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Left-sided pneumonia is the rarest form of pneumonia, which is recorded much less frequently than the right one, but is a more dangerous form of the disease, which is characterized by severe clinical symptoms.
If we analyze the entire incidence of pneumonia caused by community-acquired factors, then the mortality rate is about 5%. The vast majority of mortality is due to left-sided pneumonia.
How does the disease occur?
The lungs are the main paired organ of the respiratory system, in which oxygen is converted into carbon dioxide. Lung tissue consists of specific cells – alveoli, which perform the main respiratory function.
Anatomically, the left and right lungs are different from each other. The right one is made in three shares, the left one in two, as it has a heart notch. Each of the shares includes smaller segments.
An inflammatory focus in the alveolar tissue appears after the introduction, fixation and active life of a pathogenic agent – a virus, bacteria, fungus. At the beginning of the disease, the bronchi fall under attack, and later, the scale of the pathogenic process goes beyond them.
The peculiarity of left-sided pneumonia is that pathological transformations of an inflammatory nature can form after trauma, surgery, injections performed in violation of the rules of sterility. In this case, the infection spreads with the flow of lymphatic fluid or blood.
The descending path of origin of left-sided inflammation of the lungs is observed in infective endocarditis. In this condition, bacterial inflammation of the endocardium (middle layer of the heart) can spread to nearby lung tissue.
Signs of pneumonia, as a rule, are determined only in one lung – left or right. Unilateral inflammation can cover a different area, on which the form of the disease depends:
On a small area – a focal form.
In one or more segments – segmental / polysegmental form. In the right lung, segments II, VI, X are most often affected, in the left – VI, VIII, IX, X.
In a separate lobe – upper lobe or lower lobe pneumonia.
In all lobes of the lung – lobar form.
If the process extends to the entire lung, a total form of inflammation is recorded.
The difference between right-sided and left-sided pneumonia
The formation of left-sided pneumonia is observed quite rarely. This is due to the anatomical properties of the bronchial tree. The fact is that the left bronchus is narrower than the right one, which greatly complicates its drainage and blood supply. The peculiar structure negatively affects the completeness of the treatment received. Active compounds of drugs cannot be transported to the inflammation site in full. Insufficient drug exposure can significantly delay therapy, contribute to the transformation of the disease into a protracted form, and provoke the development of severe consequences.
Anatomical features allow the causative agents of pneumonia to penetrate into the right lung more easily and quickly. The most common pathogens are Haemophilus influenzae, pneumococcus, and staphylococcus aureus. The left lung is most vulnerable to atypical pathogens that affect its cells against the background of weakened immunity.
clinical picture
The severity of the disease, the type of pathogen, its susceptibility to specific therapy, the immune status and age of the patient, the extent of the pathological focus are all factors that affect the clinical picture of pneumonia.
Community-acquired pneumonia can occur in accordance with two main syndromes:
typical syndrome. The disease manifests itself suddenly, is characterized by a sharp increase in body temperature, the occurrence of a cough with purulent discharge. Patients complain of pain in the chest. During the study, zones of compaction in the lung tissue are determined. A typical syndrome develops when infected with aerobic and anaerobic microorganisms, some of which develop in the oral cavity.
atypical syndrome. Pneumonia is characterized by a gradual worsening of symptoms. The disease is characterized by the appearance of extrapulmonary symptoms – headache, myalgia, digestive disorders. X-ray shows minor changes in the lung. The disease develops when infected with chlamydia psitaki, tularemia, histoplasma, mycoplasma, legionella, Klebsiella.
Symptoms of the disease depending on the type of pathogen
Symptoms of pneumonia are due to the type of infectious agent. The differences can be visualized in the form of a table.
Causative agent | Features of the clinical picture |
Mycoplasma | Often leads to hemolytic anemia, erythema multiforme, encephalitis, transverse myelitis, eardrum damage |
Legionella | It is characterized by impaired consciousness, impaired liver and kidney function, and a decrease in the level of sodium salts in the urine. |
Chlamydia | On examination, wheezing, signs of sore throat, hoarseness of voice are determined |
aurococcus | The primary symptoms are fever and shortness of breath. In the future, sputum joins, the lung tissue becomes denser |
Failure | The pathology is characterized by the formation of peculiar metastatic foci on the skin, in the parts of the central nervous system |
Pneumonia can develop as a complication against the background of the main infection:
With a seasonal outbreak of a particular strain of the influenza virus.
