home Consultations What is effusion in pleuropneumonia. Lobar pneumonia (lobar, fibrinous, pleuropneumonia). Clinic, symptoms of pleuropneumonia

What is effusion in pleuropneumonia. Lobar pneumonia (lobar, fibrinous, pleuropneumonia). Clinic, symptoms of pleuropneumonia

Pleuropneumonia - what is it? Everyone should know the answer to this question. This disease is distinguished by its pronounced, intense symptoms. This diagnosis cannot be confused with something else, and the consequences of the disease are so serious that delay is life-threatening. What is pleuropneumonia? What are the symptoms, diagnosis and treatment?

Causes and stages

Causes of pleuropneumonia:

an advanced form of pneumonia can worsen and attack the body with renewed vigor;
frequent colds, flu, bronchitis can weaken the body before the attack of the virus, making it easy prey for lobar pneumonia;
the presence of tuberculosis increases the risk of contracting such a terrible, serious illness as lobar pneumonia;
in the presence of diabetes mellitus, chronic respiratory disease, as well as alcoholism, the development of pleuropneumonia is possible;
hereditary factor (sensitivity and strong reaction to the virus is transmitted from parents to children).

Lobar pneumonia in the process of conquering the body overcomes 4 stages:

The entry of the virus causes a reaction in the body - tissue swelling. The vital activity of pneumococci provokes inflammatory processes in areas where the virus multiplies (this is considered the acute stage of the disease). Diagnosis and treatment should begin from this stage.
The next stage is an increase in the foci of inflammation, filling with pus.
There are two types of care.
Resolution - this stage occurs after 10 days of progression of lobar pneumonia.

Signs of the disease

The first sign is fever and chills. With this disease, the thermometer shows the maximum permissible values. Treatment of this symptom with antipyretics does not always produce the desired effect.

The patient's health deteriorates, constant drowsiness, weakness and malaise appear. The body of a person suffering from acute pneumonia becomes covered in copious amounts of sweat. There is pain when inhaling, as well as the inability to breathe and shortness of breath.

One of the symptoms is a cough, it can be dry, but most often with sputum production. There may be pain when trying to turn or bend forward.

Consequences of progressive lobar pneumonia: the presence of hallucinations, delirium, dizziness, nervous agitation, fainting and inability to sleep. From the internal organs, signs such as lack of appetite, diarrhea, bloating, pale or yellowish skin, pain in the muscles and joints, deterioration of hearing and vision, decreased tone in the blood vessels, increased blood pressure and rapid heartbeat are observed.

Diagnosis of the disease

When the first symptoms appear, you need to call a doctor at home or consult a doctor yourself without fail. With a quick diagnosis and treatment, it is possible to avoid consequences, including the death of the patient.

The medical history begins with recording complaints about the main symptoms of pleuropneumonia. Next, the throat, tongue are examined, heart rhythm and breathing are listened to for abnormalities.

For the purpose of accurate diagnosis, the medical history includes an x-ray examination to identify foci of inflammation.

To prescribe effective medications, it is possible to take a blood and sputum test.

Treatment of the disease

After confirming the diagnosis, drug treatment is prescribed. It is better to resort to traditional methods, and add traditional medicine to the main course if desired. Such self-medication should be carried out under the supervision of the attending physician.

For treatment, strong antibiotics are used, which will rid the body of the invasion of the pneumococcal virus. You cannot neglect this medicine, justifying it by its effect on the body; this is fraught with serious consequences. To reduce the harmful effects of the antibiotic, yogurt, prebiotics, and more are prescribed.

If there are symptoms from the internal organs, additional medications are prescribed to normalize breathing, heartbeat, blood pressure and the functioning of the stomach and intestines.

It is possible to prescribe anti-inflammatory drugs for effective treatment.

Another method involves treatment with oxygen therapy. With lobar pneumonia, the body receives less oxygen necessary for life, so such therapy will improve well-being, improve the functioning of internal organs and promote healing.

Physiotherapy is also indicated for the treatment of pleuropneumonia. Quartz irradiation has antibacterial properties and reduces inflammation.

To strengthen the patient’s general condition, immunoglobulins are prescribed, which will restore and restart the immune system, allowing the patient to feel relief sooner.

