Focal pneumonia

One of the dangerous types of acute inflammation of the respiratory organs is focal pneumonia. Let's consider the characteristics of the disease, symptoms, signs, methods of treatment and prevention.

This form of infectious and inflammatory process progresses in a limited area of lung tissue, that is, within the lobes of the lung.

Focal pneumonia can be a complication of other diseases (bronchitis, tonsillitis, bronchial inflammation) or act as an independent disorder. Since the disease begins in the bronchi, it is often called bronchopneumonia.

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Causes focal pneumonia

Since the disease is most often secondary, the main factor provoking it is complications of acute respiratory viral infections. The causes of focal pneumonia may be associated with the activation of secondary infections developing against the background of bronchitis, furunculosis, whooping cough, scarlet fever, otitis and other ailments.

The main infectious agents are viruses, pneumococci, staphylococci, and streptococci. The pathogen can spread lymphogenously, bronchogenously, and hematogenously. Inflammation begins in the bronchial mucosa and gradually affects the bronchioles, alveoli, and lung tissue. Inflammatory foci can be small or large, merge, and do not extend beyond the segment or lobule.

Causes of focal pneumonia in adults and children:

• Stress and nervous experiences that exhaust the body.
• Poor nutrition, deficiency of vitamins and minerals.
• Bad habits (smoking, alcoholism).
• Presence of chronic diseases.
• Infectious lesions of ENT organs.
• Prolonged cooling or overheating in children.
• Insufficient physical development and lack of hardening.

In addition to the above reasons, the disease can occur when the permeability of the vascular wall is impaired. This contributes to the formation of serous and mucopurulent exudate, which accumulates in the lumen of the bronchial tree.

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Risk factors

Smoking, hypothermia, inhalation of toxic substances, stress and alcoholism cause disturbances in the protective systems of the bronchial tree and provoke the proliferation of harmful microorganisms with penetration to the alveoli and bronchi. The further nature of the inflammation depends on the properties of the pathogen, the disturbance of microcirculation at the site of the lesion.

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Pathogenesis

The causative agent of the disease can be any harmful microorganism. Pathogenesis is often associated with pneumococcal infection. The disorder can be provoked by: streptococci, staphylococci, anaerobic microbes, protozoa viruses, E. coli, fungi. As a rule, pathogens penetrate the lung tissue by the bronchogenic route. Lymphogenous and hematogenous routes are characteristic of pneumonia, which is a complication of the underlying disease.

Morphology of focal disease:

• Small lesion.
• Obstruction of the patency of large and small bronchi.
• Moderate impairment of vascular permeability.
• Gradually progressing inflammatory process.
• Separation of serous or purulent-mucous exudate.
• Absence of pronounced staging of the pathological process.

Pathological anatomy indicates that in the early stages of inflammation, the lung tissue is edematous, hyperemic, later it becomes dry, gray and compacted.

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Symptoms focal pneumonia

The disease is easy to recognize by its characteristic symptoms: chills, dry cough with little sputum, general weakness and pain in the chest area.

The signs characteristic of the pathology may develop gradually or take an acute form. As a rule, the disease begins to progress after catarrh of the upper respiratory tract, against the background of influenza or acute bronchitis. It is the secondary nature of the disease that does not allow the symptoms to be recognized.

Pulmonologists identify the following symptoms of focal pneumonia:

• Elevated body temperature 38-39°C.
• Painful sensations in the chest area.
• Dry cough with expectoration.
• Rapid breathing and heartbeat, tachycardia.
• Headaches and increased sweating.
• Decreased appetite and general weakness.
• Chills, fever.

The focal form is characterized by high temperature, but if the disease arose against the background of a weakened immune system, then subfebrile remains. With timely therapy, the temperature remains for 3-5 days. The cough can be both dry and wet, with admixtures of pus in the sputum. If the causative agent is a streptococcal infection, then exudative pleurisy is added to the above symptoms.

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First signs

In pneumonia, the infectious and inflammatory process affects the bronchi and surrounding tissues, several segments of the lungs. The first signs depend on the pathogen and the protective properties of the patient's immune system. The disease is characterized by a gradual onset, which occurs against the background of an acute respiratory viral infection or bronchitis. In this case, the following symptoms are observed: fever, increased weakness and sweating, shortness of breath, cyanosis of the skin, headaches. When coughing, bloody or mucopurulent sputum may be released. When listening, harsh breathing and dry wheezing are noted.

• Let's consider the signs of focal inflammation of the respiratory system depending on the infectious agent:
• Staphylococcus - the disease has an acute onset. Headaches and chest pains, hemoptysis, confusion, irregular fever and daily temperature fluctuations.
• Gram-negative diplobacillus Friedlander - most often this pathogen affects patients over 35 years old who abuse alcohol and do not adhere to a healthy diet. The main symptoms are: a strong increase in temperature, shortness of breath, cyanosis of the skin and mucous membranes, cough with mucous sputum. Sputum has an unpleasant odor, signs of intoxication are observed.
• Viral infection – acute onset, high temperature (lasts up to 12 days), nosebleeds, hemoptysis, cough, convulsions, fever, shortness of breath.

