Doctor Komarovsky about pneumonia in children. What to do if a child has repeated pneumonia? Why does this happen so often?

Children often experience new episodes of the disease after suffering from pneumonia. Children in the first three years of life get sick especially often. If the disease recurs after a full course of treatment and clinical recovery, they speak of recurrent pneumonia. And if there is no complete convalescence between individual cases of the disease, they speak of a relapse of the disease.

In case of relapses, the pathogen is not completely removed from the body during the first course of treatment, turning into an inactive dormant form. And with the next decrease in immunity, it is activated, causing repeated symptoms.

Relapses of the disease often lead to such consequences as pleurisy, lung abscess, fibrosis of the lung tissue, the formation of bronchiectasis (deformation of the bronchi), pulmonary hypertension. There are cases when a child suffers 18-20 episodes of pneumonia per year, which ultimately leads to sepsis, meningitis and other purulent complications.

Etiology of recurrent pneumonia

For practically healthy children with a strong immune system, repeated pneumonia is not typical; a single therapy is sufficient. Those children who have concomitant pathologies often get sick. It is not always possible to determine why frequent relapses of pneumonia occur, but the most common causes are:

congenital heart defects: defects of the heart septum and valves;
cystic fibrosis: an enzymatic deficiency in which the bronchi are obstructed by mucus, creating optimal conditions for the development of infection;
bronchiectasis;
frequent aspiration of fluid and gastric contents in unconscious patients, with clefts of the solid and soft palate, with skull injuries;
irrational antibiotic treatment and the presence of cross-resistance to drugs;
low immunity due to a large number of concomitant ailments.

Relapse Clinic

Symptomatically, relapses of pneumonia differ little from primary cases, but are accompanied by more severe intoxication and are more difficult to treat. In a child of the first year of life, fever may be practically absent, while digestive and nervous system. When the disease recurs, X-rays often show pleural effusion and complications such as lung abscesses and bronchiectasis.

Treatment

If treatment of the primary episode of the disease in the absence of serious concomitant pathologies can be carried out at home, then if a relapse occurs, hospital therapy is required. In this case, the antibiotic is selected only on the basis of bacterial culture of sputum and an antibiogram, which reflects the sensitivity of the pathogen to certain compounds.

The drugs should not repeat the prescription of the previous course of therapy. The most commonly used are cephalosporins and fluoroquinolones of the latest generations.

Since one of the reasons for ineffective primary treatment is low level immune defense, a child with recurrent pneumonia is often prescribed synthetic immunomodulators (Cycloferon) and herbal ones (ginseng, lemongrass). To reduce the symptoms of intoxication, non-steroidal anti-inflammatory drugs are used, and to improve sputum discharge, mucolytics (“ACC”, “Lazolvan”) are used.

Oxygen therapy helps prevent purulent complications in a child.

A common disease that creates real threat for life, is pneumonia in children, in the treatment of which modern medicine has come a long way. Even 30–40 years ago, according to statistics, doctors were able to save only every 3–4 child with pneumonia.

Modern methods of therapy have reduced the mortality rate from this disease tenfold, but this does not make the disease less serious. Prognosis in the treatment of each child always depends not only on the correct diagnosis and treatment plan, but also on the timeliness of contacting a doctor.

Inflammation of the lungs, called pneumonia, is a common disease that occurs not only in children of all ages, but also in adults.

The concept of pneumonia does not include other lung diseases, for example, vascular or allergic lesions, bronchitis and various disorders in their work, caused by physical or chemical factors.

This disease is common in children; as a rule, approximately 80% of all lung pathologies in children are pneumonia. The disease is an inflammation of the lung tissue, but unlike other lung diseases, such as bronchitis or tracheitis, with pneumonia, pathogens penetrate into the lower parts of the respiratory system.

Amazed part of the lung cannot perform its functions, release carbon dioxide and absorb oxygen. For this reason, the disease, especially acute pneumonia in children, is much more severe than other respiratory infections.

The main danger of childhood pneumonia is that without adequate treatment the disease progresses rapidly and can lead to pulmonary edema of varying severity, and even death.

In children with weak immune systems, the disease progresses in a very severe forms. For this reason, pneumonia in infants is considered the most dangerous, since they the immune system is not yet fully formed.

The state of the immune system plays a large role in the development of the disease, but it is important to correctly determine the cause of pneumonia, since only in this case its treatment will be successful.

Causes of pneumonia

For successful treatment pneumonia in children, it is important to correctly diagnose the disease and identify the causative agent. The disease can be caused not only by viruses, but also by bacteria and fungi.

Often the cause is the microbe pneumococcus, as well as mycoplasma. Therefore, the nature of the occurrence of pneumonia may be different, but this particular point is important for organizing effective treatment, since the drugs to combat bacteria, viruses and fungi are completely different.

Pneumonia can have different origins:

Bacterial origin. The disease can occur not only against the background of another illness of the respiratory system, as a complication, but also independently. Antibiotics for pneumonia in children are used specifically for this form of the disease, since it requires careful and urgent antibiotic therapy.
Viral origin. This form of the disease is the most common (detected in approximately 60% of cases) and the mildest, but requires adequate treatment.
Fungal origin. This form of pneumonia is rare; in children, it usually occurs after inadequate treatment of respiratory diseases with antibiotics or their abuse.

