Right-sided pneumonia in a newborn. Types and features of pneumonia in newborns. Treatment of pneumonia in newborns - photo gallery

Almost all adults know what pneumonia is. But, not everyone knows what can cause pneumonia in children. How to determine the presence of symptoms of the disease? What are the features of this disease? And how to cure pneumonia in newborns and how long does the treatment take? We will describe this in detail in our article.

Description and main features of the course of the disease in newborns

Pneumonia belongs to the category of acute infectious diseases. During this disease, intraalveolar exudate is formed. The infection affects the respiratory sections of the lungs. The duration of the disease, as well as the overall clinical picture, depends on the age of the patient, the nature of the pathogen and the general condition of the body of the sick person.

Pneumonia is especially dangerous in newborns, since the child's body is not yet able to cope with this kind of infection on its own. But, unfortunately, it is in children that doctors most often diagnose bilateral pneumonia.

Usually in children, pneumonia develops against the background of bronchitis or SARS. At the initial stage of the disease, the child shows the following symptoms:

In infants, bilateral pneumonia is much more severe than in adults. This is due to some features of the child's body:

• lung type of tissue occupies too small an area;
• no naturally acquired immune reserve;
• the trachea has an insignificant length;
• pleural sinuses are not fully disclosed.

Inflammation of the lungs in children is accompanied by mixed or respiratory acidosis, hypercapnia and hypoxia. Due to respiratory disorders in pneumonia in young children, disruptions in homeostasis occur. This, in turn, leads to deterioration of external respiration. The form, depth, and also frequency of breath changes. The baby breathes with wheezing and whistling.

The initial stage of the disease in full-term babies is much more acute than in premature babies. However, in the first and second cases, the likelihood that a baby who has had pneumonia will get sick again is quite high.

Therefore, immediately after discharge from the hospital, doctors recommend starting a course of vitamin therapy and starting taking bioregulators. For a whole year after recovery, a newborn who has had pneumonia is under dispensary observation.

Signs of the disease and the mechanism of development of pneumonia in infants

Pneumonia is considered a polyetiological disease. For each age group, certain causative agents of this infection are characteristic:

• Viruses;
• bacteria;
• Fungi.

Factors that can provoke the development of the disease are the following:

1. immunodeficiency state.
2. SARS.
3. Stress.
4. Severe hypothermia.
5. Aspiration.
6. Heart disease.
7. Lack of vitamins necessary for the growth and full development of the child.
8. Rickets.

According to statistics, pneumonia most often affects premature babies, as well as infants with pathologies received during childbirth. Against the background of a simple ARVI, pneumonia usually develops in newborns with hypertrophy.

Babies who spit up a lot after feeding are also at risk. This is due to the fact that during regurgitation, vomit enters the respiratory tract.

The sooner the parents of a newborn child identify the initial signs of pneumonia and sound the alarm, the fewer complications the baby will have after recovery. A child under one year old with pneumonia must be in the hospital. You cannot self-medicate. Having identified the first signs of pneumonia in a newborn, you should immediately seek help from a pediatrician.

The main symptoms of pneumonia in children:

In full-term babies, the development of pneumonia is much more acute than in premature newborns. Body temperature rises sharply, and parents cannot bring it down. The child has a fever, he suffers from a strong cough. The baby turns pale, he has a noticeable shortness of breath, breathing becomes difficult.

In premature babies, the symptoms of the disease are not so pronounced. The body temperature does not rise above 38 degrees, the cough is dry, without sputum. The baby is naughty and cries because of the muscle and headache that tormented him. It is quite difficult to diagnose such gradually developing pneumonia. The doctor can make an accurate diagnosis only after passing the X-ray and passing all the tests.

Is it possible to give birth to a baby with pneumonia?

The question of whether a newborn can be born with pneumonia is of interest to many young mothers. Unfortunately, such an infectious disease as intrauterine pneumonia is not uncommon. Most often, this disease manifests itself in premature babies. Its first symptoms are noticeable within a couple of minutes after the birth of the baby.

A child may be born with pneumonia due to a violation of the integrity of the amniotic sac. Since in this case the fetus swallows infected amniotic fluid.

As a result, a newly born baby immediately needs treatment. Often, intrauterine pneumonia develops due to the fact that the expectant mother, shortly before the birth, had ARVI. The development of the disease can also provoke prolonged or premature birth.

Pneumonia in a newborn up to a year must be treated in a hospital. Doctors recommend not only infants, but also young children to undergo treatment under the constant supervision of a doctor. This is due to the fact that children under the age of 3 cannot adequately assess their condition, and parents do not always have time to quickly respond to the deterioration of the baby's condition. Treatment of older children can be carried out at home only if the doctor does not insist on hospitalization.

