How is the treatment of community-acquired pneumonia?

Often, in therapeutic practice, this pathology is diagnosed as community acquired pneumonia, treatment which can be carried out at home. Most often the disease has an infectious etiology.

Pneumonia occurs both in adults and in children. It often occurs on the background of other severe diseases, e.g. HIV infection. The risk of pneumonia depends largely on the level of social well-being, lifestyle, immune status, working conditions, contact with sick people. Worldwide each year are diagnosed hundreds of thousands of new cases of the disease. In the absence of treatment, severe pneumonia, particularly in children, may cause death. What are the etiology, clinic and treatment of community-acquired pneumonia?

Features of community-acquired pneumonia

Currently pneumonia is the inflammation of the tissues of the lung or both lungs in which the process involved the alveoli and interstitial tissue of the organ. Pneumonia are community-acquired and nosocomial. In the first case is an acute infectious pathology that occurred outside the hospital or after 48 hours from the start of hospitalization. Depending on localization of pathological process distinguish the following types of pneumonia: focal, segmental, lobar, total, drain. The most common lobar pneumonia. In this situation we are talking about lobar pneumonia.

Adults and children can marvel at how one lung or both. There are 3 varieties of inflammation: decreased immunity, without and aspiration. The basis for the development of an infectious form of pneumonia of the lungs on the following processes: aspiration of secretions in the oropharynx, inhalation of microorganisms, contamination of air, contact with pathogenic microbes from other organs to the lungs and the spread of infectious agent through blood.

Etiological factors

If the inflammation is developed outside the hospital, the reasons can be several. The most frequent causes of the disease are:

• the presence of a viral infection;
• contact with sick people;
• hypothermia (General and local);
• violation of mucociliary clearance;
• the presence of foci of chronic infection (septic thrombophlebitis, endocarditis, liver abscess);
• penetrating wounds of the chest;
• reduced immunity (due to HIV);
• impactionizing radiation and toxins.
• the impact of allergens.
• the weakening and exhaustion on the background of severe somatic pathology.

Diseases that increase the risk of pneumonia are diseases of the kidneys, heart, lungs, tumors, epilepsy. The risk group includes persons over the age of 60 years and children. Pathogens of community-acquired pneumonia are different. Most often in the role of the pneumococcus, Mycoplasma, chlamydia, Haemophilus coli, Staphylococcus aureus, Klebsiella, Legionella. Much less frequently the disease is provoked by viruses and fungi.

Risk factors of this disease are chronic alcoholism, Smoking, presence of COPD, bronchitis, congestion groups (nursing homes, schools, kindergartens, boarding schools), nasyrovna the mouth, contact with ventilation system (with air conditioning). In a separate group it is necessary to allocate pneumonia aspiration type. In this situation, they arise when released into the bronchi foreign objects. It can be food, vomit. Less common cause of inflammation is a thromboembolism of small branches of the pulmonary artery.

Clinical manifestations

Symptoms of community-acquired pneumonia include:

• the increase in body temperature;
• productive cough;
• chest pain;
• shortness of breath when working or dormant;
• lack of appetite;
• weakness;
• malaise;
• excessive sweating.

Sometimes pneumonia occurs unnoticed by the patient and is found incidentally (during x-ray examination). All of the above features are characteristic of typical forms of the disease. Community-acquired pneumonia can occur atypical. This marked the gradual development of the disease, the appearance of dry cough, headache and muscle pain, sore throat. Pneumonia can occur in mild, moderate and severe forms. For mild characteristic negligible intoxication (rise in temperature to 38° C), normal pressure, no shortness of breath at rest. Upon examination of the lungs revealed a small hearth.

The average severity observed sweating, weakness, the temperature rises to 39° C, the pressure is a little low, and increased respiratory rate. High fever, confusion, cyanosis, shortness of breath at rest - all signs of severe community-acquired pneumonia. Lobar pneumonia is diagnosed most often. It arises acutely after a rise in body temperature, chills. It is characterized by severe shortness of breath, cough. First it's dry, then released sputum. It has a rusty tinge. Symptomscan persist more than a week. For the focal community-acquired pneumonia is more gradual.

Diagnostic measures

Diagnosis of community-acquired pneumonia includes:

• a detailed survey of the patient or his relatives about the development of the disease;
• the history of life;
• auscultation of lungs;
• ultrasound;
• echocardiography;
• conducting x-ray examination.

Radiography is the most reliable method of diagnosis. At the same time revealed focal or diffuse darkening (rarely total), the extension roots of the lungs. Also offered sputum tests to clarify the pathogen. In the process of auscultation revealed dullness of the pulmonary sound, crepitation, wheezing. Additional diagnostic methods include CT, MRI, bronchoscopy, biopsy, urine test, detection of antibodies in the blood. The blood test can detect signs of inflammation.

Treatment of pneumonia

In community-acquired pneumonia treatment should be comprehensive. In uncomplicated inflammation treatment can be performed at home. In severe cases, hospitalization is required. This also applies to small children.

Pneumonia is treated mainly with antibiotics. Medicines selected by the doctor based on the patient's condition, age and type of pathogen. Antibiotics are effective only in bacterial form of pneumonia. The drugs of choice for community-acquired pneumonia are protected penicillins (Amoxiclav, Amoxicillin, Ampicillin), cephalosporins (Cefazolin), macrolides (Rapamycin). Drugs can be used orally or injected injection (intramuscularly or intravenously).

Treatment is initiated immediately. Should not wait for the results of microbiological studies. In severe disease, the combination with cephalosporins macrolides (Macropinna, Sumamed, Azithromycin) and fluoroquinolones. In severe pneumonia, it is preferable to use Cefotaxime or Ceftriaxone. The duration of therapy is 1-2 weeks. The ineffectiveness of the medications they are replaced by others. At the end of treatment is carried out a control x-ray.

Other therapies

For a successful recovery in treatment plan is required to include means of stimulating the immune system, expectorant drugs and mucolytics, antihistamines, antipyretics, NSAIDs. Mucolytics and expectorants liquefy phlegm and improve itsexcretion. It contributes to the improvement of respiratory function. Such drugs include Bromhexine, Ambroxol, Acetylcysteine. Of NSAIDs are Indomethacin, Aspirin, Ibuprofen.

In severe respiratory failure your doctor may prescribe bronchodilators, oxygen therapy.

The obstruction of the Airways bronchoscopy is shown. With the development of infectious-toxic shock, which is the most serious complication of pneumonia is shown infusion therapy, normalization of pressure, the introduction of sodium bicarbonate (if acidosis), heart medications and Heparin, antibiotics. The prognosis for life and health with adequate treatment is favorable. The most dangerous case of pneumonia in early childhood (up to 1 year).