Inflammation of the lungs can be unilateral, affecting one lung or part of it, or be bilateral, affecting both lungs at once. As a rule, with any etiology and form of the disease, the child’s temperature rises significantly.

Pneumonia itself is not a contagious disease, and even with a viral or bacterial form It is very rarely transmitted from one child to another.

The only exception is atypical pneumonia, the cause of which was activation certain type mycoplasma. In this case, the disease in children is very severe, accompanied by high temperatures.

Special mycoplasma pneumoniae, causing respiratory mycoplasmosis and pneumonia, is easily transmitted by airborne droplets, causing various forms of respiratory system diseases, the severity of which depends on the state of the child’s immune system.

The symptoms of this type of pneumonia are somewhat different:

At the very beginning of the disease, the child’s temperature rises sharply, reaching 40°C, but after that it decreases and becomes subfebrile with persistent values of 37.2–37.5°C. In some cases, complete normalization of indicators is observed.
In some cases, the disease begins with usual signs ARVI or colds, such as sore throat, frequent sneezing, severe runny nose.
Then shortness of breath and a very strong dry cough appear, but acute bronchitis also has the same symptoms, this fact complicates the diagnosis. Children are often treated for bronchitis, which greatly complicates and aggravates the disease.
By listening to a child's lungs, the doctor cannot detect pneumonia by ear. Wheezing is rare and of varying character, traditional signs there is practically no sound when listening, which greatly complicates the diagnosis.
When examining a blood test, as a rule, pronounced changes no, but an increase in ESR is detected, as well as neutrophilic leukocytosis, complemented by leukopenia, anemia and eosinophilia.
When performing an X-ray, the doctor sees in the images foci of heterogeneous infiltration of the lungs with an enhanced expression of the pulmonary pattern.
Mycoplasmas, like chlamydia, causing atypical pneumonia, can long time exist in the epithelial cells of the lungs and bronchi, and therefore the disease is usually protracted and, having appeared once, can often recur.
Treatment of atypical pneumonia in children should be done with macrolides, which include clarithromycin, josamycin and azithromycin, since pathogens are most sensitive to them.

Indications for hospitalization

Only a doctor can decide where and how to treat a child with pneumonia. Treatment can be carried out not only in inpatient conditions, but also at home, however, if the doctor insists on hospitalization, this should not be prevented.

Children are subject to hospitalization:

with a severe form of the disease;
with pneumonia complicated by other diseases, for example, pleurisy, cardiac or respiratory failure, acute disorder consciousness, lung abscess, fall blood pressure, sepsis or infectious-toxic shock;
who have damage to several lobes of the lung at once or a lobar variant of pneumonia;
up to a year. In infants under one year of age, the disease is very severe and poses a real threat to life, so their treatment is carried out exclusively in an inpatient setting, where doctors can promptly provide emergency assistance. Children under 3 years of age also undergo inpatient treatment, regardless of the severity of the disease. Older children may undergo home treatment, provided that the disease is not complicated;
who have chronic diseases or severely weakened immunity.

Treatment

In most cases, the basis of therapy for pneumonia is the use of antibiotics, and if the doctor prescribed them to the child, in no case should they be abandoned.

No folk remedies, homeopathy or even traditional methods ARVI treatments will not help with pneumonia.

Parents, especially outpatient treatment, must strictly comply with all doctor’s instructions and strictly follow all instructions in the intake plan medicines, diet, drinking, rest and caring for a sick child. In a hospital, all necessary measures must be carried out by medical personnel.

Pneumonia needs to be treated correctly, which means you should follow some rules:

Antibiotics prescribed by a doctor must be taken strictly according to the established schedule. If, as prescribed by a doctor, you need to take antibiotics 2 times a day, then an interval of 12 hours should be observed between doses. When prescribing three doses, the interval between them will be 8 hours, and this rule cannot be violated. It is important to observe the timing of taking medications. For example, cephalosporin and penicillin series are taken no longer than 7 days, and macrolides should be used for 5 days.
The effectiveness of treatment, expressed in improvement of the child’s general condition, improved appetite, decreased shortness of breath and decreased temperature, can be assessed only after 72 hours from the start of therapy.
The use of antipyretic drugs will be justified only when the temperature in children over one year of age exceeds 39°, and in children under one year of age - 38°. High temperature is an indicator of the immune system’s fight against the disease, with maximum production of antibodies that destroy pathogens. For this reason, if the baby tolerates a high temperature normally, it is better not to bring it down, since in this case the treatment will be more effective. But, if the baby has had febrile convulsions at least once against the background of an increase in temperature, an antipyretic should be given only when the readings rise to 37.5°.
Nutrition. Lack of appetite with pneumonia is natural state. There is no need to force your child to eat. During the treatment period, you should prepare light meals for your baby. Optimal nutrition there will be liquid porridge, steamed cutlets from lean meat, soups, boiled or mashed potatoes, as well as fresh fruits and vegetables rich in vitamins.
It is also necessary to monitor your drinking regime. The child should consume large quantities clean still water, green tea with raspberries, natural juices. If the child refuses to drink fluid in the required amount, you should give him small portions of special pharmaceutical solutions for recovery. water-salt balance, for example, Regidron.
In the child's room, it is necessary to carry out wet cleaning daily, and also monitor the air humidity; for this, you can use humidifiers or place a container of hot water in the room several times a day.
It should also be remembered that immunomodulators and antihistamines should not be used in the treatment of pneumonia. They will not provide help, but they can lead to side effects and worsen the child's condition.
The use of probiotics is necessary for pneumonia, since taking antibiotics causes disruption of the intestines. And to remove toxins formed from the activity of pathogens, the doctor usually prescribes sorbents.