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Dyspnea in focal pneumonia

Dyspnea is a respiratory disorder that causes shortness of breath. Shortness of breath in focal pneumonia depends on the stage of the disease. Respiratory disorders can occur both at rest and after vigorous physical activity. Shortness of breath is one of the main signs of acute respiratory failure. With this disorder, the respiratory organs are unable to replenish the body's tissue and cell needs for oxygen, and compensatory mechanisms are completely depleted. The partial pressure of carbon dioxide gradually increases and the oxygen pressure in the blood decreases, metabolic products accumulate, which leads to respiratory acidosis.

Shortness of breath during inflammation of the bronchi and lungs occurs due to the accumulation of inflammatory exudate in the alveoli. This leads to a disruption in the exchange of carbon dioxide and oxygen between the capillaries and alveoli. There are three forms of respiratory failure:

• Parenchymatous - with normal ventilation of the blood, insufficient oxygenation of the blood, hypoxemia, and normocapnia are observed.
• Ventilation – pulmonary ventilation decreases, the perfusion-ventilation process worsens, which leads to the progression of hypercapnia and hypoxia.
• Mixed - a combination of the above forms. It is this that develops with a focal inflammatory process.

Dyspnea is accompanied by additional pathological symptoms - cyanosis, tachycardia, anxiety, harsh bronchial breathing, heart rhythm disturbances, tachypnea, arterial hypertension. With pronounced symptoms, the patient is subject to hospitalization and urgent oxygen therapy.

Shortness of breath may also appear after recovery. This complication indicates that the inflammatory process is still progressing, that is, pathogens continue to destroy lung tissue. Lack of medical care or untimely treatment at the hospital can lead to empyema of the pleura, sepsis, adhesive pleurisy and lung abscess.

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Focal pneumonia in children

Respiratory diseases in pediatric patients are always acute and cause a number of complications. Focal pneumonia in children is very common and is characterized by inflammation of small pulmonary tissues. Its course is significantly complicated if the inflammatory areas merge. In this case, the focal lesion takes a confluent form, which is difficult and prone to tissue destruction.

The disease is caused by various streptococci and pneumococci, bacteria, fungi, viruses and even physical factors. Pneumonia can be a complication of an allergic reaction or another disease affecting the respiratory tract. Pathogenic microorganisms penetrate the mucous membranes and cause their swelling, causing the accumulation of sputum.

Symptoms:

• Subfebrile temperature, which can rise to 39 degrees.
• General weakness, lack of appetite, lethargy, decreased activity.
• Wheezing and shortness of breath.
• Hyperemia of the skin of the face and cyanosis of the skin near the nose.
• After coughing, there is a painful sensation in the chest.

All of the above symptoms are a reason to immediately take the child to the doctor. With timely diagnosis and treatment, the disease can be eliminated with minimal complications.

Focal inflammation of the respiratory system in children is detected using laboratory tests (blood, urine, sputum) and chest X-ray. If the diagnosis confirms the presence of the disease, then etiotropic therapy is used for treatment. The child is prescribed drugs from different groups for optimal elimination of the infection.

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Stages

The symptoms of inflammatory lesions of the bronchi and lungs depend on the severity of the pathological process. The stages of focal pneumonia allow classifying the disease based on the first signs and the condition of the lung tissue during X-ray examination. The following stages are distinguished:

• The first 1-3 days of illness are the high fever stage.
• 4-7 days of illness – hepatization, lung tissue changes color.
• From day 7 until complete recovery – resolution stage.

Symptoms may vary in severity. Let's look at the main stages of the disorder

1. Mild – intoxication of the body is weakly expressed. The patient maintains normal blood pressure, clear consciousness, subfebrile temperature.
2. Moderate – intoxication is moderately expressed, weakness, elevated temperature, mild shortness of breath, decreased blood pressure, sweating are observed.
3. Severe (acute) – severe intoxication, temperature 39-40 degrees, severe shortness of breath, cyanosis, increased heart rate, decreased blood pressure.

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Forms

If the disease becomes chronic, then a sharp progression of all symptoms is observed. The patient complains of a lingering cough, the discharge of a large amount of sputum and a high body temperature. But a course with less pronounced symptoms, which gradually progresses, is possible.

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Acute focal pneumonia

Inflammation of the respiratory organs can have several forms, which differ in their course. Acute focal pneumonia is characterized by pronounced symptoms. The disease occurs against the background of an acute viral infection of the upper respiratory tract. Inflammation begins in the bronchi and moves to the alveoli. The first sign is a sharp increase in temperature, cough and chills. At first, the cough is dry, but after 1-2 days it becomes wet with the separation of mucopurulent sputum.

