Lung inflammation (pneumonia)

A lung inflammation or pneumonia is an inflammation of the pulmonaries alveoli and/or the lung connective tissue. The whole lung often isn't concerned but the in-flammatory changes are restricted on a lung patch or a bronchopulmonary segment. One describes this as lobar- or Segmentpneumonia. The lung inflammation starts out from the bronchial tubes and then changes on the lung tissue, it is a broncho-pneumonia.

The bronchopneumonias predominate in the infant and infancy, older little and schoolchildren are rather affected by lobar pneumonias. Shoots appear in large numbers the individual pneumonias also triggering depending on childhood (age af-finity).

The transmission of the infectious pneumonias is mainly made by droplet infection cough sneezes, speaking, (). The lung inflammation can be a complication at a cold disease such as at the bronchitis. However, the pneumonia can apparently appear from a "clear sky" also without previous illness signs.

The causes of a lung inflammation are various:

  • Infectious causative agents like viruses (Respiratory Syncytial virus > RSV, influenza virus, Adeno virus), bacteria (Hämophilus influenzae, pneumococci, streptococci, mycoplasma) and mushrooms,
  • chemical irritants (for example toxic gasses after a gangrene),
  • allergic reactions,
  • an injury of the lung by aspirierte foreign bodies (breathed in).
Viruses are, the main causes of the pneumonias bacterial shoot at infants younger at nursery school and schoolchildren these. Newborn childs, infants and children with an inborn or acquired defense weakness also can fall ill with a pneumonia which is triggered by atypical causative agents, for example pneumocystis carinii, clamydien and mushrooms.

The clinical picture at a lung inflammation appears to be different in heaviness and course. It depends on the species of the pneumonia (lobar or bronchopneumonia) and on the cause. At bacterial lung inflammations, the inflammation signs are more distinctive than at viral. The characteristic features, how high fever and chill, have to be watched well often among nursery school and schoolchildren. With newborn childs and infants, on the other hand, the symptoms have to be stated often heavily. A lung inflammation can go at them also with an only low fever.

One finds the following symptoms at a pneumonia:

  • fever which is high and suddenly entering (39 º C to 40 º C), often chill,
  • rapid, flat respiration (primarily to the beginning of the illness),
  • Mamma and stomach ache particularly at the cough,
  • Cough with and without mucus vomiting, which, however, isn't always avail-able. If he appears, then he is dry, tormenting and often painful at the begin-ning of the infection. After days the cough gets looser, the expectoration is greenish till reddish. Infants often swallow the mucus and break it open with stomach content at the cough;
  • How the lips and the mouth can dyspnea, be discolored bluishly. This is the result of the hypoxia (cyanosis);
  • Building the sides of the nose when breathing in ("sides of the nose"),
  • Sink in the skin between the ribs and between the larynx and collarbone,
  • distended abdomen.
Go at the first suspicion of a lung inflammation to the physician immediately!

For the diagnosis your treating physician will take the exact case history.

He will carry out the following examinations:

  • Bug with the stethoscope (auscultation) and knock off (percussion) Both provides typical results, depending on which lung areas affected are.
  • Roentgenogram With the x-ray image the suspicion is confirmed beyond all doubt to a lung in-flammation. The areas fallen ill stand out as so-called "shadows". Perhaps the roentgenogram also gives a reference to the causative agent since certain shoots often cause a certain extension of the inflammation.
  • Blood test The inflammation values are determined which are increased in the case of a pneumonia. In addition, a hemoculture is laid out. With it shall be certainly whether bacteria are in the blood and it is which causative agent.
At first we the lung inflammation immediately given therapy with antibiotics. The choice of the medicine is derived from it, there is probably which shoot. The exact causative agent cannot be immediately always investigated. A bacterial culture must, from the bronchial secretion (is by siphon won) or blood be laid out to which to this from the expectoration. On which medicine the shoot reacts specifically, can be tried out. However, this lasts for some days. One therefore gives therapy nonspecifi-cally till calculates once. Which don't work antibiotics, are used these medicines also at viral causative agents. The risk and endangering the child are so big that you must immediately act also without specific knowledge of the causative agent. In ad-dition, an infection often follows on the viral infection with bacteria (superinfection).

Since the introduction of the antibiotics the mortality has decreased at bacterial pneumonias except for a little percentage. The course is shortened. Within 24 to 48 hours the temperature sinks and the condition of the children improves considerably. However, a light fever still can continue to exist up to 14 day.

Newborn childs and infants less than four months must be treated in the hospital. With older children the heaviness of the illness determines whether the child can re-cover at home or must into the hospital.

The following therapeutic and nursing measures must be noticed at a lung inflam-mation:

  • The children should rest and sleep much.
  • You mustn't make an effort.
  • Pay attention to sufficient fresh air (not draft) in the sickroom.
  • Give your child something to drink much, be recommendable for herb teas, for example.
  • Frequently change the bedlinen and more frequently get your child changed since it sweats much.
  • Expectorant medicines make this easier for cough.
  • You increase the top of the bed. Put books to this under the bedposts, for ex-ample.
  • You lower the fever by juices or suppository containing paracetamol or com-press around the leg don't (overdose respect)!.
  • Wichtig! Never put your infant on the abdomen at lung inflammation because it then cannot breathe freely.
  • As a rule, the prognosis at a lung inflammation is good. It is!dependent on the age of the child, on the causative agent and on the beginning the medical treatment. With children under a year, today, the pneumonia still can be life-threatening, too. The prognosis with older infants and schoolchildren is, how-ever, good.

If a pneumonia isn't treated at full term, then it can come to the following complica-tions:

  • life-threatening heart circulatory failure,
  • Pleura inflammation (pleurisy),
  • Water-(pleural effusion) or pus accumulations (pleura empyema) in the mamma space,
  • Inflammations of the middle ear, the meninges or the heart valves if the causative agents are spread far about the blood,
  • Sepsis (blood poisoning) at heavy pneumococci infections.
A lung inflammation won't or it can get chronic or break out again and again so, treated only insufficiently. The troubles pass eight weeks or one speaks longer of a chronic lung inflammation. Reason for it being able to be lung malfor-mations, foreign body or breathed in disturbances of the immune system.

There are measures prophylactic (preventive) to protect oneself against a part of the causative agents.

The following vaccinations are available:

  • Pneumococcal vaccination: A vaccine is at disposal the protection from a pneumococcal illness ensured already in the infancy (as of 2 months). The vaccination is recommended for children with an increased health risk. Early born, children with a birth weight of under 2500 grams, children with epilepsy as well as children and teenagers with one count reason as one of it illness (diabetes mellitus, condition after a spleen resection or spleen illness, kidney damages, chronic heart and lung illnesses). You should ask your physician whether the vaccination has to be recom-mended for your child.
  • Haemophilus influenzae type B (Hib), vaccination: This vaccination is recommended for all infants as of the third life month.
  • Influenza - vaccination: This vaccination has to be recommended to children with endangering health increasely. Children and teenagers are meant with that lungs, heart, circula-tion and metabolic disease with a basic illness, for example, as chronic.
  • A vaccination against the Respiratory Syncytial virus > RSV virus is, (early given birth), for example recommended for risk groups.
The attending doctor perhaps one immune therapeutic will children incline these pre-scribe to rezividierenden illnesses of the respiratory systems. It contains freeze-dried, standardized bacterium stems which can affect the respiratory systems. Capsules or a solution must consistently be taken in certain distances over months. The immune system is strengthened by it and the number of infections reduces. There are experi-ences with these medicines with children as of a year.


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