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Bacterial pneumonia is a common complication in patients treated in the hospital and clinic. In recent years, there has been an increase in severe forms that lead to death.
What is bacterial pneumonia
Bacterial pneumonia is an inflammation of the lungs that is caused by pathogenic bacteria that enter the respiratory system.
Such inflammation is formed under two conditions: either the body itself is weakened, when the immune system cannot effectively fight bacteria, or these are very aggressive bacteria that overcome the body’s resistance. Usually both options are present to one degree or another.
Causes of bacterial pneumonia in adults
Bacterial pneumonia is most often caused by bacteria that are considered part of the microflora of the respiratory tract. These microorganisms are categorized as opportunistic pathogens. If the body is healthy, not weakened, the immune system is working properly, the bacteria do not harm in any way. But under stress, operations, exacerbation of chronic diseases, severe SARS, bacteria can become dangerous.
There are two variants of bacterial pneumonia – community-acquired and nosocomial. They differ greatly in the type of bacteria that cause inflammation.
In community-acquired pneumonia, the inflammatory process usually provokes pneumococcus, Haemophilus influenzae, or streptococcus.
Nosocomial pneumonia is caused by particularly aggressive bacteria that are resistant to many antibiotics. These pathogens usually live in clinics – Staphylococcus aureus, Pseudomonas aeruginosa, enterobacteria and some others. Often, such pneumonia occurs in people who undergo mechanical ventilation.
If patients are immunocompromised, legionella, mycoplasma, pneumococcus, Haemophilus influenzae, and pneumocystis can cause pneumonia.
Bacteria enter the lungs from the air, with the blood flow from inflammatory foci in the body, or with the lymph flow, directly, with chest injuries. Risk factors that increase the likelihood of pneumonia are:
- frequent SARS and influenza;
- bad habits (they weaken the immune system);
- constant stress and overwork;
- deficiency of vitamins and minerals;
- age over 65 – 70 years;
- living in areas with air pollution.
Pneumonia is likely in people with COPD, heart problems, diabetics, against the background of sinusitis, after operations and injuries.
Symptoms of bacterial pneumonia in adults
In many ways, the symptoms of pneumonia depend on which bacterium causes them. The more aggressive the microbe, the more severe the manifestations. The most typical manifestations of bacterial pneumonia:
- a sharp increase in temperature, which is poorly controlled by antipyretic drugs;
- severe sweating, chills;
- cough that is moist from the first days, with copious sputum (has a greenish or rusty color);
- chest pain, especially with deep breathing;
- severe weakness with malaise;
- headache, aching muscles and joints;
- pallor, sallow skin color;
- low blood pressure, rapid pulse;
- frequent breathing, shortness of breath, wheezing when breathing.
If pneumonia is not treated, respiratory and heart failure, toxicosis, and even death can develop. Very rarely, there are atypical bacterial pneumonias, which have very few symptoms, they are mild, but the lungs are affected to a significant extent.
Treatment of bacterial pneumonia in adults
Many forms of bacterial pneumonia are well treated if the inflammation is recognized early. But it is important that the treatment is carried out under the guidance of a doctor. Without treatment, it is possible to damage a significant volume of the lungs, other organs and the death of the patient.
Diagnostics
The doctor focuses on the patient’s complaints and the data that he sees and hears. If the doctor listens to the chest with a phonendoscope, he will hear typical wheezing, breathing changes and the so-called crepitus (the noise of an inflamed lung). Bacterial pneumonia can be confirmed by:
- blood tests indicating severe inflammation (leukocytosis, changes in protein levels, clotting);
- chest x-ray with areas of eclipse where the lung is affected;
- CT scan of the lungs, if the diagnosis is not clear on plain X-ray;
- sputum culture for flora with the identification of a specific bacterium (or several) and the determination of sensitivity to antibiotics;
- saturation (blood oxygen saturation) less than 95%.
Additionally, if the case is complex, the doctor may prescribe other tests.
Modern treatments
You can treat bacterial pneumonia in mild and moderate cases at home, under the supervision of a doctor. In severe forms – in the clinic, intensive care unit and resuscitation. Bed rest, a light diet, and plenty of fluids (or intravenous fluids) are shown.
The main treatment is antibiotics: the doctor selects them based on these tests. Most often, penicillins, a cephalosporin group, or macrolides are used. If these are separate forms of pneumonia, more narrowly targeted drugs are selected. Medicines are taken orally orally or by injection intramuscularly for up to 14 days, in severe cases they are administered intravenously.
