DISEASES OF CHILDHOOD : BRONCHOPNEUMONIA, NATURALNA LOBAR PNEUMONIA (BRONCHOPNEUMONIA, PNEUMONIA CATARRHALIS LOBULARIS - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Infectious disease: the most common pathogen is Streptococcus pneumoniae, less - pneumophila, Streptococcus, Bacillus Pfeyffera, etc. is of Great importance:
1) low power child, a weakened immune system, prematurity, exudative, lymphatico-gipoplasticheskaya diathesis, rickets;
2) sanitary-hygienic living conditions;
3) meteorological factors.
Occurs primarily attached to inflammation of the upper respiratory tract or is a complication of another infection (measles, whooping cough and so on).
Symptoms. The beginning of uncertain: the temperature rises, there is shortness of breath, cyanosis, pallor, impaired General health; percussion phenomenon is poorly expressed or absent; auscultatory - bronchophony, sometimes bronchial breath, wet sonorous rales. May dominate the effects of the lung (pulmonary form), cardiovascular (cardiovascular form), toxic-septic form), atony of the whole muscular system (atonic form in patients with rickets, simpatico), gastrointestinal events (putting form) and cerebral events (meningeal form).
For. Duration 1 - 3 weeks. Ends gradually lytic drop in temperature.
The transition in the chronic form; pleurisy, pericarditis, endocarditis, meningitis, nephropathy.
To differentsirovat bronchitis lobes pneumonia and pleurisy.
Prediction serious. Depends on age, General phenomena, the child's condition and care; pulmonary form is good, when the heart is doubtful if atonic - pretty bad, toxic-septic - bad case of intestinal and meningeal satisfactory.
Proper nutrition, conditioning, exercise, isolation (to prevent infection).
To provide appropriate care, extensive use of air, ventilation of the room, proper nutrition. Diet easy, liquid: a sufficient amount of liquid, sugar, vitamins; to limit fats, meat, milk. Hydrotherapy: hot tub, followed by a more cool dousing; mustard wraps, mustard bath, a warm compress (not to put infants and very weak children, as the wrap makes breathing difficult). Banks. The mustard. The oxygen. The sulfidina, alfasol, sulfathiazole, sulfadiazine and other drugs sulfonamidnuyu group. Parenteral introduction of sulfa drugs shown if the appointment of the interior causes of persistent vomiting. When parenteral application sulfidina dosed at 0.1, and in the appointment of inside - 0.1 - 0.2 per 1 kg of body weight of the child. Monitor urine and blood. In the absence of the effect of sulfa drugs and penicillin (5 000 - 10 000 - 15 000 units per 1 kg of weight, equal doses every 4 hours). In severe cases, combined penicillin - sulfonamidnuyu therapy. Drugs quinine. From other fever-reducing good for overall health piramidon. When strong anxiety - drugs bromine, bromural, luminal, urethane. With a strong cough that violate sleep, if not help, these soothing, prescribe codeine, dionin. Expectorant medicine (senega, Ipecacuanha, thermopsis) in the period of resolution, with a large number of moist rales (see acute Bronchitis). Special attention should be paid to cardiac activity: infants and small children from the first days of caffeine, more senior - heart inside and subcutaneously (camphor, gitalin on stolko drops, how old is the child, 3 to 4 times a day, adrenaline, strychnine), and breast - subcutaneously, depending on the state of cardiac activity. Especially it is possible to recommend intramuscular injection of blood 1 0 - 15 ml daily or every other day. In the absence of severe symptoms of heart failure - blood transfusion from 30 to 50 - 100 - 120 ml depending on the patient's age child. In the event of congestion of the lungs - bloodletting (30 - 50 ml in infancy, 100 - 150 ml per school) (not in a hopeless state!).