Clinical symptoms directly depend on the depth of the pathological changes and the spread of inflammation. Fever is of an irregular type and lasts up to ten days. Temperature decreases gradually, while subfebrile temperature persists for a long period of time. Many patients experience bronchophony and shortening of the percussion sound over the affected area. Auscultation reveals harsh breathing and dry wheezing.

The radiographic picture is characterized by acute changes in the lungs. Infiltration areas are combined with unchanged lung tissue. There may be single, large, small multiple and confluent foci of infiltration. The pathology may have both unilateral and bilateral forms of inflammation.

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Focal confluent pneumonia

A pathological process that affects several segments or a whole lobe of the lung indicates a confluent form of inflammation. Focal-confluent pneumonia is characterized by an increase in signs of respiratory failure and a sharp lag in breathing on the affected side.

The radiograph shows separate foci of inflammation, which alternate with microabscesses and emphysematous tissues. In its symptoms, this form is similar to lobar pneumonia. It has a severe course with toxicosis, destruction of lung tissue, cardiac and respiratory failure. Treatment is carried out in a hospital setting with a long course of antibiotics and immunostimulants.

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Community-acquired focal pneumonia

There are several forms of infectious and inflammatory lesions of the respiratory system. Community-acquired focal pneumonia is a disease that occurs on an outpatient basis, that is, at home. Despite a wide range of antibacterial drugs, the incidence and mortality rate remains high.

The etiology of the disease is associated with the progression of typical microflora that affects the upper respiratory tract. Predisposing factors include bronchopulmonary disorders, ENT pathologies, smoking, hypothermia, and a weakened immune system. Clinical manifestations depend on the form and pathogen of the disease.

• Pneumococcal – occurs in 30-50% of all cases of community-acquired form. Begins with fever, severe cough with sputum, chills. Without proper treatment leads to complications such as: acute vascular and respiratory failure, parapneumotic pleurisy.
• Streptococcal – occurs after a viral infection, has an acute course and is often complicated by sepsis. The main symptoms are: high fever with sharp fluctuations in body temperature, increased sweating, sputum with blood streaks. Possible complications: abscess formation, exudative pleurisy.
• Staphylococcal - the causative agent is Staphylococcus aureus, which is associated with respiratory viral infections, influenza viruses A and B. It is characterized by peribronchial lesions with the development of multiple and single lung abscesses. The main symptoms are: intoxication of the body, fever, shortness of breath, cough with the discharge of purulent sputum.
• Viral – caused by adenoviruses, influenza viruses A, B. Inflammation begins with pronounced swelling of the mucous membrane of the bronchi and alveoli. The main complications are thrombosis, necrosis, bleeding. From the 3rd to the 5th day, the disease takes a viral-bacterial form.

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Bilateral focal pneumonia

Long-term intubation anesthesia, artificial ventilation and pathological microbial infections lead to damage to both lungs. Bilateral focal pneumonia is accompanied by pronounced signs of intoxication and severe chest pain. This form has the following symptoms:

• A high temperature that is difficult to bring down with antipyretic drugs.
• Sharp headaches and chest pains that get worse when inhaling.
• Increased sweating and shortness of breath.
• Cough with the separation of purulent sputum with blood clots.
• Rashes, pallor and cyanosis of the skin.

Treatment is carried out with medication. The choice of drugs depends on the pathogen and the general health of the patient. Patients are prescribed a complex of antihistamines, anti-inflammatory and immunostimulants. Physiotherapy procedures are used for the fastest possible recovery of the body.

Focal pneumonia of the right lung

Right-sided inflammatory lung disease develops much more often than the disease on the left side. This is due to the anatomical features of the structure of the respiratory system on the right. The accumulation of bacteria and viruses in the right bronchus is due to its oblique direction. Infection occurs against the background of a decrease in the protective properties of the immune system, which penetrate the bronchi and begin to multiply. On the radiograph, the inflammatory process looks like small foci of shading.

Symptoms:

• Pain in the right side of the chest.
• Cough and production of viscous sputum.
• Blood streaks can be seen in the sputum.
• Severe chills, fever.
• High temperature and increased sweating.
• Chest pain when trying to take a deep breath.

The above-described signs appear in the classic form of the disease. The formation of infiltration foci occurs gradually, the disease affects the bronchioles and moves to the alveoli. The disorder has pronounced polymorphism, that is, on one side there are areas of damage at different stages of pathological development. Since the symptoms are blurred, the diagnostic process is difficult. Treatment is carried out in a hospital setting using antibiotics, anti-inflammatory drugs and other means.