If all instructions are followed, the sick child is transferred to the normal regime and allowed to go for walks. fresh air from approximately 6–10 days of therapy. For uncomplicated pneumonia, after recovery, the child is given freedom from physical activity for 1.5-2 months. If the disease is severe, sports will be allowed only after 12–14 weeks.

Prevention

Must be given Special attention preventive measures, especially after a child has suffered from an illness. It is important to prevent accumulation of sputum in the lungs, which is why the disease develops.

Maintaining sufficient humidity in your baby's room will not only help ensure easy breathing, but will also be an excellent measure to prevent mucus from thickening and drying in the lungs.

Sports activities and high mobility of children are excellent preventive measures, helping to eliminate mucus from the lungs and respiratory tract and prevent the formation of its accumulations.

Drinking plenty of fluids not only helps keep the baby’s blood in a normal state, but also helps thin the mucus in the respiratory tract and in the lungs, which facilitates its elimination naturally.

Pneumonia can be treated effectively only if all doctor's instructions are followed. But, of course, it is much easier to prevent it, and for this, any diseases of the respiratory system should be promptly and completely eliminated.

It must be remembered that pneumonia in most cases becomes a complication when colds or other diseases of the respiratory system are neglected, as well as when therapy is not carried out in a timely manner or treatment is stopped prematurely. Therefore, to avoid possible complications and the development of pneumonia, you should not self-medicate colds, but consult a doctor for any manifestations.

Each lung consists of lobes (the right one has three, the left one has two). They, in turn, are divided into segments, which are divided into smaller and smaller sections, down to the alveoli. This is a simplified representation of the structure of the lungs to make it clear what we are talking about.

With pneumonia, the smallest “units” of the lungs, the alveoli, become inflamed. It is in these small bubbles that the process of respiration occurs - the exchange of oxygen and carbon dioxide. With pneumonia, when the alveoli are inflamed, breathing becomes difficult, all organs of the body suffer from a lack of oxygen, which is not the best in the best possible way affects the child's condition.

According to WHO, pneumonia is main reason child mortality worldwide. Every year, the disease takes the lives of more than a million babies, accounting for about 18% of child deaths. The disease is especially dangerous for infants under six months of age.

If treatment is not started in time, consequences such as: pleurisy (fluid accumulation between the two membranes of the lungs), pulmonary destruction (tissue destruction), cardiopulmonary failure(circulatory disorders associated with lack of oxygen). These complications often lead to death.

To prevent serious condition child, at the slightest suspicion of pneumonia (as well as any other disease), you should go to the doctor.

Pneumonia is a very dangerous disease, especially for children

Types of pneumonia

If the symptoms of a child’s illness resemble pneumonia, you should not self-medicate. If a friend treated her baby with a certain antibiotic, you don’t need to believe that it always helps. Pneumonia can be caused by various pathogens, and the drug should be selected based on this.

Pneumonia in children is most often caused by its own microflora (staphylococci, coli) with decreased immunity, hypothermia, and pneumococci. Bacterial pneumonia is not contagious, but viral pneumonia, caused by pneumococci, is transmitted by airborne droplets. They also distinguish atypical pneumonia, the causative agents of which are chlamydia and mycoplasma.

The disease is divided into the following types based on lung damage:

focal – a lesion of 1 cm in size is formed;

segmental – one or more segments are affected;

lobar (lobar) – the entire lobe of the lung is affected;

confluent - the union of several small lesions into a larger one.

In addition, pneumonia can be unilateral (left- or right-sided), bilateral.

Causes of the disease

In adults, pneumonia is most often an independent disease, while in children (especially under two years of age) it is a complication after past diseases, for example, influenza or ARVI. The state of the immune system plays a major role in the occurrence of pneumonia - the weaker it is, the greater the risk of disease.

As for the development of pneumonia, the smaller the child, the more difficult it is. The reason for this is age physiological characteristics. In newborns lung tissue insufficiently formed, the airways are thin and weak. Therefore, diseases of the respiratory system in children develop quickly, and the condition can rapidly worsen. Children under three years of age are often treated in a hospital (in mild cases, treatment at home is possible); children under six months old are required to be under 24-hour medical supervision.

Some medical conditions increase your risk of developing pneumonia. Among them: malnutrition, rickets, iron deficiency anemia, diseases of the central nervous system, heart defects, immune system deficiency.

Atypical pneumonia

This is a special type of disease that most often occurs in children aged six months to five years. Pneumonia is caused by chlamydia and mycoplasma. It proceeds differently than the usual form. Accordingly, the treatment is completely different.