After the symptoms of the disease have been identified and the doctor has made a diagnosis, the newborn, regardless of his condition, is placed in the hospital. Inflammation of the lungs in babies is treated with antibiotics. The child is prescribed intramuscular injections, since a baby who has not reached the age of six months cannot swallow a pill. Having identified the causes of the disease and familiarized with the symptoms, the doctor prescribes a specific drug and specific doses.

If a child was born with pneumonia, he needs special conditions and a special temperature regime. Newborns diagnosed with pneumonia are kept in incubators. To maintain the right level of oxygen and stabilize breathing, doctors use some methods of oxygen therapy. The treatment of the disease should be comprehensive, therefore, in addition to taking antibiotics, specialists also prescribe a number of restorative measures for small patients.

During the treatment of pneumonia in newborns, parents should strictly follow all the advice of doctors. Being with the child in the hospital, you need to carefully monitor the condition of his body. If unilateral pneumonia is being treated, then the baby should not lie on the infected side, and if bilateral pneumonia is being treated, this means that every 2 hours the child must be turned over to the other side. The baby's chest should be tapped regularly, as this helps to accelerate the discharge of mucus.

If at birth the baby was diagnosed with pneumonia, then he will be discharged from the hospital only after all the symptoms of the disease disappear and remission occurs. Usually, doctors do not make predictions about how long the baby will have to spend in the hospital. This is due to the fact that the effectiveness of treatment depends on a number of different factors:

• individual features of development;
• congenital diseases;
• breast immunity.

Usually pneumonia in newborns is treated for 4 weeks. Regardless of what causes led to the development of the disease. The first 14 days are considered the most difficult. With the right treatment, after 2 weeks the body begins to recover. The recovery process takes approximately 14 more days.

Parents should be aware that pneumonia in newborns can be fatal. Therefore, the disease should never be allowed to take its course. When the first signs of pneumonia are detected in a baby, you should immediately seek help from a doctor.

Pneumonia in a newborn child is a fairly common infectious disease of the perinatal period. It can be classified as a particularly dangerous pathology, especially when it comes to bilateral inflammation. The statistics to date are not particularly reassuring, inflammation is diagnosed in 1% of full-term and 15% of premature babies (that is, those born before 37 weeks of gestational age).

It should be borne in mind that children in the neonatal period are especially susceptible to the action of various viruses and bacteria. Signs of pneumonia may differ depending on when the infection occurred (prenatal period, childbirth, neonatal period). Cases of manifestation of intrauterine pneumonia cannot be called rare. In such a case, the signs will be noticeable immediately after birth. Among the main factors provoking inflammation of the lung tissue, in the first place are acute respiratory infections transferred to a pregnant woman during gestation (carrying a fetus).

However, not every cold leads to the formation of intrauterine pneumonia, so do not panic. But you should not let the course of the disease go by itself.

Among the causative agents of pneumonia in babies, staphylococci and streptococci are most often isolated. It should be borne in mind that, based on the anatomical features, the lungs of a child born prematurely are less developed, respectively, he is more susceptible to the onset of this disease.

Among the main predisposing factors that provoke pneumonia, it is worth pointing out:

• severe or chronic diseases of the mother that manifested themselves during pregnancy;
• reduced immunity;
• anemia;
• the presence of foci of infection in the body of a pregnant woman, etc.

It should be remembered that pneumonia is extremely dangerous for babies. Hospitalization is required. It is dangerous to perform outpatient treatment, a small patient, together with his mother, must be under the constant supervision of specialists.

Causal factors

The development of the disease in newborns, as in older children, is provoked by various viruses, fungi, microbes, protozoa and bacteria.

Among the reasons that increase the risk of pneumonia, we can distinguish:

1. anatomical and physical features of the structure of the respiratory tract in childhood;
2. underdevelopment of the respiratory tract, especially pronounced in preterm infants;
3. bleeding in the mother during the period of gestation;
4. manifestations of chronic diseases of the mother during pregnancy;
5. acute viral diseases transferred by the mother;
6. discharge of amniotic fluid ahead of schedule, i.e. a long period without water (with an opened bladder).

Conclusion - the risk of developing pneumonia in a newborn child increases under the influence of various adverse factors.

It should be borne in mind that the risk of pneumonia in premature babies is increased several times.

Inflammation of the lungs in newborns is an extremely dangerous disease, in the absence of timely treatment, it can cause death due to acute respiratory failure. Among the causes that provoke the occurrence of pneumonia in babies during the neonatal period, there are:

• The infection passes from mother to fetus through the placenta.
• The infection enters the lungs of the fetus from the amniotic fluid.
• The infection enters the baby's body at the time of its passage through the birth canal.
• Infection of the baby occurs after birth.