Pleuropneumonia is a disease that can serve as a reason for hospitalization of the patient.

The patient needs peace, a serene atmosphere. Due to poor health and sore eyes, it is better to protect the patient from watching TV, loud music and conflicts.

You cannot endure such a serious disease on your feet. Only bed rest in a ventilated area is indicated.

Every day you need to wet clean the room where the patient is. This adds freshness and prevents more contamination.

With lobar pneumonia, you need to provide adequate nutrition, which will help the body get stronger. Even if you have no appetite, you need to eat regularly.

Vitamins and minerals must be supplied to the patient’s body, especially attention should be paid to ascorbic acid.

The patient should drink as much liquid as possible: water, tea, juice, compote, etc. You can recall folk methods and give the patient general strengthening, vitamin herbal decoctions, raspberry jam and more.

Consequences and complications

The worst thing about the treatment of acute pneumonia is its absence, which threatens the appearance of a lung abscess, and maybe even gangrene.

A complicated healing process can lead to respiratory failure in the patient. Acute symptoms affect the central nervous system and can lead to neurological diseases and mental disorders.

Another sign of complications is the appearance of anemia. A rare but very real consequence is severe meningitis. A brain abscess may occur.

In addition to respiratory failure, heart problems such as hypertension, tachycardia and heart failure may occur.

The younger the body, the easier it is to get rid of the disease, and complications most often occur in older people suffering from chronic diseases and alcoholism.

Pleuropneumonia is life-threatening, but with proper, timely treatment, you can quickly get rid of unpleasant, debilitating symptoms and protect your health from the consequences. Treatment of this disease cannot be postponed for a single day; it is important to immediately resort to consultation with specialists and the correct medication method of treatment.

The respiratory system provides the most important functions in the human body, therefore the health of its organs should be given due attention. Of course, every person encounters respiratory viral infections during their life and, provided timely treatment, the disease is not dangerous.

If timely treatment is not given, the patient may develop pneumonia or pleuropneumonia. How dangerous is pleurisy with pneumonia and how does it develop? The detailed answer to this question is left to the reader.

The term pleuropneumonia in medical practice refers to an inflammatory process in which one or more lobes of the lung are affected, involving the pleura.

For reference! Damage to the pulmonary pleura – pleurisy.

Pneumonia occurring in this form is classified as severe. Often its causative agent is pneumococcus. It can occur in an acute form; in the absence of timely therapeutic actions, the pathological process becomes chronic.

Atypical types of pneumonia are discussed in the table:

Atypical types of pleuropneumonia
View	Description of the pathological process
Central	Foci of inflammation are present in the deep parts of the lung
Abortive	In this case, the disease has an acute onset, but the symptoms disappear after 2-3 days.
Massive	It is characterized by the ability to quickly spread pathology.
Areactive	The process develops quite slowly, the symptoms characteristic of pleuropneumonia are weakly expressed.
Migratory	The lesion has a wandering character. The pathological process spreads between different parts of the lung.
Appendicular	The pathological process with damage to the lobes of the lung and its pleura occurs in the lower lobes of the lung. The symptoms are similar to appendicitis.
Meningeal	Meningeal symptoms appear.
Typhoid-like	Symptoms characteristic of typhus appear. The pathology has an acute onset.

According to the nature of its development, pleural pneumonia can be primary, that is, it can occur as an independent disease or develop as a result of the manifestation of pathologies in other organs.

Causes of the disease

Parapneumonic pleurisy can occur as a result of exposure to the following factors:

lack of timely medication for flu and colds;
penetration of viral infection;
pneumonia.

The disease is often diagnosed in patients with weakened immune systems.

young children;
teenagers during puberty;
people suffering from nicotine and alcohol addiction;
drug addicts;
patients with chronic inflammatory lesions;
pregnant women;
aged people.

Patients who belong to risk groups need to pay special attention to the prevention of various respiratory pathologies.

Characteristic symptoms

Pneumonia with pleurisy develops quite sharply and has an acute onset. In any case, the patient will feel the symptoms and will be able to accurately determine the date of onset of the pathology.