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Left-sided focal pneumonia

Small lesions and moderate intoxication with smoothed symptoms indicate a unilateral inflammatory process. Left-sided focal pneumonia is characterized by settling of the left part of the chest during forced breathing. During examination, auscultatory and percussion changes are revealed, indicating pathology in the lungs. The anatomical and physiological features of the organ structure cause difficulties in diagnosis due to the heart located nearby. Therefore, if left-sided lesions are suspected, CT and ultrasound are performed.

Symptoms:

• Severe dry cough.
• Pain in the left side.
• Coughing up sputum with streaks of blood.
• Intermittent fever.
• Alternating worsening and improving general condition.

As a rule, the disease occurs against the background of an infection, for example, bronchitis, acute respiratory viral infection or a cold. Depending on the state of the immune system and the activity of the pathogen, the disease can be represented by small foci, part of a lung segment or an entire lobe. Antimicrobial, anti-inflammatory and antibiotic agents are used for treatment.

Focal lower lobe pneumonia

Diseases of the bronchopulmonary system have a negative impact on the functioning of the entire body. Focal lower lobe pneumonia can cause serious complications (pulmonary edema, reactive pleurisy), so it requires timely diagnosis and proper treatment.

Most often, this form of inflammation is diagnosed in pediatric patients. The disease can occur as a result of a systemic disease or a long-term allergic reaction in the lungs. Harmful pathogens penetrate the lung tissue from the upper respiratory tract. Further reproduction and spread of bacteria depends on the state of the immune system. Microbes affect the alveoli and, together with the mucus of the respiratory tract, attack the lower lobes of the lungs.

Symptoms:

• Subfebrile temperature.
• Dry cough with scanty sputum production.
• Chills and general weakness.
• Increased sweating.

As a rule, this form proceeds with moderate severity, but if complications occur and the pathological process is neglected, it can cause a fatal outcome. During the diagnostic process, special attention is paid to the X-ray and auscultation of breathing. Lower lobe inflammation is characterized by increased shallow breathing, wheezing, focal shadows. Treatment is carried out on an outpatient basis, the patient is prescribed antibiotics, antimicrobial agents and vitamin preparations to support the immune system.

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Upper lobe focal pneumonia

This form of respiratory disease is characterized by a sudden and acute onset. Upper lobe focal pneumonia causes severe chills and headaches, fever, chest pain. From the first days, a dry cough appears, which quickly turns into a productive cough with sputum discharge. Herpes-like rashes appear on the lips, cyanosis and hyperemia on the face. Due to the increased level of bilirubin in the blood, yellow spots are possible on the skin and on the sclera of the eyes. Shortness of breath appears, which makes itself felt even at rest.

X-ray, CT and ultrasound of the respiratory organs are used for diagnostics. In addition, the patient must pass a number of tests, including sputum to determine the pathogen. Since the upper lobe form is of bacterial origin, methods of differentiation with pulmonary tuberculosis are used in diagnostics. Antibacterial therapy is selected based on the test results. As a rule, with timely treatment, the disease can be cured within 5-7 days.

Complications and consequences

A prolonged course of any disease has a negative impact on the functioning of all organs and systems. The consequences of inflammation of the respiratory system can cause pathological changes in the cardiovascular system (tachycardia, heart rhythm disturbances). If the focal form takes on a croupous form, then on the radiograph this is displayed as a significant increase in the shadow of the roots of the lung. Blood tests reveal an increase in ESR and leukopenia.

Damage to the bronchi and lungs takes a long time to heal, so there are common cases where those who have recovered face the following consequences:

• Bronchial asthma (infectious-allergic form).
• Chronic bronchitis.
• Closed pneumothorax.
• Empyema of the pleura (due to infection entering the pleural cavity).
• Lung abscess.
• Pulmonary fibrosis.
• Infectious-allergic myocarditis.
• Acute cardiovascular failure.
• Dysbacteriosis.
• Infectious toxic shock.

Most often, the disease causes respiratory failure due to disruption of gas exchange in the respiratory organs. This leads to diseases of both the cardiovascular and respiratory systems. With timely treatment and correct diagnosis, negative consequences can be avoided.

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Complications

In focal pneumonia, complications most often arise from the respiratory system. Complications are considered to be pathological processes in any body systems that are not a direct manifestation of inflammation of the bronchi and lungs, but are pathogenetically and etiologically associated with it. They are characterized by specific manifestations that determine the course and prognosis of the disease.

Pulmonary complications:

• Empyema of the pleura.
• Multiple lung destruction.
• Edema and gangrene of the lungs.
• Parapneumonic pleurisy.
• Respiratory failure.
• Broncho-obstructive syndrome.

Extrapulmonary complications:

• Sepsis.
• Endocarditis.
• Anemia.
• Acute pulmonary heart disease.
• Non-specific myocarditis.
• Psychoses.
• Endocarditis.
• Meningitis.
• Pericarditis.