The danger of pneumonia at an early age lies in the fact that pathology can lead to a lot of complications. In order to prevent such consequences, in the presence of the first symptoms of the disease, the baby should be shown to the doctor.

The duration of treatment is determined depending on the stage of the pathological process. Therefore, the sooner you consult with a specialist, the faster you can cure the baby.

Breast symptoms

As you know, inflammation of the lungs is characterized by damage to the walls of the alveoli under the influence of an infectious process that occurs in the tissues of the lungs. Symptoms of pneumonia in infants may vary depending on the type of pathogen that enters the baby's body, the method of infection and the overall resistance of the body.

With the intrauterine form of infection, babies are born into the world with already occurring pathological processes in the lungs. The likelihood of this form is significantly increased if the mother at the time of pregnancy also fell ill with pneumonia, especially viral.

It is not easy to diagnose the presence of pneumonia in crumbs. Among the characteristic features are:

• decreased muscle tone;
• pallor of the skin;
• difficulty breathing;
• intestinal spasms;
• loss of appetite;
• listening to wheezing on inhalation and exhalation;
• cyanosis of the nails on the hands and feet;
• refusal of fluid;
• frequent regurgitation, vomiting;
• a significant increase in body temperature.

Neonatologists will notice manifestations of inflammation in a baby after birth even before the mother and child are discharged from the hospital (maternity hospital). If there are signs of pneumonia in a child under one year old, you should immediately go to the hospital and undergo an examination, because inflammation is especially dangerous not only in the first month of a child's life, but also during the first three years.

If the baby's body temperature rises rapidly, it is necessary to call an ambulance.

Cough at the beginning of the disease may not be pronounced, but this symptom should be paid attention to. Nasal discharge and shortness of breath should also alert the mother. Shortness of breath leads to the appearance of cyanosis of the limbs due to a lack of oxygen in the body.

Features of diagnostics

It is easier to make an accurate diagnosis based on the examination of the newborn and radiological data than on the basis of an objective examination of the child alone. To confirm the presence of an infection, a series of laboratory tests should be performed to prove the presence of an infection. In any case, a child, even with suspected pneumonia, should be admitted to the hospital without delay. It is important to remember that the risk of death is too high.

Diagnosis of this disease in young children should include the following activities:

1. analysis of the clinical manifestations of the disease;
2. collection of anamnesis;
3. examination of the child;
4. x-ray examination;
5. study of laboratory parameters.

Particular attention should be paid to X-ray examination. In many cases, parents are looking for ways to refuse this event, but this is not true. Only radiography will help doctors identify the presence of foci of inflammation in the lungs of a newborn and help eliminate the likelihood of congenital anomalies of the lungs and bronchi, which aggravate the course of inflammation.

X-ray examination cannot be called a useful procedure for the baby, but in case of suspected pneumonia, it is unreasonable to refuse this event.

At this stage in the development of medicine, there are no more gentle and accurate methods for diagnosing pneumonia in pediatric practice. The first thing parents should think about is the possible consequences if the disease is detected late.

Proper treatment is the key to a successful recovery.

Early diagnosis of pneumonia in an infant is essential to a successful recovery. If the manifestations of pneumonia have become noticeable in a newborn even in the maternity hospital, he is placed in a special incubator to maintain and constantly monitor breathing and temperature.

Treatment of pneumonia involves active tactics. It is impossible to cure pneumonia in a child of the first days of life without the use of antibiotics. Depending on the condition, the use of a drug is prescribed, the active substance of which is penicillin or cephalosporin (in some cases, other active components may be used). Perhaps oral, intramuscular and intravenous administration. The expediency of using this or that form of the drug is determined by the doctor. Complex vitamin therapy is shown, the child's body must be provided with all the vitamins necessary for normal development.

Some bacteria and viruses are resistant to penicillin, therefore, the introduction of drugs from other groups is recommended.

Features of therapy are determined based on the severity of the course of the disease and the individual characteristics of the baby's body. However, taking antibacterial drugs is indicated for all forms of the disease. The temperature in the first days of the pathological process almost does not go astray, it drops only after the antibiotic "kills" most of the infectious agents. The baby's body begins to recover after the body temperature drops - the child's appetite returns, his breathing gradually returns to normal.

Dangerous Consequences

If the therapy of the disease is started in a timely manner, the risk of complications is low. If initially the therapy was chosen correctly, then after the acute stage of the disease, unexpressed symptoms of pneumonia may still persist for a certain time. The recovery phase lasts several months. At this time, the baby may be lethargic, refuse food. In some cases, severe pneumonia provokes a developmental delay.