The symptoms of SARS resemble a respiratory disease: the child experiences sneezing, a sore throat, and a runny nose. There may be no temperature at all. The cough is dry, debilitating, as happens with acute bronchitis. Wheezing in the lungs also has its own characteristics. Diagnosing the disease and selecting an antibiotic in the case of atypical pneumonia is difficult - in order to prescribe effective treatment, a sputum test is taken. On early stages This disease is difficult to identify - this is its danger.

Atypical pneumonia is diagnosed differently than regular pneumonia

Signs of pneumonia in children under one year old

Symptoms of the disease differ depending on what pathogen it is caused by. Also, the course of the disease differs depending on the age and state of the child’s immune system. Most often in children younger age meet following symptoms pneumonia.

Temperature increase. Body temperature can rise to 39.5 degrees, although sometimes it does not exist at all. The peculiarity of the disease is that attempts to reduce the temperature are either ineffective or give short-term results (only for a couple of hours).

Decreased appetite. Almost all children begin to refuse food. Breast babies They ask for the breast, but they need it more to calm them down - they suck milk sluggishly. This applies not only to pneumonia - lack of appetite in children is a signal of health problems.

Disruption of the central nervous system. When a child suffers from pneumonia, his behavior completely changes. Drowsiness, unusual calmness, or, conversely, agitation and tearfulness are possible.

In children, signs typical of “adult” pneumonia, such as severe cough and chest pain, may be completely absent. In the first days of the disease, wheezing in the lungs is not detected. For these reasons, diagnosing the disease in children is difficult.

Symptoms of the disease in children

Pneumonia is accompanied by fever

Fever. The temperature may rise to varying degrees. In some children it reaches 39.5 degrees, in others – 37.2. Sometimes there is also a lack of temperature. However, unlike influenza and ARVI, it is difficult to bring it down, and besides, it only helps for a short time - after a couple of hours, hyperthermia returns.

Rapid breathing. Shortness of breath is the most common sign of pneumonia not only in children, but also in adults. The disease is indicated by:

more than 60 breaths in a newborn (up to two months);

more than 50 breaths in babies under one year old;

more than 40 breaths in children over one year old.

Skin retraction. In children with pneumonia, the skin in the rib area almost always sag. This is easy to notice if you undress a child - changes in relief skin in the area of the ribs is clearly noticeable when breathing.

Cyanosis of the nasolabial triangle. In children, the area between the lips and nose often turns blue with pneumonia. Blue discoloration is clearly expressed when the baby sucks at the breast, cries, sneezes, or coughs.

First of all, the symptoms of toxicosis appear - poor appetite, lethargy or agitation, tearfulness. Body temperature also rises, the wings of the nose swell, breathing and pulse quicken. A cough may appear only on the fifth day of the disease.

School-age children and teenagers get sick just like adults. Usually it all starts with symptoms of a general ARVI, after a few days there is an improvement, and treatment is stopped in a timely manner. After another couple of days, the temperature rises, a cough and chest pain appear.

If pneumonia is caused by Friedlander's bacillus, characteristic symptoms pneumonia is accompanied by vomiting and diarrhea. The cough begins in the first days of illness. Typically, such pneumonia occurs as an epidemic in children's groups.

In newborns, hospital-acquired pneumonia usually occurs (signs of the disease appear in the first 72 hours of life), but the possibility of intrauterine infection cannot be ruled out - in this case, the cause of the disease is an infection of the maternal body.

Pneumonia can be noticed by any attentive mother. Signals of a serious illness are: increased temperature that lasts more than three days, severe shortness of breath, asymmetric wheezing in the lungs. Under no circumstances should you treat pneumonia yourself; only a doctor should prescribe medications. Usage traditional methods It will only take away precious time, but will have no effect.

Diagnosis of the disease

When listening and tapping the lungs, the doctor finds following signs pneumonia: wheezing characteristic of of this disease, at the site of inflammation, breathing is weak or not audible at all. An x-ray shows a darkened area of the lung; a blood test shows inflammatory process.

The doctor conducts a comprehensive diagnosis

When making a diagnosis, the doctor focuses not only on clinical picture and test data, but also on the result of an X-ray examination of the lungs. In children, especially young ones, take into account the data microbiological research as an accurate result is impossible, since the wrong microorganism that caused pneumonia may be sown from sputum and nasopharynx.

Treatment of pneumonia

In children, as in adults, pneumonia is treated symptomatically, that is, all signs of the disease and foci of inflammation are eliminated. Despite the information below, under no circumstances should you self-medicate - you should consult a doctor. It is also unacceptable to use folk remedies - not only will they not give the necessary therapeutic effect and time will be lost, we should not forget that modern children are often allergic, and can respond to herbal treatment in a completely unpredictable way.

If you have pneumonia, you should never self-medicate

In order to remove the source of inflammation, doctors prescribe a course of antibiotics. Despite the fact that these drugs negatively affect the immune system and gastrointestinal tract of even an adult, not to mention children, it should be understood that it is impossible to cure pneumonia without antibiotics. The type of drug and dose are determined by the doctor depending on the age of the child, the causative agent of the disease and the severity.