A severe form of pathology with large lesions and tissue destruction, causes a number of complications associated with the effects of toxins. As a rule, this is acute cardiac, hepatic and respiratory failure, infectious-toxic shock, acid-base imbalance, thrombohemorrhagic syndrome.

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Diagnostics focal pneumonia

Several methods and procedures are used to detect pneumonia and determine its type. Diagnostics are based on symptoms and are usually not difficult. There is such a thing as the "gold standard" of diagnostics (developed by A.G. Chuchalin in 1997), let's consider it in more detail:

1. Acute onset (fever, elevated temperature, chills).
2. Cough with the separation of purulent sputum with streaks of blood.
3. Auscultatory changes over the affected lung (shortening of the pulmonary sound).
4. Leukocytosis, leukopenia.
5. Infiltrate in the lungs (determined by X-ray).

During the examination of a patient, doctors use the diagnostic minimum, which consists of:

• Chest X-ray (two projections).
• General and biochemical (liver enzymes, urea, electrolytes, creatinine) blood tests.
• Sputum examination to determine the pathogen.
• Serological diagnostics.
• Arterial blood gas analysis (performed in severe cases of the disease).

The diagnosis is made in the presence of focal infiltration of lung tissue confirmed by X-ray and at least two clinical symptoms (fever, cough with sputum, wheezing, fever, etc.). The absence of infiltration makes the diagnosis uncertain and imprecise. In this case, the doctor relies on complaints, local symptoms and epidemiological anamnesis data.

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Tests

Diagnosis of focal inflammatory lesions of the respiratory organs is a rather complex process. Tests allow us to identify pathological changes in the body and confirm the diagnosis.

Laboratory signs of the disease:

• General clinical blood test – reveals leukocytosis with a shift in the leukocyte formula. If the disease has taken a croupous form, then toxic granularity of leukocytes appears. Severe course is characterized by an increase in ESR, aneosinophilia. If there is no reaction from the blood, then this indicates a reduced status of the immune system.
• Biochemical blood test – signs of inflammation are manifested as an increase in haptoglobin, lactate dehydrogenase, alpha-2 and gamma globulins, sialic acids and the appearance of C-reactive protein in the blood.
• Blood gas analysis – performed in severe and complicated cases of the disease. Arterial blood is used for diagnostics, in which a decrease in oxygen saturation, hypoxemia and hypercapnia are detected.

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Sputum examination

Microbiological examination is very important when there is a suspicion of focal pneumonia. Sputum allows us to identify the pathogen and conduct a quantitative assessment of the microflora content. But this type of diagnostics has certain difficulties. First of all, this is due to the fact that the coughed up material is contaminated with opportunistic bacteria. As a rule, this is contamination with anaerobic bacteria. To confirm the diagnosis, a study of the anaerobic microflora of the material obtained from the lower respiratory tract by aspiration through the trachea, bronchoscopy or transthoracic puncture is carried out.

The causative agent of the disease is considered to be microorganisms cultured from sputum in the amount of 1 million or more microbial bodies. Simultaneously with the sowing on elective biological media, smears of sputum are taken during bacterioscopy. Some of the smears are stained for cytological analysis using the Romanovsky-Giemsa method. This allows determining the presence of atypical cells, erythrocytes, alveolar and bronchial epithelium, the number of leukocytes. The second part of the smears is used to identify gram-positive and gram-negative microorganisms and assess the microflora. Staining is performed using the Gram method.

Instrumental diagnostics

Many different methods are used to detect focal inflammation, but instrumental diagnostics deserve special attention. This diagnostic complex includes chest X-ray. It allows detecting pathological changes in tissues from the first days of the disease. Focal inflammation is characterized by the appearance of individual lesions, which can be localized in one or several segments of the lungs.

If the disease has a complex course, then CT and ultrasound are used as instrumental diagnostics. This is also necessary for differentiation from pleural effusion, lung abscesses, encapsulated pleurisy and other diseases with similar symptoms. There are invasive instrumental methods that help in diagnosing the disease. These are fibrobronchoscopy with quantitative assessment of sputum, transthoracic biopsy, transtracheal aspiration and other procedures.

Differential diagnosis

In its symptoms, focal inflammation of the lungs and bronchi is similar to other diseases affecting the respiratory system. Differential diagnostics allows to recognize pneumonia from other lesions. First of all, differentiation is made with tuberculosis, various tumors, pulmonary infarction, chronic bronchitis, abscess. For clarification, X-ray and tomography of the lungs, morphological and cytological examination of sputum, biopsy and bronchoscopy are performed.

Pneumonia differs from tuberculosis by the localization of inflammation in the lower lobes, characteristic X-ray data and the absence of tuberculosis mycobacteria in the sputum. The disease is difficult to distinguish from focal pneumosclerosis. The pathology is characterized by small bubbling rales in a certain area of the lung over a long period of time. Exacerbation of pneumosclerosis is similar in its signs to the acute onset of focal pneumonia.