Among the list of main symptoms, the following manifestations are distinguished:

acute pain in the chest area;
a sharp increase in body temperature;
chills;
it is possible that abdominal pain may occur;
the patient feels a loss of strength and experiences noticeable weakness;
headaches appear, which can be periodic or constant;
nausea, which ends with vomiting;
the patient may experience decreased concentration, clouding of mind;
there is severe shortness of breath even at rest;
sputum has a red or brownish tint, possibly containing blood streaks;
breathing quickens;
heart rate changes;
redness of the cheeks appears;
the skin takes on a white or bluish tone.

It is quite difficult to ignore these symptoms. The rate of development of pleuropneumonia differs significantly depending on the type of lesion. The duration of the pathology, provided that therapeutic manipulations are carried out in a timely manner, is no more than 2 weeks.

Attention! If correct treatment is not carried out, the patient may face dangerous complications, for example, acute respiratory failure.

The symptoms of the pathology in children have some similarities with the features of manifestation in adult patients. Most often, the disease develops in children under 6 years of age.

Doctors associate this fact with the instability of the immune system and lack of protective properties. If treatment is carried out in a timely manner, the risk of complications for the child is minimal.

Diagnostic methods

Diagnosis of pathology begins with an initial examination of the patient and study of medical history.

Differential diagnosis of pleuropneumonia uses the following manipulations:

radiography;
CT scan;
Magnetic resonance imaging;
laboratory tests of the patient’s blood and urine;
study of the process of external respiration;
sputum examination.

The listed methods make it possible to determine or refute the development of pleuropneumonia. The video in this article will tell you about the diagnostic methods used in pulmonology.

How to treat the disease?

Treatment of such a pathology cannot be carried out at home. To achieve successful results, therapeutic intervention requires placement of the patient in a hospital pulmonology department. The doctor must constantly monitor the patient’s condition and changes in examination results during therapy.

Attention! It is impossible to achieve positive dynamics using traditional medicine. Such methods can cause harm to the patient’s body when diagnosed with pneumonia with pleurisy.

To treat the disease, drugs from the following medicinal groups are used:

antipyretics;
antibacterial and non-steroidal anti-inflammatory drugs;
expectorant components;
painkillers;
bronchodilators.

The instructions for drugs of such groups do not allow us to determine the possibility of using certain drugs in a particular case. It is important to remember that the drugs and their dosages are selected individually by the doctor for each patient.

After stabilization of temperature indicators, physiotherapy can be carried out:

oxygen therapy to eliminate symptoms of respiratory failure (the method is shown in the photo);
quartz therapy – ensures the elimination of painful manifestations;
mustard plasters can be applied at home with the permission of a doctor;
physiotherapy;
chest massage.

To speed up the body's recovery process, it is necessary to balance the patient's menu. His diet should include vitamins and other components.

What happens if the disease is not treated?

If pleuropneumonia is not treated, irreversible consequences develop, with the average life expectancy of patients being 1 year.

Among the list of possible complications are the following:

The consequences of such complications are often fatal. The cost of delay is high. In view of such complications, you should contact a specialist at the first suspicion of the development of pleuropneumonia.

It is extremely difficult to miss the symptoms of pathology, because they manifest themselves quite actively. The patient's main task is not to ignore them. There is no need to panic; modern medicine techniques make it possible to identify and successfully treat pleuropneumonia.

Inflammation of the lung tissue is a serious infectious disease of the respiratory system, and one of the most severe forms is acute, or lobar pneumonia. People often wonder: is this disease contagious to others? To answer this, you first need to understand, at least in general terms, what this disease is and how people get pneumonia.

Sometimes you hear that the pneumonia process is not much more serious than a trivial acute respiratory infection. This opinion is not only wrong, but also dangerous. This disease is far from a joke and requires careful and long-term treatment.

At the same time, it is quite simple to get pneumonia: one out of every two hundred inhabitants of our planet suffers from it every year. According to statistics, children and the elderly or older people are most often affected - from eighty years of age and older, and for many it has a tragic ending: among this category of the population, the mortality rate from it is about twenty percent. Among ailments in which there is a high probability of death, it ranks fifth after cardiovascular diseases, malignant neoplasms, various types of injuries and poisoning.

The most common two main forms are:

bacterial;
viral lobar pneumonia.

The most severe type of pulmonary inflammatory process of a bacterial nature is the so-called lobar pneumonia. It is its bilateral form, with simultaneous damage to both the right and left lungs, that is the main cause of almost all deaths in this pathology, since it often leads to the development of pulmonary and heart failure.