Complementary treatment:
- antipyretic drugs, anti-inflammatory drugs (Nurofen, Nise, Ibuklin, Rinza, Panadol);
- hormonal preparations in a short course;
- droppers with protein, saline solutions, vitamins and glucose;
- oxygen therapy;
- drugs for coughing up sputum (Bromhexine, ACC, Ambroxol, Fluimucil).
As the condition improves, the doctor adds breathing exercises, massages, physiotherapy, exercise therapy and subsequent rehabilitation in a sanatorium to the treatment.
Prevention of bacterial pneumonia in adults at home
Prevention measures are quite simple:
- timely treat foci of chronic infection – sinusitis, tonsillitis, otitis media;
- strengthen immunity through proper nutrition, physical activity, taking vitamins;
- get vaccinated against pneumococcal, haemophilus influenzae, and influenza;
- avoid contact with sick people;
- follow the rules of hygiene.
Popular questions and answers
Although a bacterial infection is treated with antibiotics, it is not as simple a disease as it might seem at first glance. Inflammation of the lungs can lead to serious complications in a short time, which she told us about. pulmonologist Elena Zaryanova.
If we talk about bacteria, then pneumococcus is the most common causative agent of community-acquired pneumonia and accounts for up to 30-50% of cases. Therefore, the clinical picture of pneumococcal pneumonia is considered typical for most community-acquired pneumonia. Community-acquired bacterial pneumonia usually develops after hypothermia against the background of reduced immunity, more often in winter. Bacterial pneumonia is characterized by infection of the lungs by inhalation of oropharyngeal secretions and less often by inhalation.
Viral pneumonia, unlike bacterial pneumonia, develops in several stages. Respiratory viruses primarily infect the epithelium of the upper respiratory tract, and then descend into the lower respiratory tract and infect alveolar cells (alveocytes). The pathogenic effects of viruses are manifested in the deterioration of the mucociliary clearance (the apparatus of the lower respiratory tract, which provides protection and purification of the lungs from inflammatory agents). This facilitates the penetration of bacteria into the lower respiratory tract, suppresses the protective, including antibacterial function of immune cells, resulting in the creation of conditions for the formation of viral-bacterial associations.
Mixed infection leads to a more severe course and a change in the clinical picture of the disease, a violation of the drainage function of the lungs, and a prolonged resolution of inflammation.
What are the complications of bacterial pneumonia?
● the appearance of wheezing in the chest;
● increased shortness of breath;
● the development of shortness of breath and poor expectoration of sputum.
Less common complications such as pleurisy, when the inflammatory fluid enters the pleural cavity surrounding the lungs, and squeezes them from the outside. In this case, the patient on the side of the lesion may experience pain in the chest during breathing, intensify or develop shortness of breath, and a sharp rise in temperature.
Another serious complication that requires hospitalization of the patient is the destruction of tissue as a result of pulmonary inflammation with the formation of cavities in the lungs filled with purulent contents (abscesses) and the development of systemic septic inflammation, which can lead to damage to various organs and systems, the development of acute and severe respiratory, heart, kidney and liver failure.
Elderly patients, immunocompromised individuals with chronic diseases, the risk of complications from pneumonia is very high, and therefore it is advisable to immediately hospitalize such patients in a hospital.
When to call a doctor at home for bacterial pneumonia?
If by the 3rd day of the disease the patient does not improve from the prescribed antibiotic therapy or notes a gradual increase in respiratory symptoms, an increase in body temperature and symptoms of general intoxication by the 7th day of the disease, then it is necessary to call a doctor or an ambulance to the house to resolve the issue. on the replacement of an antibacterial drug and possible hospitalization for the purpose of further selection of treatment and additional examination in a hospital setting.
Bacterial pneumonia develops quickly, begins acutely and is manifested by the following symptoms:
● increase in body temperature,
● the appearance of a cough with sputum, more often of a purulent nature,
● chest pain when breathing,
● signs of general intoxication: palpitations, headaches, loss of appetite and nausea, weakness, sweating, etc.
With these complaints, the patient should soon seek medical help from a polyclinic doctor in order to examine and clarify the diagnosis, determine the place of his treatment (at home or in a hospital) or call a doctor or an ambulance team at home (if the body temperature is above 38 ° C, severe shortness of breath has developed, there are signs of general intoxication, hemodynamic disturbances in the form of an accelerated pulse, a decrease or increase in blood pressure, etc.).