The difference between lobar pneumonia and focal pneumonia

All diseases affecting the respiratory organs are similar in their symptoms. The difference between lobar pneumonia and focal pneumonia lies in the mechanism of development of the disease.

1. Lobar pneumonia is an inflammatory process that affects an entire lobe of the lung. It occurs due to staphylococcal or pneumococcal infection.
   • Acute onset, sudden rise in temperature, cough, severe chest pain, general sweetness, facial flushing, shortness of breath, tachycardia, persistent high temperature.
   • The disease has several stages of lung tissue damage, which are determined using radiography. The first (confluent) stage occurs in the first days of the disease, the hepatization stage is 4-7 days, and the resolution stage is from 7-9 days until complete recovery.
   • Active therapeutic treatment is used to eliminate the disease. Patients are prescribed a course of antibiotics or sulfonamides. Treatment can be done both in hospital and outpatient settings. Patients are prescribed bed rest, plenty of fluids, and dietary nutrition.
2. Focal pneumonia is an inflammatory lesion of small areas of lung tissue, alveoli and bronchi.
   • It occurs against the background of an infectious and inflammatory process in the bronchi and bronchioles, spreading to the entire respiratory system. Very often it is preceded by acute respiratory viral infections, laryngitis, tracheobronchitis and even an advanced cold.
   • The causative agents are various harmful microorganisms (staphylococci, pneumococci, streptococci), often in combination. Infectious diseases, lung injuries, the postoperative period can also lead to the development of the disease.
   • Characterized by an acute onset with severe chills, a sharp increase in temperature, rapid breathing and cough with sputum. If the disease appears as a secondary lesion, then the symptoms are blurred. Against the background of a slow onset, a deterioration in the general condition, tachycardia, and subfebrile temperature are observed.
   • Treatment usually takes place in a hospital setting under medical supervision. Patients are prescribed antibiotics, antimicrobials and anti-inflammatory drugs. Particular attention is paid to lung ventilation, as pneumonia can cause pathological complications.

To differentiate between croupous and focal inflammation, radiography, microbiological and bacteriological examination of sputum, ultrasound, CT, and bronchoscopy are used.

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X-ray for focal pneumonia

One of the most reliable methods of diagnosing respiratory diseases is an X-ray. X-rays have extensive capabilities that allow you to detect inflammation from the first days.

Indications for X-ray:

• Cough with sputum production, chills, fever, increased white blood cell count.
• To monitor treatment results and track changes in tissue condition.
• If you suspect inflammation of the lung tissue or another disease.

The only contraindication is pregnancy. However, if acute inflammation is suspected, the X-ray is performed with maximum protection of the woman from radiation.

Signs of focal lesions:

• Intense infiltrate of non-homogeneous structure.
• Linear stringiness and fluid level in the costophrenic sinus on the affected side during inflammation of the pleura.
• The shadings have a fuzzy outline.

X-ray at the resolution stage:

• Disappearance of infiltration.
• Adhesive process of the costophrenic sinus.
• Linear stiffness due to connective tissue.

After the image shows no infiltrates, a deformation of the lung pattern appears in the affected area. To detect residual tissue changes, radiography is performed a month after recovery.

Treatment focal pneumonia

Various methods are used to eliminate pneumonia. Treatment depends on the pathogen, in 80% of cases it is pneumococcus. But staphylococcus, streptococcus, chlamydia, E. coli, mycoplasma and other harmful microorganisms can also cause damage to the respiratory system. Therefore, antibacterial drugs should be present in the treatment: fluoroquinolones, cephalosporins, penicillins. Medicines can be combined, used for both intravenous and intramuscular administration, the duration of use should not exceed 14 days.

In addition to antibiotics, the patient is prescribed general tonics and anti-inflammatory drugs. Particular attention is paid to mucolytic drugs. They are indispensable for coughing with phlegm to clear the bronchi of mucus and bacteria. Expectorant mixtures have a similar effect. For local treatment of the throat, inhalations and sprays based on drugs and vegetable oils are used.

If the inflammation is secondary, i.e. it appeared against the background of the main disease, then this disease is treated first. In case of prolonged pneumonia, the best treatment option is considered to be the use of strong antibiotics (Streptomycin, Penicillin, Biomycin). Chronic forms are treated with autohemotherapy, i.e. drugs that cause a general restructuring of the body. This method is based on the introduction of the patient's own blood, not mixed with drugs. Cardiovascular drugs can be prescribed as a supportive treatment.

Once the acute symptoms of the disease have passed, the patient is prescribed physiotherapeutic procedures - electrophoresis, UHF. Treatment with any medications should only be carried out according to a doctor's prescription and under his supervision. Self-medication threatens to worsen the condition and cause death.

Medicines

Treatment of focal pneumonia is based on the use of various drugs. The drugs are selected individually for each patient. Immediately after diagnosis, the patient is prescribed broad-spectrum antibiotics. The duration of antibiotic therapy is from 5 to 14 days.