However, this type is quite rare - most often one lung or its lobe (segment) is affected. Therefore, in modern medical literature the term “lobar pneumonia” or lobar pneumonia is more popular. The old name is due to the fact that the inner surface of diseased respiratory organs is lined with a film reminiscent of the one that occurs with diphtheria croup. This film is an exudate (liquid formed during the inflammatory process) transformed into fibrin (connective tissue). As it thickens, it covers the alveoli (bubbles located on the inside of the respiratory organ and are responsible for the gas exchange process), preventing normal breathing. This contributes to the occurrence of hypoxia - oxygen starvation, especially dangerous for organs such as the heart and brain.

The causes of lobar pneumonia are multiple, and therefore experts classify this infection as a polyetiological type of disease.

The main causative agent of lobar pneumonia is pneumococcus bacteria. It can be caused by pathogenic microorganisms of the genus Streptococcus pneumoniae. If the influenza virus is added to this, a bacterial-viral combination occurs. In this case, the disease acts as a post-flu complication.

In addition, among the factors complicating the course of such an ailment as lobar pneumonia are:

Severe hypothermia.
Injury to the thoracic region.
Nervous and physical exhaustion caused by prolonged stress or starvation.
Concomitant diseases are cardiovascular and endocrine, primarily diabetes.
Congestive manifestations, often occurring in older people as a result of injuries and illnesses that require prolonged bed rest.

The disease sometimes develops abruptly, right off the bat, and the patient may have no contact with other people. This suggests that lobar pneumonia can also occur as an autoinfection. A major role in the occurrence of a pathological situation is played by immune defense weakened for one reason or another.

The main forms in which lobar pneumonia manifests itself are as follows:

Community-acquired – occurring outside of medical institutions or at the very beginning of the hospitalization period. It is characterized by a relatively mild course and a generally favorable prognosis - the probability of death does not exceed ten percent.
Sick leave – its cause is an infection that occurred within the walls of a medical institution. Symptoms appear no earlier than two to three days after a person is admitted to the hospital. Pathogenic microorganisms circulating in such conditions, as a rule, have increased resistance (resistance) to antibiotic drugs. Therefore, lobar pneumonia of hospital or hospital type is sometimes extremely difficult, and can cause up to forty percent of deaths, especially when it comes to children and elderly people.
Aspiration - the impetus for the development of this form is the entry of the contents of the oral cavity or nasopharynx into the lower part of the respiratory tract. This usually occurs in the case of an epileptic seizure or severe alcohol poisoning.
Against the background of immunodeficiency caused by cancer or taking medications that reduce the level of natural immunity (they are necessary for people who have undergone internal organ transplantation to counteract their rejection by the recipient's body), lobar pneumonia can also develop.

With this pathology, symptoms in adults and children appear equally acute, but in the second case the rate of their appearance is much higher.

The symptoms of lobar pneumonia are very clear.

The most characteristic are:

Elevated temperature – up to 39-40 degrees. This can lead to confusion and delirium, which indicates brain damage due to lack of oxygen.
Severe fever causing the whole body to tremble.
Cough with the release of reddish sputum - due to the admixture of blood, sometimes turning into mild hemoptysis. It is often accompanied by severe chest pain on the affected side, which worries the person so much that he tries to restrain his coughing movements. Although there are no nerve endings in the lung tissue, the pain is explained by concomitant pleurisy, since inflammation also affects the pleural membrane surrounding the respiratory organs, in which the nerve endings are already fully present. It is known that with the described form, a disease such as pleuropneumonia often develops.
Increased heart rate (HR).
Cyanotic (blue discoloration) of the skin in the area of the “triangle”, which includes the lower part of the face, lips and chin, and fingernails - this symptom indicates hypoxia - oxygen starvation of the body. Most of all, this condition poses a danger to the heart and brain.
Rapid, often hoarse breathing, in which the chest actively moves. This is explained by the fact that with this form of pulmonary infection, the pulmonary alveoli are clogged, and the body uses auxiliary muscles to ensure the respiratory process.

This human condition requires emergency medical care, so people around the patient should call an ambulance as soon as possible. This will be followed by immediate hospitalization, since treatment of such a severe infection as lobar pneumonia is possible only in a hospital setting.

