when the surface of the bronchi is inflamed. It may have a greenish or yellowish color.
• Extrapulmonary symptoms may also be observed: muscle pain, increased heart rate, confusion, indigestion, skin rashes.