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Diagnosis of chronic pneumonia
Medical expert of the article
Last reviewed: 04.07.2025
Chest X-rays of patients with chronic pneumonia show convergence of the pulmonary pattern elements in the affected area, increased airiness of adjacent segments, and shift of the median shadow toward the affected area. These signs of the affected area of the lung are expressed the better, the larger the volume of the lesion and the more pronounced the pneumosclerosis.
Bronchography is the main method that reveals the localization and volume of lung damage, the degree and nature of bronchial deformations. In the affected area, the convergence of the bronchi, loss of their conicity, decrease in the depth of contrast, lumen deformation and bronchiectasis are determined, which in chronic pneumonia are only cylindrical.
The bronchographic picture is characterized by heterogeneity of bronchial changes, the presence of both deformed and dilated bronchi in the affected section. This distinguishes chronic pneumonia from changes in congenital malformations of the lungs, in which there is a more or less uniform lesion of the bronchi.
Bronchoscopy: as a rule, the changes are unilateral, depend on the phase of the disease, vary widely from local to widespread and from catarrhal to purulent endobronchitis.
FVD - 70% of children have ventilatory failure. In sputum in chronic pneumonia, two predominant pathogens are found: Haemophilus influenzae (60-70%) and pneumococcus (35-40%), both in monoculture and in associations. Moraxella catarrhalis is sown in 5-10%.
The course of chronic pneumonia is characterized by alternating periods of remission and exacerbation (more often after acute respiratory infections - of the bronchitis type with increased secretion of mucous or purulent sputum).
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