Delay in treatment is fraught with the transition of pneumonia to the chronic stage. In such a case, periods of exacerbation will often be repeated. Also, the inflammatory process can capture healthy areas of the lungs and bronchi. Among severe complications, pleurisy and destruction of lung tissues are distinguished.

It is important to remember that in the event of a favorable outcome of the disease, any cold within a few months after recovery is dangerous with a potential complication in the form of pneumonia.

Editor

Pulmonologist, doctor of the highest category

Pneumonia is a group of diseases characterized by the development of inflammatory processes in the lung tissues. Pneumonia is an acute infectious disease that is widespread in both adults and children.

In this article, we will consider the features of the disease in newborns, as well as how and for how long it is treated.

Features of the disease in infants

In the case of pneumonia in newborns, the infection spreads inside the womb or immediately after birth. In this regard, their pneumonia is divided into two types:

1. - the infection spread during pregnancy through the placenta, amniotic fluid or through the birth canal.
2. Acquired- infection occurred after childbirth.

Usually, symptoms appear immediately or, in case of infection during childbirth, within two days. Most often, the disease appears if the fetus is premature, the mother's genitals are infected, or during prolonged labor.

Other development factors include:

• asphyxia and lack of oxygen in the womb;
• injuries received during childbirth;
• congenital heart defects with the development of heart failure;
• muscle underdevelopment.

Possible injury to the baby during childbirth

Inflammation of the lungs is the leading cause of death in children. Previously, death among newborns suffering from this disease reached 80% . Now it has dropped to 50% but still high. Action must be taken immediately after diagnosis.

There are also certain clinical recommendations for the diagnosis, treatment and prevention in infants (at the end of the article).

Symptoms

Symptoms of congenital pneumonia in infants are asphyxia, severe and sudden fever, weak and muffled cry, blue skin, rapid heartbeat and breathing, belching, vomiting is possible. The acquired form has similar symptoms, but diarrhea and general weakness are often added to them.

For diagnosis, parents are checked for infections, a general examination of the patient, additional instrumental and laboratory tests are carried out.

Treatment

If pneumonia is detected in a baby, it must be immediately hospitalized. In the first few months of life, it is treated only inpatiently children are under constant supervision. Doctors must carefully monitor the maintenance of the correct conditions (temperature, humidity), nutrition, and the condition of the baby.

General scheme of antibiotic therapy

All forms of pneumonia in newborns and infants are treated with. In most cases, the drug is administered parenterally (injection), but oral administration (swallowing) is not excluded.

It is difficult to clearly differentiate pneumonia (of what origin it is), and long-term diagnostics by determining the pathogen only hinders the initiation of timely treatment.

To prevent complications, therapy should be started as soon as possible. Typical forms of the disease are recommended to be treated with drugs of first choice. These include amoxicillin. The drug is well tolerated, has a low cost, and has a wide spectrum of antibacterial activity.

The following antibiotics can be used as analogues for therapeutic action:

• co-amoxiclav(penicillin);
• spiramycin, clarithromycin, azithromycin, erythromycin(macrolides);
• cefaclor, cefuroxime, ceftriaxone, cefotaxime(cephalosporins).

Cephalosporin group of antibiotics

If against the background of the use of penicillins there is no effect, it is necessary to “connect” the macrolide group, especially if pneumonia caused by chlamydia or mycoplasma is suspected. Therapy is carried out intramuscularly or intravenously. The calculation of the dose for newborns is carried out by a neonatologist. Doses are determined taking into account the weight of the baby.

In the absence of the effect of macrolides within 48 hours therapy should be changed. In such a situation, the use of drugs of the cephalosporin group is required. For example, a newborn may be offered cefuroxime, it is prescribed at the rate of 30 mg / kg / day. The drug is administered parenterally.

In the absence of positive dynamics after the use of cephalosporins, most likely there will be a need to use chloramphenicol(10-15 mg/kg). After the condition improves, the oral form of the remedy is applied.

Important! To rationalize the use of antibiotics allows only preliminary culture for sensitivity to antibiotics. Its results allow you to unambiguously determine which bacterium has caused harm. Unfortunately, the results of bacterial culture sometimes have to wait up to 5 days or more.

The choice of antibiotics depending on the form of the disease

Anaerobic pneumonia is treated clindamycin, lincomycin(according to the instructions it is allowed from the age of one month, in practice it is used earlier), inhibitor-protected penicillins.

Atypical forms of pneumonia are amenable to macrolides.