• If the disease is acute, then in addition to antibiotics, sulfonamides are prescribed: Sulfalen, Bactrim, Sulfathiazine, Biseptol.
• For anti-infection protection, Immunoglobulin, Remantadine (anti-influenza drug) and Anistaphylococcal plasma are used.
• Of the anti-inflammatory drugs, Indomethacin, Antipyrine, Etimizole are most often used. Erespal, Hydrocortisone, Prednisolone have anti-inflammatory and expectorant properties.
• To regenerate the drainage function of the bronchi, bronchodilators are necessary: Adrenaline, Euphyllin, Ephedrine.
• For dry, debilitating coughs, use antitussive medications - Tusuprex, Codeine, Glauvent.
• For better expectoration of sputum, Bromhexine, Lazalvan, Solutan and physical therapy methods are prescribed - chest massage, breathing exercises, positional drainage.

If the disease is severe, then auxiliary means are used to normalize the acid-base balance, cardiovascular, diuretic and pain-relieving drugs.

Antibiotics for focal pneumonia

Pneumonia is an infectious inflammatory disease affecting the interstitial tissues of the lungs, bronchi and alveoli with accumulation of exudate. Antibiotics for focal pneumonia are used from the first days of the disease. They are prescribed after determining the pathogen, so at first, broad-spectrum antibiotics are used.

Modern antibacterial agents:

1. Semi-synthetic penicillins
   • Amoxicillin
   • Solutab
   • Augmentin
   • Amoxiclav
   • Sulacillin
   • Tazocin
   • Ampiox
   • Oxacillin
2. Cephalosporins
   • II generation – Cefuroxime, Cefaclor, Axetil.
   • III generation – Claforan, Cefotaxime, Ceftazidime, Cefoperazone, Ceftibuten.
   • IV generation – Cefpirome, Cefepime.
3. Fluoroquinolones
   • Levofloxacin
   • Avelox
   • Moxifloxacin
   • Tavanic
4. Carbapenems
   • Tienam
   • Meropenem
   • Cilastatin
   • Imipenem
5. Macrolides
   • Azithromycin
   • Fromilid
   • Sumamed
   • Midecamycin
   • Klacid

In addition to the above-described groups of drugs, aminoglycosides (Amikacin, Amikan), monobactams (Azaktam, Aztreonam) and tetracyclines (Vibramycin, Doxycycline, Solutab) are also used.

The advantage of modern antibiotics is that they are more effective and active against most microorganisms. They have an extended spectrum of action with minimal toxic effects on the central nervous system, kidneys, and liver. They also have high bioavailability and minimal side effects.

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Folk remedies

In the treatment of pneumonia, both classical methods approved by medicine and non-traditional ones are used. Traditional treatment is used as a supplement to the main therapy. But do not forget that herbal remedies and other traditional methods are not an alternative to modern drugs.

Traditional treatments include:

• Herbal teas and infusions
• Inhalations
• Warm foot baths
• Massage and rubbing
• Compresses

All procedures are used for symptomatic therapy, restoration of the drainage function of the bronchi and general strengthening effect. Such treatment helps to eliminate cough and improve general well-being. But non-traditional methods can be used only after the doctor diagnoses focal form of lung and bronchial damage.

Folk recipes for focal pneumonia:

• Peel a couple of heads of garlic, chop them and place them in a glass container, closing the lid. After 30-40 minutes, strain and add a liter of Cahors wine to the garlic juice. The remedy should be infused for 2-3 weeks, after which it should be strained again and poured into a jar or glass bottle. The medicine is taken 1 spoon per hour throughout the illness.
• Grind one onion and squeeze the juice out of it. Mix the juice with an equal amount of honey and let it brew. Take a spoonful of the remedy before each meal.
• Heat 100 g of honey and mix it with the same amount of fresh cottage cheese. Spread the resulting mixture evenly on the body in the chest area, cover the area with a warm cloth or towel. It is better to apply the compress overnight, after drinking hot tea.
• Grind a couple of heads of garlic and mix them with 500 g of melted goose fat. The mixture should be heated in a water bath for 10-20 minutes, applied to parchment and applied to the body. Wrap the compress with a warm woolen scarf on top and leave overnight.

Herbal treatment

Traditional medicine methods help to minimize painful symptoms and speed up the recovery process. Herbal treatment of focal pneumonia is especially popular. Let's look at effective herbal recipes used for inflammation of the respiratory tract.