With a disease such as lobar pneumonia, the symptoms depend on the stage of the disease. The disease has its own characteristics.

According to the morphological changes that occur in the respiratory organs during the development of the disease, experts distinguish four stages of lobar pneumonia:

The first stage of hot flash, or microbial edema, which lasts one day, is characterized by hyperemia - increased blood flow and edematous phenomena. At the same time, an increased content of pathogenic microflora is noted in the intrapulmonary fluid.
The continuation of the disease is the so-called red liver stage, which occurs on the second day and is caused by a sharp increase in the permeability of blood vessels penetrating the lung tissue. Red blood cells leave the bloodstream into the lumen of the alveoli, causing the lung to become denser.
4-6 days after the onset of the disease, it enters the gray hepatization phase. It is characterized by the increased development of fibrin - connective tissue, the threads of which pass through the pores, connecting the alveoli with each other. The pleura becomes coated with fibrin, and the tissue becomes dense, heavy, and gray in color as the number of red blood cells in the blood vessels decreases.
The last stage is called permissive, and means the entry of the pathology into the final part. This usually occurs on days 9-11 of the disease and lasts several days. During this period, with a favorable prognosis, the fibrinous film gradually resolves, and the cleansing of the respiratory system begins, marking the first stage of recovery.

As lobar pneumonia develops, it goes through all four stages, each of which has its own symptoms.

The tidal stage is characterized by the most acute manifestations - high fever, fever, painful blush on the cheeks, herpes rashes along the edges of the lips. A dry cough gives way to rusty-looking sputum. When listening to the chest using a phonendoscope, crepitus appears - a sound reminiscent of the sound that occurs when dry hair rubs against each other. When tapped, it is dull, especially in the area of the lesion.

As hepatization develops, bronchophony occurs. What it is? This term means that while listening to the chest, the doctor clearly hears the patient’s voice through the bronchi.

In the final period, normal breathing is gradually restored, and the sound when tapping becomes clearer.

Diagnosis of lobar pneumonia includes a number of studies using the latest technologies and modern medical equipment. Therefore, it is possible only in a hospital setting, and if a doctor suggests hospitalization, you should under no circumstances refuse it. Delay in starting treatment for such a dangerous form of pathology can cost the patient his life. On the one hand, determining the diagnosis does not seem to be difficult. To do this, it is enough for the doctor to listen to the patient’s chest using a phonendoscope. At the same time, it is impossible to establish the pathogen, as well as the location, depth and nature of the lesion, without the use of special techniques.

To make an accurate and comprehensive diagnosis, the following are used:

X-ray is one of the most effective methods for diagnosing pulmonary pathologies of any form, allowing you to accurately determine the location and size. As a rule, an x-ray is performed in two projections - frontal and lateral, which allows the doctor to get the most complete overview. The doctor decides which projection to choose depending on the expected location of the lesion. To obtain a dynamic picture in order to assess the results of the effects of the therapeutic agents used, radiographic examination is carried out several times: upon admission of the patient to the hospital, after a week of stay there and in the third or fourth week from the date of the onset of the pathological process.
If there are any difficulties, computed tomography is used to establish the diagnosis. The degree of sensitivity with a computer examination is much higher than with an x-ray: 94 and 80 percent, respectively. It makes it possible to obtain a 360-degree view and make visible the structural layers of the lung, which are indistinguishable on an x-ray. At the same time, according to existing rules, an x-ray must precede a computer examination: it is carried out only if the doctor has any questions that cannot be answered by an x-ray. CT is excluded during pregnancy, as well as in extremely serious conditions. Conducting an examination using a contrast agent is not recommended for people with allergic reactions, as well as renal failure and diabetes.
The study of respiratory function (external respiration function) makes it possible to determine the degree of dysfunction of the respiratory-respiratory system.
Bacterial culture of biological fluids - sputum, blood, urine - makes it possible to identify the pathological pathogen, as well as the degree of its response to the use of certain antibiotic drugs.

Bronchoscopy and bronchography are also recommended. These studies allow you to take biopsy tissue samples in order to exclude from the diagnostic picture such pathologies as cancer or lung infarction, tuberculosis infection - they all have similar symptomatic signs.