The drug Biseptol 480 (co-trimoxazole)

Cytomegalovirus pneumonia requires the use of specific anticytomegalovirus immunoglobulin. If the cause of pneumonia is the herpes virus, an antiviral agent should be used. acyclovir.

Immunodeficiency pneumonia needs drugs such as vancomycin + amikacin. Also for the treatment of this form of pneumonia are recommended cephalosporins III-IV generations.

Pneumocystis pneumonia in newborns is treated co-trimoxazole(appointed from 6 weeks of life).

Therapy of fungal pneumonia takes place with the help of antifungal agents, for example, amphotericin B.

Course and recovery period

Therapeutic therapy, especially in severe pneumonia, requires control x-ray studies. In some cases, with the appearance of severe complications: pleurisy, pneumothorax, destructive complications, one has to resort to surgical methods of treatment.

Newborns who have had pneumonia are obligatorily placed on dispensary records. The frequency of receptions is determined by the pediatrician. Usually examinations are scheduled after 1, 3, 6 and 12 months.

The disappearance of intoxication and retraction of the lower part of the chest, the normalization of body temperature are the main criteria for the effectiveness of treatment.

In addition, the child is given glucose (maintaining energy and life), saline solutions (detoxification), drugs to relieve symptoms. In particular, nose drops, rosehip decoctions, infusions, compresses and more. The baby also needs to be turned from side to side so that there is no stagnation of mucus.

How much is treated?

How long a newborn is treated depends more on the child himself and his immunity than on. According to the degree of damage, the following types are distinguished:

1. - inflammation of individual small areas of the lungs.
2. - inflammation of one lobe.
3. - defeat of one or more segments.
4. - damage to the connective tissue of elastic fibers and smooth muscles that make up the interstitial tissue of the lungs.
5. - inflammation of the tissues of the entire organ.

Duration of antibiotic therapy depending on the severity, etiology and site of therapy

How many newborns (premature babies) are in the hospital also depends on the disease, the baby itself, how long the pathogenetic symptoms last, and other data.

As a rule, the acute period of pulmonary inflammation lasts 2 weeks. With positive results, therapy continues 1–2 weeks after which the child recovers.

On average, recovery in newborns takes 4–5 weeks. It is considered complete when all clinical symptoms disappear and the nervous system works stably, the normal state returns to the baby.

After discharge from the hospital, a newborn child is redirected to a dispensary registration at a polyclinic. Examination by a doctor once a week.

Complications

Complications may develop, then intravenous infusions will be required. Complications are possible as follows:

• the appearance of seizures;
• poisoning the body with toxic substances;
• constant high temperature;
• a sharp decrease in appetite;
• elevated acetone.

The consequences of complications are different: abscess, respiratory failure, pleurisy, ITSH (toxic shock). They can also be secondary changes, catalysts for complications. In extremely severe cases, death is possible. Therefore, in no case should you engage in self-diagnosis and be treated without the supervision of a highly qualified specialist.

Folk methods

When treating a newborn with folk remedies, it is important to consider that many of the existing methods may cause allergic reactions The child has. Therefore, it is better to refuse folk remedies.

• compliance with bed rest;
• fractional and carefully selected;
• timely intake of prescribed medications.

Lactation

How long is the treatment and the healing process? In general, if the child does not have an acute stage, about 2 weeks.

Physiotherapy

Forecast and what to do after recovery

The prognosis is favorable with timely diagnosis and the use of antibiotic therapy. In advanced cases, complications, chronic difficulty in breathing, toxicosis, and chronic bronchial diseases may occur. In the worst case, death.

After pneumonia, it is necessary to ensure that the newborn child is calm, to ensure that none of the adults have a cold or other illness, as well as regular examination by a doctor. The basis of prevention are:

• prevention of infectious diseases;
• lactation;
• fractional proper nutrition;
• healthy lifestyle.

Thus, a timely visit to a doctor in a medical institution, as well as careful adherence to clinical recommendations, increase the chances of recovery.

Useful video

We invite you to watch an informative video in which Professor Ilyina N.A. makes a presentation on the topic “Pneumonia in children and newborns”

Pneumonia itself is a serious disease, and when it comes to young children, the situation can be critical. Congenital pneumonia in newborns is not so rare, and this is due to the fact that during pregnancy the expectant mother suffers an infectious disease. This subsequently affects the child, and the disease progresses in the first three days.

When a baby is born, the symptoms are immediately visible, and asphyxia, which occurs during childbirth, and the fact that the child is premature, join the painful condition.