The following groups of antibiotics are mainly used to treat children: penicillin, semisynthetic penicillins (amoxiclav, amoxicillin, ampicillin, etc.), macrolides (rovamycin, erythromycin, azithromycin, etc.), cephalosporins (cefuroxime, cephalexin, cefoperazone, ceftriaxone, etc. .d.). IN severe cases pneumonia is treated with aminoglycosides and imipinemas. Sometimes drugs from different groups are combined.

Sputum analysis, which allows identifying the pathogen, lasts more than one day, so the doctor prescribes the drug by studying the child’s medical card and focusing on the clinical picture. If after 48 hours (in acute conditions - 24 hours) there is no improvement in the general condition, as shown by the x-ray, the antibiotic is changed.

Elimination of the symptoms of the disease, aimed at improving the well-being of the sick child, is also important. To do this, the doctor prescribes antipyretic drugs and mucolytics, facilitating the discharge of sputum.

Mucolytic drugs also enhance the effect of antibiotics. These include drugs based on acetylcysteine (mucomist, ACC, mucobene, fluimucil), derivatives of the alkaloid vazicin (bisolvone, bromhexine, mucosalvan). Despite the fact that such drugs seem harmless, only a doctor should prescribe them, taking into account the possibility of combining certain drugs.

If a child has a fever, you do not need to bring it down immediately when you see a mark of 37 degrees. An elevated temperature helps the body fight microbes, so it is worth bringing it down only when it is more than 38 degrees. This recommendation does not apply to children under one year of age or to those who have previously had low-grade seizures.

All doctor's prescriptions must be strictly followed.

Treatment at home and in hospital

Many parents worry that treatment will take place in a hospital. However, treatment at home is also possible. The following factors are taken into account when making a decision.

Child's age. In infants, pneumonia is a serious threat to life. If the child is under three years old, the doctor suggests hospital treatment. You should not refuse this: the consequences of the disease in children can be different, up to sudden stop breathing. To prevent this from happening, it is better for the child to be under the supervision of doctors around the clock until recovery.

The child's condition. If a child over three years old is sick, his state of health is taken into account when choosing the form of treatment. For example, if you have a weak immune system or have chronic diseases may be offered to stay in hospital for treatment.

Type of pneumonia and severity of the disease. If a child has simple focal pneumonia, treatment can be done at home. But it is dangerous to treat lobar (lobar) at home - it is fraught with serious complications.

It is these factors that influence the decision to hospitalize a child with pneumonia.

Treatment can be carried out at home, but under the supervision of a doctor

Duration of treatment

How long treatment will last depends not only on the age of the child, the type and severity of pneumonia, but also on the characteristics of the body. In uncomplicated cases, antibiotic treatment lasts 7-10 days.

If the disease has a complex course, there are complications, and also in cases of atypical pneumonia, treatment may be longer. Sometimes pneumonia is treated with antibiotics for a month. The duration of treatment is determined only by the doctor.

If treatment was started in a timely manner, there are no complications and the drugs are prescribed correctly, full recovery(until the symptoms disappear completely) occurs in about a month. If you self-medicate and do not seek help from a specialist, the consequences can be very dire.

Caring for a sick child

Of course, it is very important to follow all your doctor's instructions regarding medications. But besides this, the patient needs to provide proper care, healthy eating. All this will help you heal faster.

Since antibiotics negatively affect the functioning of the digestive system, which is already weak in children, it is necessary to provide a light, but at the same time healthy and high-calorie diet. Children should not be introduced to new foods at this time, and older children should be given boiled meat, cereals, vegetable soups, fruits, and vegetables. Heavy, fatty foods are unacceptable. However, when a child is recovering and asks for a certain dish, you should not limit him in this desire. During treatment with antibiotics, you need to take enzyme preparations.

A sick child needs careful care

The child must receive enough fluids. At the age of three, the amount of fluid per day should reach three liters. You can give clean water(not carbonated), juices, tea, compote, milk. If children drink little fluid, against the background high temperature Dehydration is possible, which will affect the entire body. In addition, sufficient fluid intake improves sputum discharge.

With kids infancy the situation is more complicated. For every kilogram of weight there should be 150 ml of liquid. If the baby is on breastfeeding, it's hard to track. But if he suckles well and urination is normal, it means there is enough milk. If a baby has a poor appetite and does not want to suckle milk, he needs to be fed with a spoon. But since such children are in a hospital, you don’t have to worry too much about this - if necessary, fluid will be administered intravenously.

Of course, it is difficult to put children to bed, but with pneumonia this is a prerequisite for recovery. At temperature, observe bed rest definitely necessary. You don't have to lie down - you can sit. You need to ensure that bed linen and clothes are clean. You should not dress your child too warmly. You will have to forget about swaddling during the illness - breathing is already difficult, and wrapping it worsens the condition even more. The chest and head should be slightly raised, for this you can add an additional pillow.

The environment should be calm - no guests, bright lights, loud conversations. It is recommended to maintain the temperature in the room at 20-22 degrees. The room is ventilated several times a day. At this time, the child should be in another room. If this is not possible, then the patient should be covered with a warm blanket and the children should be dressed. Under no circumstances should there be drafts. In summer, it is recommended to go out to the balcony with your child - fresh air is very important for pneumonia.