All of the listed diagnostic methods must be applied as quickly as possible, since it is impossible to carry out competent and complete correction of the pathology without being sure of the diagnosis.

If the pathology is not treated in a timely manner, lobar pneumonia leads to very serious complications. The most serious of these is sepsis - blood poisoning.

It is also possible:

abscess - the formation of abscesses in the lung tissues;
pericarditis – inflammation of the pericardium (heart lining);
purulent pleurisy;
infectious-toxic shock.

Complications of lobar pneumonia can further lead to death. Although such cases are quite rare in recent times, it is still impossible to completely exclude such a development of events. The outcome of the disease depends on whether a competent therapeutic process was started on time or not.

The more time the patient spent outside the walls of a medical institution and without medical care, the higher the risk of developing complications of lobar pneumonia.

How exactly lobar pneumonia should be treated is determined only by the attending physician. As a rule, the course includes antibiotic drugs of the penicillin group of the latest generations. If specialists have reason to suspect that the bacterial microflora that has affected the patient is resistant to a particular drug, and examination data show no positive dynamics, the drug should be replaced with another no later than 72 hours.

It is also necessary to use oxygen therapy, and in the most severe cases, mechanical ventilation (artificial ventilation).

As the condition of a patient diagnosed with lobar pneumonia improves, treatment includes physiotherapeutic procedures: UHF, electrophoresis, massage.

After discharge from the hospital, a recovering person needs a long rehabilitation period, which is best spent in a sanatorium, away from such unfavorable factors as air pollution from man-made emissions. Good nutrition, rest, and walks in the fresh air are recommended. Moderate physical activity, walking and moderate hardening procedures are necessary - all this will help strengthen the immune system and prevent consequences. Only after going through a period of rehabilitation without complications or relapses can you consider yourself fully recovered from such a serious illness as lobar pneumonia.

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Pneumonia is a set of certain pulmonary diseases that lead to inflammation of the lung tissue and its gradual destruction with the formation of edema and blood-purulent discharge, as well as a huge number of complications after the disease. A large set of ailments that cause pneumonia are divided into viral, bacterial, fungal, allergic and mixed types.

Lobar pneumonia refers to a mixed type of pneumonia that has an infectious-allergic origin and is usually located not in the entire organ, but in its specific lobe, several lobes, or in the entire lung, affecting the pleura - the membrane of the lungs (pleurisy) and can spread to the membranes of other vital organs. organs.

The second name for lobar pneumonia is pleuropneumonia, which is due to the pleurisy that often accompanies it.

Classification of lobar pneumonia is carried out according to its location and severity. Depending on the location, pleuropneumonia can be:

Upper lobe, involving the upper parts of the lung.
Lower lobe - lower.
Average share - average.
Interlobar pneumonia is pneumonia located between the lobes.
Right-handed.
Left-handed.
Double-sided.

According to the nature of the flow:

Acutely current – rapidly forming and developing.
Protracted – lasting more than four weeks.

Symptoms of lobar pneumonia

Lobar pneumonia begins extremely abruptly with a sudden rise in temperature or freezing state.
Patients begin to suffer from headaches, weakness, and sweating.
First, shortness of breath appears, which then begins to be accompanied by pain in the affected area, dependent on breathing, and pleural chest pain. The pain has a clear localization and is very pronounced, especially with a deep breath, and if you try to bend the body in the painful direction, your breathing will become weak and shallow.
Increased sputum production and cough, but in the early stages a dry cough without sputum can cause deep breaths.
Fever may be absent in frail patients and is most often absent in older people.
The sputum is mucopurulent, rusty in color or with blood.
There is a clear feeling of lack of air, which can result in problems with the cardiovascular system, and blueness of the nasolabial triangle.
Severe intoxication of the body, under the influence of which the patient may have not only problems with sleep, inability to move, neuralgic disorders, agitation, but even delusions and hallucinations, as a result of which he requires constant monitoring and care.
Release of fluid into the pleural cavity and signs of pleurisy.
Jaundice discoloration of the skin, whites of the eyes and mucous membranes due to intoxication.
Pain in muscles and joints.
Fall in blood pressure.
Intestinal problems.