Infants are a special category of patients, since their defenselessness and vulnerability to severe infection is obvious. The physiological characteristics of the baby contribute to the fact that the risk of getting sick increases significantly. Narrow passages in the bronchi, larynx, do not allow us to say that the baby can fight for life as well as an adult. The mucosa in babies is prone to edema, and removing sputum from the lungs is a rather difficult task. All systems have not yet been launched, they are not able to function fully. The lungs are more filled with blood than in adults, less elastic and therefore vulnerable.

Although inflammation can occur in the baby and outside the hospital, most often, the most severe cases occur with infection in the womb. It can also be the consequences of past diseases, such as SARS, whooping cough, measles.

With congenital pathology, the risk that the disease will be more severe than usual is quite large.

You can determine the symptoms of pneumonia, which was obtained in utero, by the following signs:

• the shade of the skin is bluish, the manifestations are most pronounced in the area of ​​​​the lips, on the tongue, the legs and arms may be bluish;
• the cry at birth is very weak, or not heard at all, since inflammation of the lung tissue does not allow it to be manifested in full force;
• breathing is confused, noise and wheezing are heard;
• the temperature in children born on time is significantly increased, as for non-term ones, it is below 36 degrees;
• the child is lethargic, poorly responsive to stimuli, reflexes are reduced;
• the appearance of edema on the legs is possible;
• the gag reflex is expressed, constant regurgitation is observed, both after eating and between them;
• weight decreases, the umbilical cord falls off an order of magnitude longer than in healthy children, and the wound in the navel area can become inflamed.

Symptoms that signal that infection occurred during childbirth are similar, but there are certain differences:

• high body temperature;
• refusal to eat, regurgitation is constantly observed, and vomiting occurs;
• the lips and the area in the nose become bluish;
• the stool is broken, constant pain in the abdomen, the child is naughty and does not sleep well;
• in full-term babies, breathing is noisy, with wheezing, while not full-term babies breathe weakly and rarely;
• intoxication of the body does its job, and this period is characterized by: weakness, drowsiness, poor reaction.

Types

The incubation period is short in time, and can range from several hours to seven days. Several forms of pneumonia in newborns, intrauterine and acquired, have been identified. Congenital, which are obtained during pregnancy, are divided into:

• transplantation, in which the pathogen enters the baby through the mother's placenta;
• intranatal, when infection occurs during the passage of the child through the birth canal;
• antenatal, in which infection occurs through the amniotic fluid, and affects the lungs.

After birth, the baby also has a high risk of getting sick, as the body is weakened, the immune system is not yet working, or is weak, which leads to infection. They share the infection outside the hospital, when the baby is already infected, and the hospital, if pneumonia occurs during the stay in the maternity hospital. This can happen in the intensive care unit, or in the pathology department. It should be noted that clinical manifestations also have a certain qualification, and they are divided into several types:

1. Focal, in which the focus and the area of ​​​​the lesion are large enough. The disease develops progressively, within about one week, or sudden, rapid development within three days, while the course of the disease occurs in a mild form, easily treatable with certain groups of antibiotics;
2. segmental does not manifest itself in any way, only with the help of x-rays it is possible to determine the compaction in the segments of the lungs, and it is usually caused by a viral infection. Can cause both SARS and influenza. There may be similarities with the segmental form, the symptoms are similar in the initial stage, but the general picture, which can be revealed using x-rays, does not appear until 2 weeks;
3. croupous differs in that its manifestation is affected by the allergic resistance of the child to infection. Against the background of bacterial diseases, this can be extremely rare, since the child's body has not met with such an infection and does not perceive it;
4. the intertitial form is characterized by seals, and is accompanied by an allergic reaction. Rashes and peeling appear on the skin, which may indicate the nature of the disease.

The reasons

Several causes that can cause this severe manifestation of pneumonia are divided into subgroups. The most common is bacterial infection.. These can be streptococci, anaerobic microorganisms that can exist in an oxygen-free environment, bacteroids that live in the soil. You can also find Listeria there.

Viruses can also be the cause of the disease, of which cytomegavirus and herpes are especially common. Herpes occurs against the background of reduced immunity. If during pregnancy the mother suffered one of the forms of herpes, then there is a high risk that the baby will be born with a pathology. Therefore, it is so important to follow all the rules and recommendations of doctors.

Fungal pathogens are also observed, which, with a weakened immune system, are activated, penetrate into the lower respiratory tract.

Much depends on what chronic diseases the woman suffered from, how she bore the child, in what conditions.

Combined pneumonia in newborns can also be observed, the consequences of which are not always good. It is important that there is an experienced specialist nearby who can determine that the baby is sick and take the necessary measures. It is the diagnosis that is in the foreground, only the speed of decision-making sometimes depends on the life of the baby.