Children with pneumonia must be bathed. But not in the bath, but under the shower, for a few minutes. If the condition is severe, the child should simply be wiped with a damp towel.

Physiotherapy

At the speed of recovery in a positive way affects special physiotherapy. In addition, it helps to avoid complications. Gymnastics is a must for all children over three years of age.

Therapeutic exercises will help get rid of the disease

The simplest thing is turning in bed, which begins from the very first hours of the disease. Pneumonia is usually accompanied by unpleasant (and even painful) sensations in the chest, on the side where the inflammatory process is located. Therefore, patients, both children and adults, try to sleep on the opposite side to reduce discomfort. However, because of this, they may develop adhesions, resulting in the formation of pleural adhesions.

The child must be turned from one side to the other, as well as onto his back, from time to time. Even if he is already a teenager, you still need to control the process.

Approximately on the third day of illness, you can start breathing exercises. When performing the exercise, the patient should place his hands on his stomach and take deep breaths at least fifteen times. When the child feels better and begins to get out of bed, it is necessary to do the following exercise: do deep breath, slowly raise your arms and lower them while exhaling deeply. The exercise is repeated at least ten times.

All event data is included in the system dispensary observation. After transfer acute pneumonia The pediatrician must monitor the child’s condition for another year. A blood test is taken approximately every two months. If there is a suspicion of a chronic process in the lungs, a chest X-ray examination is prescribed. The condition of the body is also monitored by other specialists: an immunologist, an allergist, a pulmonologist, an ENT specialist.

Vaccinations against pneumonia

In children over two years of age, the main cause of pneumonia is pneumococcus. The disease caused by these microorganisms is contagious and transmitted by airborne droplets. After recovery, immunity to the transferred pneumococcal serotype remains. The pneumonia vaccine contains bacterial antigens of the most common serotypes.

Today, about a hundred serotypes of pneumococcus are known, a quarter of which are constantly transmitted from one person to another. The goal of vaccination is to reduce the mortality rate from pneumonia. Vaccination forms immunity in the body, but for a short time: up to five years.

The most famous vaccines against pneumonia are Pneumo-23 (France) and Prevenar (USA). The first is given to children over two years old, the second - from two months. Vaccines are administered intramuscularly or subcutaneously. Adverse reactions may be: swelling, redness, pain at the injection site. A small number of vaccinated people develop a fever on the first day. Local manifestations usually disappear after a couple of days.

In our country, debates continue about whether it is advisable to do this vaccine. It is not included in the list of mandatory ones, but doctors recommend doing it to children with weak immunity. In several dozen countries around the world, all children are vaccinated against pneumonia. mandatory. In any case, it is unacceptable to make a decision on the introduction of a particular vaccine on your own - you should definitely consult with your doctor and immunologist.

Prevention of pneumonia

First of all, the child must have good immunity. This directly depends on the diet and daily routine, which many parents neglect. Children should receive fresh fruits, vegetable dishes, dairy products, and meat daily. Infants - mother's milk.

The child’s diet should be designed in such a way that the body receives all the vitamins, micro- and macroelements it needs. If the child does not receive enough nutrients, his immune system suffers, and the body cannot fight pathogens.

The daily routine for children is very important. If a child is put to bed either at nine o'clock or at twelve, and allowed to do whatever he wants during the day, the body will constantly experience stress. Therefore, the child must be put to bed strictly at a certain time ( nap must be), distribute time for studying and playing. Children should not be very tired.

Pneumonia - serious illness, which can lead to severe consequences. If you suspect pneumonia, you should not hesitate or self-medicate - you should immediately call a doctor. If you start treatment on time, you can defeat pneumonia without complications - this is true for any disease.

Pediatric allergist-pulmonologist, K.M.N. talks about the peculiarities of the course of pneumonia in children. Snezhana Vasilievna BYCHKOVSKAYA.

Pneumonia is an acute infectious inflammation of the lung tissue, accompanied by impaired respiratory function. Community-acquired pneumonia is one of the most common diseases in children among all diseases of the pulmonary system.

The causative agent of pneumonia is overwhelmingly various bacteria. The occurrence and course of this disease depend on the age of the child. Pneumonia in children under one year old and in preschoolers are completely different diseases. This difference is due not only to pathogens, but also mainly to the state of immunity, that is, the ability of the child’s body to protect itself from the pathogen.

The child is born sterile and without immunity. For normal life, he needs various beneficial bacteria, for example lactobacilli, which he receives primarily from his mother: during childbirth - through contact with the birth canal, and later - through contact with the mother's breast. Together with beneficial bacteria a newborn can also get harmful ones, causing various diseases, including pneumonia.

The causative agents of pneumonia in infants are most often staphylococci or intestinal flora. Staphylococcus enters a child's lungs from adults who carry this microbe, and from various objects that have not been disinfected - nipples, pacifiers, bottles and rattles. Intestinal flora can enter the baby's lungs with food during eating and regurgitation. Normally, this does not happen, since a full-term healthy newborn already has ways of protecting itself. One of them, humoral immunity, is formed in the baby during the first months of life. Nature did not leave the baby alone with external environment— until one’s immunity is formed, it is protected from infection by antibodies found in mother’s milk; doctors call them passive immunity.