Depending on the lobar location of the disease, symptoms may differ slightly:

Upper lobe pneumonia is a disease whose symptoms are very bright and acute, accompanied by cardiovascular and neurological disorders.
Middle lobe pneumonia is hidden deep in the body and the inflammatory process is felt weakly.
Lower lobe pneumonia is pleuropneumonia, which is more similar to a disease of the gastrointestinal tract with acute abdomen syndrome.

Pathogenesis of pleuropneumonia

Lobar pneumonia begins with infection of the body by some pathogen, most often a representative of bacteria (pneumococci) or viruses.

The route of infection can be anything: from airborne droplets to infection through blood or lymph.

First, the pathogen settles in the human nasopharynx and releases antigens. These antigens in certain people cause a very acute allergic reaction, which quickly spreads throughout the respiratory system, causing severe inflammation of the lung tissue.

First, this inflammation is localized in one specific area, for example, lower lobe pneumonia on the left, and then the focus grows, filling the entire lung, spreading to the pleura and the second lung. Inflammation of the pleura of the lungs also quickly spreads to the pleura of other organs.

The stages of development correspond to the usual stages of any pneumonia with a period of incubation, development, tide, resolution and rehabilitation, however, a severe illness in combination with acute allergies is difficult to tolerate and is very dangerous with an increased risk of death, which is caused by rapid spread, high intoxication, and temperatures above 39 degrees , severe hypoxia and pleurisy.

Diagnosis of lobar pneumonia

Diagnosis of lobar pneumonia is carried out in the same way as for any other type of pneumonia, combining laboratory tests and instrumental diagnostic methods:

A urine test with a positive result contains protein with cellular elements - the first sign of almost any inflammation.
A blood test reveals an increased content of leukocytes and bodies, which are underdeveloped immune cells.
In addition to the pathogen, the sputum analysis will contain a large number of leukocytes and particles of lung tissue (possibly blood and pus).
A cardiac examination will show a drop in blood pressure and will be reflected in the ECG results as follows: depression of the ST interval, a decrease in the T wave and an increase in the P wave in the second and third sections.
Respiratory failure is recorded.
X-ray shows in the initial stages an increase in the pulmonary pattern in the affected area and darkening of the lung. At the height of the disease, severe darkening of the lobe and effusion of pleural fluid or pleurisy are observed.

Complications

Lobar pneumonia is characterized by a large number of very serious complications that can easily lead to death or disability:

Acute respiratory failure can be associated with the disease itself, or remain after it due to irreversible changes in the lung tissue.
The development of lung abscesses - purulent formations with dead tissue that must be removed surgically.
Lung gangrene is a putrefactive-purulent tissue necrosis that spreads very quickly.
Pleural empyema is an inflammation of the pleural sheets with effusion of pleural fluid between the membrane and the lung, which may contain pus.
Pleurisy is inflammation of the serous membrane of internal organs.
All kinds of purulent complications when infection enters the blood: purulent pericarditis (purulent inflammation of the pericardium of the heart), purulent meningitis (purulent inflammation of the brain), purulent abscesses of the brain or other organs and other similar complications.
Cardiac disorders, aortic valve damage and the development of heart failure.

Lobar pneumonia in children

The course of lobar pneumonia in children occurs even more suddenly and acutely than in adults. Throughout the entire period of the disease, an extremely high, unbreakable temperature is observed. In addition to blue discoloration, a herpetic rash may appear in the area of the nasolabial triangle. Children are also particularly susceptible to headaches and severe muscle weakness. The main symptoms and general course of the disease are exactly the same as with pleuropneumonia in an adult, however, complications on the nervous system can cause acute psychosis in a child during and for some time after the illness, as well as acute disturbances in brain activity, which can affect its development.

Treatment of lobar pneumonia

Treatment of lobar pneumonia is almost always carried out in a hospital, especially for children, with strict mandatory bed rest. Antibiotic therapy begins immediately after diagnosis, without waiting for the result of a culture test for a specific organism, with drugs to which most pathogens are most sensitive. Antiallergic and antipyretic drugs, immunostimulants, and agents are also additionally prescribed. Improving sputum discharge. Physiotherapy contains standard physiotherapy procedures for pneumonia.

