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Right-sided pneumonia is an acute inflammation of the right lung caused by viruses, bacteria or fungi. It occurs more often than the left-sided one, which is associated with the structural features of the organ.
The fact is that the right bronchus is smaller and wider than the left one, which facilitates the process of penetration of microbial flora into lung tissues.
The disease can develop due to a primary infection of the respiratory system, or become a complication of an existing inflammation. Typical symptoms of right-sided pneumonia are cough, chest pain, shortness of breath, fever.
Causes
Pathogenic flora leads to the development of inflammation in the right lung. The most common causative agents of the disease:
Streptococci.
Pneumococci
Mycoplasma and chlamydia.
Haemophilus influenzae.
Legionella.
Causative agents of viral infections: parainfluenza viruses, respiratory syncytial viruses, enteroviruses, rhinoviruses, etc.
Fungal flora: aspergillus, candida, pneumocystis, etc.
Risk Factors
Trigger factors for the development of right-sided pneumonia:
Congestive heart failure.
Chronic respiratory diseases (bronchus, nasopharynx, lungs).
The presence of a chronic focus of infection in the body.
Severe immunodeficiency.
Weakened and exhausted body, for example, after undergoing chemotherapy, severe injury or surgery.
Forced bed rest.
Hypothermia, stress.
Diabetes.
Smoking and alcohol abuse.
Elderly age.
Pathogenesis and ways of spread of infection
Pathogenic flora enters the right lung through the respiratory organs (distribution mechanism: airborne or contact), through blood or lymph. If the protective bronchopulmonary barrier is reduced, inflammation manifests in the alveoli. It quickly spreads to other departments.
Mucus accumulates in the lungs, which makes it difficult for normal gas exchange. This leads to the development of respiratory and oxygen insufficiency, which is manifested by symptoms characteristic of pneumonia. If the disease has a complicated course, then the patient develops heart failure.
Classification
Right-sided pneumonia is classified according to different criteria. Depending on the characteristics of the course of the disease, typical and atypical inflammation are distinguished.
Classification by pathogenesis and mechanism of development:
Primary (independent right-sided pneumonia).
Secondary (acts as a complication of other diseases).
Post-traumatic.
Postoperative.
Less often, the disease is caused by allergic agents, toxins and ionizing radiation. Also distinguish between community-acquired and nosocomial pneumonia.
The right lung consists of 4 segments. In this regard, there are:
Lower lobe right-sided pneumonia.
Middle lobe right-sided pneumonia.
Upper lobe right-sided pneumonia.
Radical right-sided pneumonia.
Polysegmental right-sided pneumonia (the whole organ is affected).
The disease can be acute, or become chronic, but with regular relapses.
Types
There are 4 types of right-sided pneumonia:
Croupous.
Focal point.
Interstitial.
Purulent.
The last type is the most dangerous. It is with purulent pneumonia that a large number of deaths are observed.
Symptoms
Regardless of the type of illness, there are common symptoms that suggest right-sided pneumonia. These include:
Increase in body temperature. In severe cases of the disease, it can reach 39 degrees and above.
Cough. At first it is dry, but from 3-4 days sputum appears.
Chills. The higher the body temperature, the stronger it is.
Dyspnea.
Pain in the chest, which will be concentrated on the right side. It is aggravated by coughing and trying to take a deep breath.
Change in skin color. Due to hypoxia, it becomes pale, cyanosis of the nasolabial triangle is possible.
Decreased blood pressure, increased heart rate.
On the right side of the chest, the skin is drawn into the intercostal spaces.
Increased sweating.
During breathing, the right side will, as it were, “lag behind”. In severe cases, it remains motionless.
Features of the course of right-sided pneumonia in children
The younger the child, the more dangerous right-sided pneumonia is for him. This is due to the immaturity of the immune system, which increases the risk of complications. In this case, the symptoms may be mild, especially in children under one year old.
Parents should consult a doctor if they notice a dry cough in a child, fever, cyanosis of the nasolabial triangle, shortness of breath. Infants refuse to eat, but their thirst increases.
In preschool children, right-sided pneumonia is most often the result of SARS or influenza. Therefore, it is recorded mainly in the cold season. Parents should pay attention to the atypical course of bronchitis or other colds. A cough that does not go away for a long time should alert.
Diagnostics
Diagnosis of right-sided pneumonia in most cases is not difficult. The only exceptions are atypical forms of the disease.
If you experience symptoms resembling pneumonia, you should consult a doctor. The doctor will listen to complaints, examine the patient, auscultate the chest.
The following studies are required to confirm the diagnosis:
Donating blood for general and clinical analysis. With pneumonia, the ESR increases, leukocytosis is observed.
Urinalysis for analysis (possibly proteinuria).
Submission of sputum for BAC culture to determine the pathogen and its sensitivity to antibiotics.
X-ray of the lungs. The image will show the focus of inflammation and its exact localization.
These studies are enough for the doctor to make a correct diagnosis. Sometimes an ultrasound of the pleural cavity is performed.
Treatment
Depending on the severity of the course of the disease, the doctor decides whether the patient needs to be hospitalized. If the person’s condition is satisfactory, outpatient treatment is possible.
Medical treatment:
Antibiotics. Penicillins are the drugs of choice. If after 3 days there is no improvement, they switch to cephalosporins, macrolides or fluoroquinolones. Sometimes an integrated approach is required using 2-3 drugs from different groups. The method of administration of the drug is determined by the severity of the course of the disease.
Mucolytics. They are designed to facilitate the discharge of sputum.
Antihistamines. They are designed to relieve swelling and reduce the severity of the inflammatory reaction.
Glucocorticosteroids and immunomodulators. They are used as a last resort.
Antipyretic drugs, for example, Ibuprofen or Paracetamol.
Even if the patient is not hospitalized, he must adhere to bed rest. At the same time, it is impossible to lie on the right side of the body for a long time, so that sputum does not stagnate in the affected lung.
Be sure to follow the diet. Products should be light, but nutritious. The menu includes fresh herbs, fruits and vegetables. From alcohol for the period of treatment and recovery refuse.
For better sputum liquefaction, plenty of fluids are indicated. Drinks must be warm. Be sure to regularly ventilate the room, carry out wet cleaning in it.
After 3-5 days from the start of therapy, you can connect breathing exercises, inhalations using a nebulizer. Percussion massage helps a lot.
Complications and prognosis of the disease
Right-sided pneumonia is a serious disease that is associated with a risk of complications. The most frequent of them are:
bronchial obstruction.
Gangrene or abscess of the right lung.
Respiratory or heart failure.
Endocarditis or myocarditis.
Pleurisy
The prognosis depends on whether the patient develops complications. With timely and competent treatment, it is favorable. Complete lung recovery is observed in 70% of patients. In this case, the age of the patient, the type of infectious agent, the state of immunity, the presence of chronic diseases are important. Right-sided pneumonia is especially dangerous in children under one year old and in the elderly.
Video: general practitioner Galina Kostousova “how dangerous is pneumonia?”
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