• Pour 300 ml of vodka over a handful of wormwood and let it brew for 4-6 days. The remedy should be shaken daily and kept in a cool, dark place. Once the medicine has brewed, it should be filtered and taken 1 spoon 3-4 times a day.
• Pour 500 ml of boiling water over a spoon of calendula, chamomile and St. John's wort flowers and leave for 1-2 hours. Strain the infusion and take 1/3 cup 2-3 times a day.
• Mix 200 g of oats with 50 g of melted butter, 150 g of liquid honey and a liter of milk. Mix the medicine well and heat to a boil over low heat for 30 minutes. Strain the resulting decoction and take 1 glass before bed.
• Pour 500 ml of hot liquid flower honey over the viburnum berries and leave for 5-8 hours. Pour a glass of boiling water over a spoonful of the honey-berry mixture and leave for 1.5-2 hours. Strain the resulting infusion and take it warm, 1/3 of a glass 2-3 times a day. This remedy is excellent for severe coughing and wheezing.
• Take raspberries, coltsfoot leaves and oregano in a ratio of 2:2:1. Pour boiling water over a spoonful of the mixture, let it brew for 20-30 minutes and strain. Take the medicine before bedtime, it is contraindicated for pregnant women.

Homeopathy for focal pneumonia

In addition to traditional medicine, homeopathy is considered another non-traditional method of treating infectious inflammation. The use of homeopathic remedies is quite popular. Homeopathy is suitable for patients with individual intolerance to strong chemical-based drugs. A properly selected homeopathic remedy allows you to qualitatively and completely cure pneumonia of any form.

The famous homeopath Pierre Jousset has developed an effective treatment regimen for focal pneumonia, let's look at it:

At the onset of the disease, the following remedies are used:

• Aconitum 3X, 3
• Belladonna 3, 6,
• Veratrum viride
• Ferrum phosphoricum 3, 6

As soon as the temperature begins to decrease, take Ipecacuanha 6 and Bryonia 6, 5-7 drops every 2 hours. For dry cough, Ipecacuanha 6 and Phosphorus 6 are prescribed, 5 drops in turn every 2 hours. If the disease is complicated, then Jousset is recommended Arsenicum album 3, 6. This scheme is considered conditional, since the drugs and their dosage are selected depending on the symptoms of the disease and the individual characteristics of the patient's body.

Surgical treatment

If pneumonia occurs with serious complications, then conservative therapy alone is not enough. Surgical treatment is used in case of lung decay, persistent cicatricial changes in the lung tissue, the presence of purulent exudate and purulent cavities, bronchiectasis and other pathologies. The operation can be performed in chronic forms of the disease, when long-term intoxication leads to irreversible morphological changes in the lungs and other vital organs.

If the disease occurs with a large accumulation of fluid in the pleural cavity, the patient undergoes bronchoscopy with bronchial tree lavage. In case of an abscess and the threat of infection of the pleural cavity, drainage is performed (puncture is contraindicated).

Rehabilitation of patients with focal pneumonia

Recovery from respiratory diseases is a long process. Rehabilitation of patients with focal pneumonia takes about 3-4 months. In order to fully recover, patients are prescribed a program that consists of several stages, let's consider them:

1. Fighting the pathogen and destroying it, alleviating painful symptoms.

If the disease proceeds without complications, this stage takes 1-2 weeks. The patient is prescribed antibiotics, immunostimulants and a number of other drugs to eliminate the disease. This stage ends after the X-ray shows no foci of inflammation and the high temperature has gone.

2. Regeneration of lung functions and prevention of complications.

The patient is prescribed a diet, special procedures to stabilize the electrolyte balance. Inhalations, electrophoresis and UHF, therapeutic exercises are used. This stage can take place in special institutions - sanatoriums, hospitals. The main goal of such measures is to restore the activity of the alveoli.

3. Complete rehabilitation of the body.

If the above stages are effectively completed, at this stage the normal functioning of all organs and systems is completely restored.

Prevention

To prevent focal pneumonia, many effective methods and procedures are used. Let's consider the main preventive measures:

• Timely treatment of colds and any other diseases of the body.
• Treatment of chronic diseases.
• Strengthening the protective properties of the immune system (vitamin therapy, hardening).
• Proper healthy nutrition.
• Physical activity, breathing exercises and therapeutic exercises.
• Avoid hypothermia and contact with infected people.

Prevention of focal pneumonia helps strengthen the body and increases resistance to various viruses, infections and inflammations.

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Forecast

The outcome of treatment depends on a number of factors, including the patient's age, the type of pathogen, the presence of concomitant diseases, the general state of immunity and the body's adequacy to the therapy. The prognosis is significantly worsened by complications such as:

• Immunodeficiency state of the patient
• Exudative pleurisy
• Respiratory and cardiopulmonary failure
• Abscesses
• Resistance of pathogenic microflora to antibiotic therapy
• Endocarditis
• Anemia
• Toxic shock

Focal pneumonia, with timely and adequate treatment, always leads to recovery. According to medical statistics, in 70% of cases, complete restoration of lung tissue is observed, in 20% - pneumosclerosis and in 2% of patients - a decrease in the lobe or segment of the lung.

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