If a child is born premature, neither the airways themselves nor the mechanical methods of protecting them have time to form. There is a high risk of developing pneumonia in children born to mothers who have had serious problems with health during pregnancy. The baby may be born on time but respiratory system he may not be formed, like premature babies. Children born with a birth injury are more likely to suffer from pneumonia, since they have a reduced protective mechanism such as the pharyngeal reflex. Microbes easily enter the lungs and cause inflammation.

Another fairly large group of children under one year old who often suffer from pneumonia are babies of smoking mothers. If a woman smokes during pregnancy, she is often born premature baby. But even with a full-term pregnancy, the child is born, as a rule, with immature airways. When a woman continues to smoke after giving birth, her baby becomes a “passive smoker.” Tobacco smoke paralyzes the work of the ciliated epithelium - the natural mechanical protection of the lungs from any microbes.

Correct diagnosis

It is necessary to suspect pneumonia in an infant if, during colds, the body temperature remains above 38.5 degrees for more than three days and does not decrease when taking antipyretic drugs. Let us clarify that antipyretic drugs should be used at temperatures above 38.5 degrees: fever is a natural protective process of the body against infection - this time is running production of protective antibodies and interferons. Subsequently, when encountering microbes and infectious agents, the child’s body will already have enough factors to protect itself. But if the baby has already had convulsions due to high temperature, then antipyretic drugs should be given already at a temperature of 38 degrees. And immediately call a local pediatrician to your home. If a baby develops a high temperature over the weekend, you should not wait until Monday; you should call an ambulance.

It will tell a doctor a lot to make a diagnosis of “pneumonia.” appearance baby. Against the background of a high temperature, the child is lethargic, lethargic, refuses to take the breast and drink any liquid, and often burps. His skin takes on a grayish-marble hue, his arms and legs become cold, and his forehead becomes hot. All these signs are a direct indication for an X-ray examination of the chest organs, especially the lungs. And blood test studies. These tests will confirm the presence of pneumonia in the baby.

Pneumonia in children under one year of age is treated in the hospital, because the baby needs medical supervision around the clock. Due to the fact that the immunity of infants is not yet sufficiently developed; the disease often occurs in a severe form, various complications can develop very quickly, the infection can quickly spread throughout the body, and this is already a threat to the child’s life. It is children under one year who have the highest mortality rate from pneumonia. Therefore, leaving a sick baby at home is dangerous! Moreover, pneumonia in children is treated with medications that are administered intramuscularly or intravenously in a certain time schedule - by the hour. Such treatment is difficult at home. Regular observation of a sick child by a doctor will make it possible to promptly recognize emerging complications and prescribe appropriate measures, including transferring him to the intensive care unit or resuscitation room.

Why and how do they get sick?

The causative agent of pneumonia in preschool children is most often pneumococcus. In 96 percent of children, these bacteria “live” in the upper respiratory tract, but defense mechanisms do not allow them into the lungs. And when this protection weakens or disappears altogether, pneumococci penetrate the lungs and cause bacterial inflammation. Most often this occurs after acute respiratory viral infections that depress local immunity and paralyze the work of the ciliated epithelium of the respiratory mucosa.

Pneumococcal pneumonia is a classic lobar pneumonia. Begins suddenly with high fever, cough, chest pain when breathing; accompanied by severe intoxication - headache, chills, weakness, lack of appetite. Due to chest pain, the child cannot take a deep breath, and shortness of breath appears even at rest.

Closer to school, starting from the age of 5, pneumonia in children is increasingly caused by intracellular microbes: chlamydia and mycoplasma. In the last five years, there has been simply a “spike” of atypical pneumonia in preschoolers and junior schoolchildren. As a rule, at the end of summer - beginning of autumn, when children return to organized groups: kindergartens and schools. The peculiarity of the course of atypical pneumonia in children is whooping cough-like paroxysmal cough. Often combined with inflammation of the mucous membranes of the eye - conjunctivitis or pharynx - pharyngitis. Another characteristic feature of atypical pneumonia is the development of broncho-obstructive syndrome. The child develops shortness of breath, wheezing when breathing, and it becomes difficult for him to exhale air. The same thing happens with bronchial asthma.

If broncho-obstructive syndrome develops, it is advisable for the child to be treated in a hospital. He needs therapy that relieves bronchospasm, active inhalations with special medications. It may be necessary to lavage the bronchi, intravenous administration drugs or hormone treatment. If a child with similar manifestations of pneumonia is not treated promptly and efficiently, the risk of him developing bronchial asthma in the future is very high. Often children who have had atypical pneumonia fall into the group of children who cough for a long time, since their cough reflex. There is no longer any infection in the body, but the child continues to cough, sometimes for a year.

The diagnosis of pneumonia for a preschooler is made by a local pediatrician after examining the child and listening to his lungs. Diagnosis is confirmed x-ray examination chest organs and blood tests. The doctor decides where - in the hospital or at home - the child will be treated. Preschoolers can be treated at home, but this depends on the severity of pneumonia. If the doctor insists on hospitalization, do not refuse or hesitate - the child has severe pneumonia with possible complications. If you decide to treat a child at home, you need to create peace for him, good care, exclude communication with strangers. But the main thing is to strictly follow all the doctor’s recommendations.