Prevention

First of all, it is worth paying attention to the state of the epidemiological situation in the maternity hospital. It is this factor that is significant. Most often, congenital pneumonia in newborns occurs precisely inside the hospital, which is associated with non-observance of hygiene rules. In recent times, mortality from pneumonia has been a significant percentage, measures have been taken and certain requirements have been adopted that have helped to avoid many troubles.

At the moment, all conditions have been created in order to localize the infection as soon as possible and avoid death.

The prognosis for the course of the disease depends on many factors, and with the timely detection of the disease, the implementation of operational measures to neutralize the cause of the disease, the success of therapeutic actions is guaranteed.

Breastfeeding is desirable, since through breast milk the child receives all the necessary enzymes, the mother's immune defense, and this prevents the penetration and activation of the virus in the baby's body.

After the birth of a child, it is better not to put the risk of infection, not to stay in public places, try to isolate him from potential patients. The body of the baby is so weak that it can accept any infection, and thus be at risk of getting sick.

For a mother, before getting pregnant, it is important to exclude all inflammatory processes in the body, cure all possible diseases, and only then plan a pregnancy.

Treatment

Each child should have an individual approach, since only after a thorough study of the pathology of the mother, determining the presence of her diseases, effective treatment can be prescribed. It is desirable to stay in a hospital, and, at the first signs of illness, a prerequisite for a speedy recovery is the provision of qualified assistance. In this case, one cannot do without antibiotics, but for a small one it is always fraught. But, with a competent approach, everything is fixable, and the life of a child sometimes depends on the doctor, mother, relatives.

Carry out regular monitoring of body temperature and respiratory rate. The skin and mucous membranes must always be in perfect condition. Breastfeeding is shown, good nutrition is the key to successful treatment.

Immunoglobulins and antibiotics are indispensable drugs during treatment, only with their help can the disease be defeated.

Complications

If the therapy was carried out in a timely manner, and adequate drugs were prescribed to help localize the disease, then the prognosis for the treatment of such a disease as congenital pneumonia in newborns is quite favorable. Within a few weeks, everything will return to normal, and the baby will be healthy.

If you start the disease, then there is respiratory failure, toxicosis, refusal to eat, which leads to death.

In premature babies, the risk of getting dysplasia is high, the lung tissue does not function at full strength, there is a repeated exacerbation of diseases associated with the broncho-pulmonary system. This often leads to death.

Pneumonia in a newborn is usually called an acute disease of an infectious nature (causative agents of the disease are microorganisms), which is characterized by damage to the respiratory (participating in the actual gas exchange) sections of the lungs.

In this case, the child may show symptoms of systemic (affecting not only the site of the introduction of the pathogen) inflammation. Often, the signs of pneumonia in infants are reduced to respiratory distress, while the suspicion of pneumonia in a newborn occurs only with an x-ray examination (the image usually shows a shading area in the lower parts of the lungs - this is the focus).

Since from the very first minutes of life the location of the child is determined by the obstetric or pediatric department, pneumonia in a newborn can be congenital or nosocomial.

Pneumonia in a newborn is usually divided, depending on the microorganism, after the introduction of which inflammation in the lungs occurred, into the following types:

There are factors that predispose a child to develop congenital pneumonia. The latter are fetal prematurity, complicated pregnancy, the consequences of severe strangulation during childbirth, as well as infectious diseases in the mother (then the infection can be transmitted directly from the mother; this is called the transplacental transmission mechanism: through the placenta - the organ through which the fetus is nourished, with blood mother).

An illustration of the trans-placental transmission route in general.

An additional risk is a caesarean section (removing the baby through an incision in the abdominal wall and uterus, respectively). Also, the reasons due to which congenital pneumonia occurs may lie in the violation of the sanitary and epidemiological regime by the hospital staff (for example, insufficient care for the child's respiratory organs). In addition, the introduction of the pathogen into the body of a newborn can occur during a blood transfusion. Unfortunately, such consequences of medical activity are not so rare.

Fundamentally, different causes of pneumonia in a newborn are possible. However, most often the microorganism-causative agent is transplacental in the lungs of the child (consequences of the exchange of blood with the mother), as well as in the case of aspiration (inhalation by the newborn) of the infectious agent along with the amniotic fluid (the fluid that was the habitat for the fetus before birth). That is, congenital pneumonia is the most common.

In the first day of a child's life, if he has inflammation in the lungs, it may be difficult for a doctor to interpret the resulting signs of the disease as symptoms of congenital pneumonia. To understand the true cause of respiratory disorders in a child, you need to know about the indirect signs of inflammation in the lungs. The earliest signs are violations of the function of the gastrointestinal tract, which consist in the growth of food debris in the stomach, mixed with bile.

