Causes of pneumonia in children
Pediatric pneumonia is the most common respiratory disease in children, which is easy to occur all year round. Babies under 3 years old are more prone to pneumonia in winter and spring. If the treatment is not thorough, it is easy to relapse and cause a variety of serious complications, affecting the child's development. It is characterized by fever, cough, shortness of breath, dyspnea, and rales in the lungs. Some people have no fever but have severe cough and asthma. Children's pneumonia has typical symptoms and atypical symptoms, especially neonatal pneumonia. Pneumonia caused by bacteria and viruses is the most common. At present, pneumonia in children can be prevented by vaccines.
Etiology of pneumonia in children
1. Prenatal fetus lives in the uterus filled with amniotic fluid. When there is hypoxia (such as umbilical cord around the neck, fetal heart changes, abnormal fetal movement), respiratory movement will occur, and amniotic fluid will be inhaled, causing aspiration pneumonia; If the water is broken early, the labor process is prolonged, or in the process of delivery, bacterial contaminated amniotic fluid or birth canal secretions are inhaled, which is easy to cause bacterial pneumonia; If amniotic fluid is contaminated by meconium, inhalation into the lungs will cause meconium aspiration pneumonia.
2. If there is a carrier (such as a cold) in the crowd that the child contacts, the child is easily infected and causes pneumonia; Neonates are infected with pneumonia through blood circulation due to septicemia or omphalitis and enteritis, which can be caused by bacteria; In older newborns, pneumonia may also be caused by viruses and other microorganisms.
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1. White blood cell examination
In cellular pneumonia, the total number of white blood cells increases, about 15 ~ 20? 109/L, severe staphylococcus aureus pneumonia and influenza pneumonia, sometimes the total number of white blood cells decreases, the white blood cells of viral pneumonia are normal or decreased, the proportion of lymphocytes increases, and neutrophils do not increase.
2.c reactive protein test
Bacterial infection, septicemia, etc. The value increases, and the increase is proportional to the severity of infection, but it does not increase in virus and mycoplasma infection.
3. Cytopathological examination.
4. Virus etiology examination.
5. chest x-ray examination.
diagnose
Diagnosis can be made according to clinical manifestations and related examinations.
differential diagnosis
Children's pneumonia is easily confused with bronchitis, acute miliary tuberculosis, caseous pneumonia, bronchial foreign body, bronchiolitis, children's cold and other diseases.
Symptoms of pneumonia in children
The severity of pneumonia in children varies greatly. Generally speaking, older children have mild symptoms, while infants have severe symptoms. Children with pneumonia can recover quickly as long as they are found in time and treated effectively. However, serious cases are prone to complications, such as poor prognosis if not treated in time.
1, incubation period: 2 ~ 3 days or a little longer.
2, the symptoms are mild: only nasal symptoms, such as runny nose, stuffy nose, sneezing and so on. , can also be used for tears, cough or throat discomfort, and can be cured naturally within 3 ~ 4 days. At first, it was frequent irritating dry cough, and then there was phlegm in the throat. Cough may be accompanied by vomiting and choking. Such as infection, often involving the nasopharynx and pharynx, often appear fever, sore throat, tonsillitis and hyperemia and hyperplasia of lymph tissue in the posterior pharyngeal wall, and sometimes lymph nodes can be slightly enlarged. Breathing is shallow and fast, the nose is flapping, and some children have mild cyanosis around their mouths and nails. In addition to respiratory symptoms, children can also be accompanied by general symptoms such as listlessness, irritability, loss of appetite, chills and diarrhea. It is easy to cause vomiting and diarrhea in infants. Most of them have high fever, which can last for 2 ~ 3 days to 1 week. 3. Severe: In addition to mild pneumonia, persistent high fever, systemic poisoning and other symptoms are serious, accompanied by other organ function damage.
The body temperature can reach 39 ~ 40℃ or higher, accompanied by cold feeling, headache, general weakness, loss of appetite, restless sleep and so on. Herpes and ulcers will soon appear due to local redness, which is called vesicular pharyngitis. Sometimes the swelling is obvious, and it spreads to tonsils, showing follicular purulent exudate, sore throat and systemic symptoms, and nasopharyngeal secretions change from thin to thick. Shallow and rapid breathing, reaching more than 80 times per minute, flapping nose, three concave signs, breathing groans, obvious cyanosis on face and limbs, and even pale or gray face. Dense moist rales can be heard in both lungs. The submandibular lymph nodes are obviously swollen and tender. If the inflammation spreads to the sinuses, middle ear or trachea, other symptoms will appear, and the systemic symptoms will be more serious. In the more serious symptoms, we should pay attention to febrile convulsion and acute abdominal pain, and make differential diagnosis with other diseases.
