The word “pneumonia” is widely known today. We are talking about an infectious inflammatory process in the lungs (note that non-infectious pulmonary inflammations are also possible, but they are called differently and are not considered here), This article will deal with the concept of Pneumonia, causes of pneumonia, symptoms of pneumonia and its management.
WHO and other medical organizations, international and national, regularly publish epidemiological data and mortality statistics in connection with pneumonia. This fact alone should be alarming: most serious sources of pneumonia are defined as one of the global problems of mankind, and there are certainly reasons for such an assessment – pneumonia annually causes up to 7% of all deaths in the world. It should be noted, however, that published statistics on pneumonia are somewhat chaotic and often contradict each other; they vary widely in various social, regional, problematic and other private samples (for example, in Russia as a whole, mortality from pneumonia has been halved over the past five years, but even today this figure exceeds 2% of the total number of cases).
In other words, the prevailing ideas about pneumonia as a “common disease, antibiotics for which are sold in any pharmacy” are fatally erroneous. The lungs are the most complex paired life-support organ, the functions of which are not limited to gas exchange (external respiration); the lungs are also involved in maintaining salt and fluid balance, filtration, thermoregulation, lipid and protein metabolism. Therefore, a decrease in the functional status of the lungs (and the inflammatory process inevitably affects the performance of any organ) becomes a serious problem for the whole organism and can lead to severe irreversible consequences. To quote the cheerless pulmonology saying: Lung problems are never easy…
In fact, pneumonia is not one disease, but an extensive group of them: a variety of pathogens, localization options, clinical forms, severity, extent of damage, types of course, etc. are possible. Accordingly, for various scientific and practical purposes, many classifications of pneumonia have been developed, which are based on clinical, etiopathogenetic, trigger and other criteria. For example, they distinguish between community-acquired pneumonia and hospital-acquired pneumonia (nosocomial, nosocomial, associated with artificial ventilation of the lungs in a hospital), primary and secondary, typical and atypical, focal and total, acute and chronic, radiation and immunodeficiency, etc.
The reasons
In an extremely compressed form, the direct cause of pneumonia is the vital activity of pathogens, the main risk factor is the weakening of immunity, and the pathophysiological soil is a change in the natural properties of sputum secreted by the bronchi.
The causative agents of pneumonia can be pathogenic bacteria (streptococci, staphylococci, pneumococci, Haemophilus influenzae, and many others), but also viruses, intracellular parasites, fungal cultures – in other words, representatives of almost all kingdoms, classes, species and genera known to microbiology.
The development of pneumonia is facilitated by SARS, smoking, alcohol abuse, injuries, surgical interventions (especially thoracic and abdominal), physical inactivity (in the broadest sense – from office work to home or hospital bed rest), severe chronic diseases, elderly or early childhood, hypovitaminosis , hypothermia, overwork, environmental or occupational hazards – and any other factors that weaken the body’s natural immune defenses.
As for bronchial mucus, any changes in its composition, volume and circulation (primarily cough removal) create favorable conditions for lung infections.
Symptoms
The most typical symptoms of pneumonia in the initial stage are dry (aproductive) cough, fever, general weakness, sweating, fatigue, shortness of breath, cyanotic shade of the nasolabial triangle. Indirect signs are often an unusually long course of a seasonal respiratory infection, persistent “causeless” subfebrile condition, resistant to standard antipyretics.
However, the clinical picture can be completely different: in some forms of pneumonia, the onset is acute, the temperature reaches 40 degrees and above, a cough with purulent discharge immediately appears. In particular, in children, pneumonia often develops rapidly.
The factors that determine the clinical picture of each individual case are very diverse (see above: a specific pathogen and the degree of its activity, localization and spread of the process, general somatic and immune status, age, and many others).
Diagnostics
In the diagnosis of pneumonia, traditional methods for medicine such as collecting complaints and anamnestic information, auscultation (listening to the acoustic characteristics of breathing), percussion (tapping), laboratory blood and sputum tests do not lose, and hardly ever lose their value. Of the instrumental methods, radiography and bronchoscopy are the most informative. According to indications, for example, for differential diagnostic purposes, MRI, MSCT, biopsy and other research procedures may also be prescribed.
Treatment
First of all, it should be understood: if pneumonia is conclusively diagnosed, then any deviations from the scheme prescribed by the doctor – arbitrary or early withdrawal of drugs, reduction or increase in doses, violation of the prescribed regimen, attempts at self-treatment of the so-called. folk methods – deadly in the most literal sense of the word. This is especially true of antibiotics, the uncontrolled intake of which is also a worldwide problem (again, without any exaggeration).
However, most cases of lung infection do indeed have a bacterial etiology, and, accordingly, antibiotic drugs play a key role in therapy. Their choice and dosage is the exclusive prerogative of the doctor. In cases where inflammation is caused by a non-bacterial pathogen, the scheme of etiopathogenetic and adjuvant (additional) treatment may turn out to be completely different from what is described on the Internet, in the recommendations of a recently ill neighbor, in “recipes of alternative medicine” and other sources of this kind.
Medication, physiotherapy, nutritional treatment is prescribed based on the results of the examination and taking into account many individual factors. The optimal and necessary regimen for the treatment of pneumonia – and this is another problematic issue – is a hospital regimen. For any suspicion of pneumonia in a child, as well as for the rapid deterioration of the condition of an adult with symptoms of pneumonia, hospitalization should be carried out according to an urgent protocol.
The foregoing is by no means “medical intimidation” or reinsurance. The risk of complications is too great with pneumonia; their long list includes, in particular, pleurisy, pulmonary edema, endocarditis, life-threatening ARF (acute respiratory failure), sepsis, meningitis, etc. Therefore, if any of the symptoms listed here appear in any combination, even if they are mild and at first do not affect the quality of life too much – a visit to the doctor is necessary and mandatory.
