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Viral pneumonia has significant differences from bacterial pneumonia, and not only in treatment, but also in symptoms. Viruses are less likely to cause damage to the lungs, but if inflammation develops, it requires special attention, as the risk of complications is high.
With viral pneumonia, damage to the lung tissue (air sacs or alveoli, as well as the interstitial tissue surrounding them) occurs, an inflammatory process occurs, which is initiated by various types of viruses.
Usually, viral pneumonia occurs against the background of SARS or influenza, significantly complicating the general condition of the patient.
According to statistics, in childhood, up to 80% of all inflammatory processes in the lungs and bronchi are provoked by viral infections. With age, this ratio changes, adults are much less likely to get viral pneumonia, with the exception of older people, after 65-70 years.
Acute inflammation of the lung tissue can be caused by various types of viruses, but they all belong to the respiratory category – they enter the body through the upper respiratory tract, by inhaling drops of contaminated saliva, mucus from the nose or throat.
Most often provocateurs of viral pneumonia are:
- influenza virus type A, less often – type B;
- parainfluenza;
- adenoviruses;
- coronaviruses (in addition to SARS-CoV-2, which provoked the COVID-19 pandemic, MERS-CoV or SARS-CoV, which provoked outbreaks of infections in 2015 and 2002, are also dangerous).
More often, viral pneumonia affects people who, for whatever reason, have a reduced immune defense of the body. In such cases, pneumonia can be triggered by herpes viruses or cylomegaly, Epstein-Barr virus. Even less often, pneumonia provokes enterovirus, hantavirus, metapneumovirus. A similar inflammatory process in medicine is sometimes combined under the general term – atypical pneumonia. Viral pneumonias are of two types:
- primarywhen the inflammatory process in the lungs occurs in the first 3-5 days of illness;
- viral-bacterial (secondary, mixed) pneumonia is an infection that was initially provoked by a virus, but after about 5 to 7 days, pathogenic bacteria “settled” on favorable soil, increasing the inflammatory process in the lungs.
Viral pneumonia often occurs during the period of increased incidence of colds, flu – this is autumn, winter and early spring.
At risk for the development of this type of pneumonia, and, with its unfavorable course, include:
- people over 65 years old with a whole “bouquet” of chronic pathologies;
- patients with various types of immunodeficiencies;
- adults with heart disease, severe hypertension or coronary artery disease;
- men and women who have chronic bronchitis, asthma or COPD;
- diabetics, people who are on hemodialysis for serious kidney problems.
Viral pneumonia has its own characteristics of the course, depending on the virus that caused them and the characteristics of the patient. If it is pneumonia with adenovirus infection, it is typical for it:
- high temperature, which is poorly controlled by conventional antipyretics;
- strong dry cough;
- red throat, pain when swallowing;
- conjunctivitis and severe runny nose;
- swollen lymph nodes in the neck.
The malaise can last up to 2 – 3 weeks, the temperature can fluctuate within a day within 2 – 3 ° C, the doctor will hear wheezing in the lungs.
With pneumonia caused by the influenza virus, in addition to the typical symptoms – high fever, severe weakness, muscle and joint pain, nasal congestion, redness of the throat, there may be:
- severe shortness of breath;
- sharp painful cough with sputum streaked with blood;
- wheezing in the lungs;
- cyanosis of nails and nasolabial triangle;
- pain when breathing.
In severe influenza pneumonia, there may be vomiting, convulsions, impaired consciousness due to brain hypoxia (lack of oxygen).
Each viral pneumonia is unique in its course, but in general, three degrees of severity can be distinguished. This division is important for doctors who select treatment and draw up a plan for monitoring the patient, determine whether he needs to be hospitalized in a hospital.
Mild degree – with pneumonia, the syndrome of intoxication is poorly expressed (weakness, loss of appetite, headache, pallor). The temperature usually fluctuates between 37,5 – 38,0 ° C, decreases after taking antipyretic drugs. Usually a small amount of lung tissue is affected (up to 10 – 25%), changes in blood tests are slightly pronounced.
Medium severity – intoxication is more pronounced, nausea, vomiting, pallor, severe malaise with weakness at the slightest activity are possible. The temperature fluctuates between 38,0 – 38,8 ° C, the respiratory rate exceeds 22 – 24 per minute, the heart rate does not exceed 100 per minute. The volume of the affected lung tissue does not exceed 25 – 50%.
heavy defeat – intoxication is extremely pronounced, consciousness can be disturbed, metabolism is upset. The patient suffers from severe shortness of breath, the pressure is reduced, the pulse is extremely frequent, the changes in the analyzes are pronounced. Lung damage exceeds 50%, reaching 60 – 75%. Complications from organs and tissues are possible – blood clots, sepsis, cerebrovascular accident with coma.
If more than 75% of the lungs are affected according to CT, pneumonia is considered extremely severe, and the prognosis is unfavorable.
If you suspect the development of pneumonia, a doctor’s consultation is required. Only a specialist can determine the severity of the condition and the possibility of treatment at home or in a hospital. In the treatment of viral inflammation of the lungs, there are many of its own characteristics, so it is dangerous to be treated on your own.
Diagnostics
The first step is to contact a doctor at a clinic, a private clinic, or call an ambulance (if you suspect COVID-19 or a general serious condition). The doctor will definitely ask in detail about the symptoms and their development, in parallel assessing the general condition. Listening to the lungs (typical wheezing), measuring pressure and pulse, blood oxygen saturation with a pulse oximeter will be carried out (the norm is above 95%).
Of the surveys needed:
- blood tests – general, biochemical, coagulation, PCR for certain viruses;
- radiography of the lungs;
- sputum examination (including cultures, examination under a microscope);
- in case of suspected coronavirus or in difficult cases – CT scan of the lungs;
- consultation of other specialists in the presence of concomitant symptoms.
Modern treatments
Uncomplicated mild viral pneumonia can be treated at home. In more serious cases and patients at risk are treated in a hospital. Bed rest is indicated for the duration of fever and malaise, diet and plenty of fluids (warm fortified drinks).
Of the medicines can be prescribed:
- drugs against viruses – Acyclovir, Relenza, Tamiflu, Cytovir-3, Ribavirin or others, as decided by the doctor;
- antipyretic drugs (Rinza, Nurofen, Paracetamol, Nimesil, Ibuklin);
- B vitamins and ascorbic acid, vitamin D;
- antibiotics, but will be recommended only with changes in the analysis and the addition of microbial flora;
Your doctor may recommend oxygen therapy, drainage massage, and breathing exercises to clear your lungs and bronchial tubes as your condition improves.
The basis for the prevention of viral pneumonia is vaccination against influenza and coronavirus infection. In addition, it is necessary to observe the recommended precautions during the cold season – wearing protective masks, washing hands with soap and water, treating with antiseptics.
To stimulate immune defenses, hardening, vitamin therapy, physical activity and a healthy diet are indicated.
Popular questions and answers
Viral pneumonias are more difficult to diagnose than microbial ones. In addition, they have a number of features in the treatment, they can give specific complications. How contagious these diseases are, what are their features and whether it is worth using traditional medicine, we talked with general practitioner Vitaly Gorbunov.
To distinguish between viral and bacterial pneumonia, microbiological tests will be required, which is not always possible. Therefore, doctors, when making a diagnosis, are guided by a lot of supporting data (epidemiological history, methods of X-ray examination, and others).
If before pneumonia, for health reasons or age, you didn’t move much, you can’t do without an instructor in physiotherapy exercises.