Febrile convulsion caused by acute upper respiratory tract infection is more common in infants, and it occurs several times in succession 1 ~ 2 days after onset. The child has anorexia, vomiting, diarrhea and abdominal distension. In severe cases, the vomit is brown or bloody in the stool, the bowel sounds disappear, toxic intestinal paralysis and toxic hepatitis. Acute abdominal pain is sometimes severe, mostly around the navel, without tenderness, often early, mostly temporary, which may be related to intestinal peristalsis; But it can also persist, sometimes similar to appendicitis symptoms, mostly caused by acute mesenteric lymphadenitis. Infantile pneumonia is often accompanied by cardiac insufficiency. Severe pneumonia is often accompanied by irritability, lethargy, gaze, strabismus and upward eye movement; Sleepiness, even coma and convulsions; Bulbar conjunctival edema; Pupil changes, slow response to light or disappear; Irregular respiratory rhythm; Swelling of anterior fontanel with meningeal irritation sign. In addition to elevated pressure, cerebrospinal fluid is often called toxic encephalopathy. In severe cases, the intracranial pressure is high and brain hernia may occur. Sometimes metabolic acidosis and respiratory acidosis occur. There may be mixed acidosis.
4. Hemogram: Generally, the white blood cells infected by virus are low or within the normal range, but the total number of white blood cells and the percentage of neutrophils in the early stage can be high; Bacterial infection often increases the total number of white blood cells, and sometimes decreases it in severe cases, but the percentage of neutrophils still increases.
5. Course of disease: the fever time of mild cases is 1 ~ 2 days to 5 ~ 6 days, and the high fever of severe cases can reach 1 ~ 2 weeks, and occasionally the low fever can last for several weeks. Because the focus has not been cleared, it will take a long time to recover.
In addition, pneumonia in children can also be complicated with atelectasis, emphysema, bullae and bronchiectasis. Therefore, children's pneumonia is not only a common disease, but also a critical illness. Parents must pay attention to prevention and nursing.
Treatment of pneumonia in children
The principle of treating pneumonia is to kill pathogenic bacteria with anti-inflammatory drugs. According to different pathogenic bacteria, choose sensitive drugs, early treatment, full treatment, and choose treatment plan according to the condition. At the same time, symptomatic treatment should be taken, such as taking antipyretics when fever occurs, expectorant and antitussive drugs for cough, and timely hospitalization for severe pneumonia.
1. drug therapy
(1) Antibiotic therapy is used for bacterial pneumonia. Choose penicillin treatment. If the effect is not good or allergic, lincomycin and cefotaxime can be used. Mild people can take antibiotics orally.
(2) Antiviral therapy with ribavirin or acyclovir.
2. Symptomatic treatment
(1) Patients with cyanosis are given oxygen.
(2) Relieve cough by oral administration or intramuscular injection.
(3) Atomizing and inhaling expectorant chymotrypsin.
Prevention of pneumonia in children
1. The indoor air is fresh.
Keep the indoor air fresh and quiet, and let the children have a good rest.
2. Diet and expectoration
Eat more digestible, high-calorie, vitamin-rich foods in the diet, and soft foods are the best, which is conducive to the absorption of the digestive tract. When coughing, pat the child on the back, which is conducive to the discharge of sputum. When you pat the back, pat it from the bottom up. Don't be too dry in the room. Children should properly drink water to dilute sputum, which is conducive to the discharge of sputum.
3. Strengthen exercise and pay attention to increasing clothes appropriately.
Prevent upper respiratory tract infection, pay attention to strengthening exercise, and choose appropriate exercise methods according to age. When outdoor activities, pay attention to the appropriate increase in clothes. There is a cold in society, so don't take your children to public places. Someone at home has a cold, so don't contact with children.
4. Enhance the disease resistance of infants and young children
Adhere to physical exercise, enhance disease resistance, pay attention to climate change, and add or subtract clothes for children at any time to prevent colds and colds. Reasonable feeding to prevent malnutrition. Educate children to develop good hygiene habits, don't spit everywhere, and let them get more sunshine. Constantly enhancing the disease resistance of infants and young children is the key to preventing diseases.
Conclusion: As a kind of pneumonia, children's pneumonia is also caused by lung infection, which greatly harms children's health. Through this article, I hope that young parents can fully realize children's pneumonia and take protective measures in peacetime to prevent it before it happens!
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