Also, sometimes patients with this type of pneumonia are connected to a ventilator, undergoing therapeutic bronchoscopy, blood pressure stabilization, oxygen barotherapy (hardware treatment with air with a high oxygen content) and other procedures.

Rehabilitation after lobar pneumonia is more complex, since most of its complications end in amputation of part of the lung, but it is based on the same physiotherapeutic and traditional methods as rehabilitation after any type of pneumonia, but requires more effort and time if the illness had consequences.

Prognosis for patients with pleuropneumonia

Lobar pneumonia is a very serious and serious disease with a lot of complications and serious consequences, as has been mentioned more than once above, however, if you consult a doctor in a timely manner, it can be successfully treated. This disease is an acute disease, which is characterized by a strong and vivid, but rather transient course, therefore, if all necessary measures are followed, it goes away quite quickly. However, the prognosis is not very good for patients at risk: children under five years of age, patients with immunodeficiency conditions and the elderly, as well as those who have had severe concomitant diseases or operations.

> Lobar pneumonia (pleuropneumonia)

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What kind of pneumonia is called lobar?

Lobar pneumonia (pleuropneumonia) is one of the types of pneumonia, an acute infectious disease of the lungs, in which an entire lobe (sometimes two or three) of the lung is affected with the obligatory involvement of the pleura (the lining of the lung) in the pathological process.

Depending on the location of the inflammatory focus, it can be right- or left-sided, as well as upper-, lower- or middle-lobe. Most often, the causative agents of pleuropneumonia are pneumococci or diplobacillus Friedlendor, which is extremely rare.

How does the clinical picture of the disease develop?

The previously inherent cyclical nature of the clinical course of lobar pneumonia with defined stages is no longer observed today. The disease begins acutely with an increase in body temperature to 39–40°C, severe chills, and headache. Chest pain appears almost immediately, especially worse when coughing and taking deep breaths. Because of this, breathing becomes cautious and shallow. Depending on the location of the pathological focus and the degree of involvement of the pleura in the process, pain can “simulate” myocardial infarction, acute appendicitis, acute cholecystitis and other diseases.

The patient's face has a characteristic appearance: shiny eyes, dry cherry-red lips, bright blush, sometimes only on one cheek on the side of pneumonia. It is not uncommon to see herpetic rashes on the face and neck. The cough is dry and weak at first. But gradually sputum begins to appear, which, due to its viscosity and thickness, is very difficult to cough up. The rusty sputum previously characteristic of pleuropneumonia is no longer found. At the height of the disease, breathing becomes extremely difficult, the patient groans as he exhales. Blueness of the lips and nose may appear.

Possible complications

If the diagnosis of lobar pneumonia is made on time and treatment is started immediately, the prognosis of the disease is quite favorable. Otherwise, complications may develop, which are sometimes extremely severe and pose a danger to the patient’s life: degenerative changes in the liver and myocardium, acute glomerulonephritis, scar changes in the lungs, cardiopulmonary failure, pleural empyema, acute endocarditis of the aortic valve, neurological symptoms ( hallucinations, psychosis) and others.

Approximate examination algorithm

Diagnosis of lobar pneumonia is carried out on the basis of complaints and objective examination data (examination of the patient, percussion and auscultation of the lungs). To make a final diagnosis, an X-ray examination of the chest organs is required, clinical and biochemical blood tests, a general urine test, and sputum culture for flora are performed to determine its sensitivity to antimicrobial drugs. Sometimes consultations with a cardiologist, surgeon, phthisiatrician, or psychiatrist-neurologist are required.

Features of the treatment of lobar pneumonia

Patients with pleuropneumonia are subject to mandatory hospitalization with strict bed rest throughout the febrile period. From the first day, antibacterial drugs are prescribed, first of the penicillin series, and then taking into account the established sensitivity of the pathogen to them. In severe cases of the disease, it is possible to prescribe two antibiotics at once. These drugs are discontinued only after stable normalization of the patient's condition. The complex therapy of lobar pneumonia includes medications that expand the lumen of the bronchi and dilute sputum, expectorants, and painkillers (for severe pain). Treatment of severe forms of the disease is not complete without intravenous drip infusions. With a persistent decrease in temperature and a decrease in symptoms of intoxication and respiratory failure, chest massage, physical therapy, and physiotherapy are recommended. The patient's diet should be protein-vitaminized.