During measles, chickenpox is combined with the appearance of a characteristic rash.
In syncytial virus, a respiratory infection most commonly seen in immunosuppressed children and adults.
Cytomegalovirus – in patients with HIV, patients undergoing immunosuppressive therapy after organ transplantation.
If pneumonia is the main pathology, then the clinical picture manifests itself in the form of a rapid increase in body temperature, fever, persistent dry cough without sputum. The addition of extrapulmonary symptoms is characteristic. Against the background of measles, influenza or chickenpox, a violation of respiratory functions is manifested, which provoke the development of secondary inflammation of the lungs.
Pneumonia of secondary origin can form simultaneously with the main infectious disease, regardless of its viral or bacteriological origin. In some cases, pneumonia manifests itself as a distant complication, a few days after the main symptoms have subsided.
Main symptoms
Clinical manifestations are not much different from pneumonia of other localization. Patients complain about:
Significant increase in temperature up to 40°C.
Hacking cough.
Attacks of night sweats.
Viscous sputum.
On examination, tachypnea, cyanosis of the nails, acrocyanosis is determined.
Diagnostics
The doctor may notice the first signs of left-sided pneumonia when examining the patient. During respiratory movements, the lagging of the left side of the chest is visually determined. When percussion over the affected areas of the left lung, a shorter sound is recorded. Fine bubbling rales, signs of crepitus are determined on auscultation.
Laboratory diagnostics. To determine the type of pathogen, a bacteriological analysis of sputum is performed.
A blood test allows you to set the level of leukocytosis with a shift in the formula, a higher ESR. Blood biochemistry determines the parameters of the main plasma protein.
Treatment
As we have repeatedly said, left-sided pneumonia requires the appointment of a long-term complex treatment.
Physicians face a number of challenges:
elimination of the infectious agent.
Restoration of the drainage function of the bronchi.
Stabilization of general immunity and resistance of the lungs to external factors.
Antibacterial therapy
Antibiotics are prescribed as early as possible, at the slightest suspicion of pneumonia. This step allows you to alleviate the main symptoms, prevent the development of complications. The appointment of a particular drug is carried out by a doctor. He also sets the duration of antibiotic intake.
If pneumonia resolves without exacerbation of other chronic disorders in a mild or moderate form, drugs of the aminopenicillin class, macrolides are prescribed. In the case when pneumonia is aggravated by concomitant pathologies, it is advisable to use II-III generation cephalosporins, amoxiclav in combination with macrolides of the latest generation.
If within 2-3 days there is no improvement in the patient’s condition, the antibacterial drug is changed. A certain positive effect is observed when prescribing III-IV generation fluoroquinolones (moxifloxacin, levofloxacin). In the case when pneumonia passes without complications, treatment at home is allowed. The patient takes all prescribed pharmaceuticals, and the attending physician periodically visits him and monitors the dynamics of the disease. When a person notes the positive results of therapy, you can not stop taking this or that drug on your own. This can exacerbate the overall picture of the disease, especially in infants, children, age patients. Only a doctor prescribes or cancels treatment.
Pneumonia in severe form requires hospitalization of the patient in a specialized department. Antibacterial drugs are administered intramuscularly or intravenously. First, aminopenicillins are prescribed. If the treatment does not give positive changes, the use of the latest production cephalosporins, macrolides, respiratory fluoroquinolones is started.
Additional therapeutic methods
Mucolytics are prescribed to thin the sputum and soften its removal. This is a group of drugs that can activate the functionality of the cilia of the bronchial epithelium. In order to detoxify, infusions of saline solutions, glucose, and albumin are indicated. To stimulate the general protective properties of the body, immune preparations are indicated.
Alkaline drinking positively affects the increase in the drainage properties of the bronchi. When the temperature stabilizes, massage is allowed, some exercises are performed right in bed. To facilitate the elimination of discharge, patients with left-sided pneumonia should lie more on their right side. Breathing exercises bring certain benefits.
After a patient with left-sided pneumonia recovers, a long course of immunostimulating drugs and vitamin complexes is recommended to strengthen immunity.
Video – how not to die from pneumonia:
ձախակողմյան թոքաբորբ,ուղեկվող ուժեղ գլխացավով։ինչ անե՞լ։