Children get sick very often colds, but in 90 percent of cases it is a viral infection, which antibiotics have no effect on. And most mothers immediately start giving their child the first available antibiotic. home first aid kit. Uncontrolled use of antibiotics leads, firstly, to the emergence of resistant forms of microbes, on which antibiotics cease to act; secondly, the number of allergic reactions in children. Whether antibiotics are needed, which ones and in what dosage, only a doctor can decide, especially for pneumonia. At correct selection When treated with medication, uncomplicated pneumonia is completely cured, and the lung tissue begins to function in the same way as before the disease.

What should mom do before the doctor arrives:

- a sick child must be undressed and put to bed. Give him as much liquid as possible - tea, fruit drink, mineral water - not cold or hot, but warm;

- Take the child's temperature. If it is above 38.5 degrees, you can give the child antipyretic drug- paracetamol, as a rule, it is in the home medicine cabinet. Pay attention to the dose of the drug. If paracetamol is for children, you can give 1 tablet. If paracetamol is for an adult, the dose is given based on the child’s age—1/10 tablet for 1 year of life, that is, a five-year-old child can be given half a tablet of adult paracetamol. If the temperature does not decrease 20-25 minutes after taking the medicine, you should not repeat taking paracetamol, so as not to cause a reaction to an overdose of the drug. In this case, it is easier to reduce the temperature by physical influence - wipe the child with a sponge and water at room temperature. Just don't wipe it alcohol solution or wash your baby in the shower.

Infants need to be fed with mother's milk for up to a year. No artificial formula replaces breast milk; they do not contain protective antibodies. Most children who are fed artificial formula later fall into the group of children who are often and long-term ill. It is necessary to follow all recommendations for the proper treatment of nipples, bottles, rattles and other household items for the baby. From birth, do not wrap or overheat the child, but, on the contrary, begin hardening procedures. In our city there are special children's centers where specialists deal with the hardening of infants.

In preschool children, pneumonia most often develops after viral infections. Therefore, in order not to get pneumonia, it is necessary to give your child an antiviral vaccination. In the period preceding the flu epidemic, the most dangerous viral infection, the child should be vaccinated against influenza. For a group of frequently ill children, pediatricians recommend simultaneously receiving antiviral (influenza) and antibacterial (pneumococcal) vaccines. The combination of two vaccinations provides lasting immunity against both influenza and pneumonia.

Material prepared by Nadezhda Frolova

No matter how hard parents try to treat their children’s illnesses calmly, a situation where a child often suffers from pneumonia throws them out of their rut in life. How to protect yourself from frequent pneumonia in a child? The answer is in this article.

No matter how much doctors urge parents to treat their children’s illnesses calmly and philosophically, as temporary troubles, not everyone succeeds in this and not always.

As a result, there is often a situation when a mother simply cannot say how many times during the year her child was sick respiratory diseases, one snot smoothly turns into another, nasal congestion turns into sore ear, the redness of the throat goes away, but the voice becomes hoarse, the cough becomes wet, but the body temperature rises again. This is no one's fault. Yes, they used to say that you have to be patient, that this is a feature child's body. Today they are trying to treat and restore immunity using all methods. Often, the most incredible attempts to protect a child from acute respiratory infections or to cure an existing cold lead to the fact that he gets pneumonia more than once a year.

If a child often suffers from pneumonia, this is a consequence of secondary immunodeficiency, that is, the child is born normal, absolutely healthy, but under the influence of numerous external factors his immune system stops developing or is somehow suppressed.

Therefore, if a baby that is normal from birth often gets sick, then he has a conflict with environment. To solve this problem, you can either use medications to reconcile the child’s body with the outside world, or change the environment so that it has a positive effect on the child.

Formation and normal operation immune systems are determined only external influences: food, drink, air, clothing, physical activity, rest and treatment of illnesses.

If a child has frequent pneumonia and this problem cannot be solved, then it is necessary to eliminate the conflict between the child’s body and the environment and change the lifestyle. There are no magic pills for all diseases, but there is a very real algorithm for parents’ actions in the fight against frequent acute respiratory infections and pneumonia.

So, first of all, make sure that there is always clean, cool and, most importantly, humid air in the children's room. Remove everything that smells: varnishes, deodorants, paints and detergents.

Everything in the nursery should be wet cleaned without use. disinfectants. Install a temperature regulator on the radiator, install a humidifier in the room, store all toys in a drawer, and books behind glass.

Before each night's sleep, wet clean the room by wiping off dust and putting away everything scattered. The child should sleep in a cool, damp room. Never force your child to eat, but wait for him to ask for food. It is better to prefer natural sweets, such as honey, raisins, dried apricots, to artificial ones. If you before the child All drinks have been heated, then it’s time to gradually reduce the heating intensity. Outdoor walks should take place under any conditions except rain and severe frosts, and active. Start to harden your child - for starters, playing sports in the fresh air, rather than in confined spaces, is considered an ideal option. Swimming in a public pool is not suitable for a weak child. The ideal holiday for a frequently ill child is summer in a village with an inflatable pool, cool well water, and plenty of sand. After such a 3-4 week rest, the immunity, weakened by city life, is restored.