Symptoms in this case are poor suckling of the breast and constant spitting up during feeding the baby. At the same time, symptoms of general intoxication of the body can be observed: pallor (up to “gray”) skin,

enlargement of the spleen (splenomegaly) or liver (hepatomegaly). And sometimes even pathological jaundice occurs - yellow staining of the skin due to a violation of the processes of bile formation and bile secretion (there is also physiological jaundice: it is usually distinguished from pathological by how much bilirubin was detected in the patient during a biochemical blood test).

But the symptoms of pneumonia, characteristic of an adult patient, such as fever (fever) and cough, are completely uncharacteristic of pneumonia in infants.

If the newborn does not have congenital pneumonia, but acquired (nosocomial), it may be hidden behind conditions that require resuscitation (severe suffocation and other critical respiratory disorders of the child). All these are objective consequences of the natural (until treatment is prescribed) course of lung disease. Often, such a development of events accompanies premature babies, especially if a caesarean section was performed (an additional risk factor for infection).

Diagnostic measures in the detection of the disease

To confirm the diagnosis of pneumonia in a newborn, it is necessary to obtain x-ray data,

and also perform seeding

from the birth canal of the mother and the respiratory tract of the child, in order to understand whether the microflora (microorganisms) is the same in them. Also important signs are an increase in the level of leukocytes in the blood (an indicator of inflammation), an increase in the level of C-reactive protein in the time limit of 72 hours after birth (also confirms inflammation). In addition, there may be the following symptoms: the presence of purulent sputum during the first intubation (the introduction of a respiratory tube into the infant's respiratory tract), a significant increase in the newborn's liver on the first day after birth, as well as inflammation in the placenta, which is detected during its special histological examination (study of the tissue structure ) research. All these signs, especially if several of them are found together, indicate the presence of the disease with a high degree of certainty.

In addition to the above signs, important data indicating the possibility of pneumonia in a newborn may be previous infectious diseases in the mother: respiratory infections during pregnancy, chronic inflammation of the female organs or kidneys. Complications that occur in the mother after pregnancy are also important. They indirectly indicate its not quite favorable course.

At the same time, while listening to the child's lungs, wheezing in them will be detected, as well as weakening of breathing (muting of respiratory sounds).

Listening to the heart will give an increase in the number of its contractions in one minute (this is called tachycardia) and some muffled heart beats.

Basic therapeutic measures

Pneumonia is treated successfully (including the consequences of the disease) if optimal conditions for nursing the patient have been previously created.

Non-drug treatment consists mainly in inhalation (based on inhalation) measures: the newborn is given a humidified air-oxygen mixture. At the same time, the tension (quantity) of oxygen in the blood is controlled. Treatment is often accompanied by the transfer of the child to artificial ventilation of the lungs (the introduction of a tube into the trachea with parallel oxygen supply from a special apparatus).

Drug treatment of the disease usually involves antibiotic therapy. They are usually treated with penicillin antibiotics in combination with aminoglycosides (ampicillin is a broad-spectrum antibiotic). If the causative agent of the disease is established and this is Pseudomonas aeruginosa (pseudomonas aeruginosa, usually represents a nosocomial, rather than congenital infection), then the disease is treated with cephalosporins (also antibacterial drugs) of the 3rd generation (ceftazidime) with aminoglycosides (netilmicin).

In general, it should be noted that the choice of an antibacterial drug, first of all, depends on how many pathogens were found in the lungs of a particular child, which groups of microorganisms they belong to, and also on what consequences the disease had already caused by the time it was diagnosed. .

If the disease is especially severe, treatment may include drugs that directly target the immune system of the newborn. In children, it is not yet perfect, so it is better to avoid such effects. However, if the condition of the baby is really critical, immune therapy may be necessary.

Summary

If we calculate the percentage of mortality in pneumonia in newborns, figures of about 5-10% will be obtained. At the same time, lethality depends, first of all, on the processes against which the disease occurred, as well as on the degree of maturity of the child (pneumonia in premature babies occurs more often and is accompanied by formidable complications). The prognosis worsens if the disease occurs while the child is in the intensive care unit.

To understand whether a congenital disease or nosocomial, you need to take into account how much time has passed from the moment the child was born until the moment when he had the first symptoms of the disease.

Maternal behavior during and before pregnancy plays an important role in the prevention of pneumonia in newborns. In addition, it is important to comply with the sanitary and epidemiological regime, use the material once, as well as distribute babies in a ratio of no more than two newborns per nurse in the intensive care unit.