Repeated pneumonia in an infant. Pneumonia in newborns - symptoms and treatment

Progressive pneumonia in infants and newborns is accompanied by severe symptoms of lung damage and has extremely unpleasant health consequences. Therefore, complex treatment must be timely, hospitalization of the patient is necessary, and the use of antibacterial drugs is mandatory. Pneumonia in an infant can develop from the first days of life; premature babies and newborns with birth injuries are at risk.

What is pneumonia in newborns

This is an infectious disease that is accompanied by an inflammatory process of the lung parenchyma and bronchial walls. A disease with inflammatory foci can be determined after performing ultrasound and radiography. The relapse progresses in utero or develops against the background of infection of the lungs in the first days after the baby is born. Secondary pneumonia is an already acquired ailment that becomes a complication of the underlying disease. To avoid intoxication of the body, effective treatment must be started on time.

Symptoms of pneumonia in infants

The disease progresses spontaneously and occurs during acute intrauterine infections. Extensive pathologies due to intrauterine infection are obvious from the first days of life; the general manifestations of acute pneumonia in the body of a newborn are presented in detail below, making the child nervous and irritable:

• intermittent breathing, wheezing;
• high body temperature;
• swelling of the lower extremities;
• complete lack of appetite;
• severe signs of dyspepsia, accompanied by bloating;
• symptoms of general intoxication of the body;
• indigestion;
• severe belching, bouts of vomiting;
• frequent regurgitation, bouts of vomiting.

Signs

With increased activity of bacterial infections in the tissues of the lungs and bronchi, pneumonia develops. During the prenatal period, unilateral or bilateral damage progresses; doctors do not rule out fetal hypoxia. The first signs of pneumonia appear during childbirth, since the newborn is characterized by cyanosis of the skin, lips, and mucous membranes. Other manifestations, in addition to cyanosis of the skin, are presented below:

• weak cry of the baby at birth;
• weakening of unconditioned reflexes;
• underweight newborn;
• enlarged liver and spleen;
• low blood pressure;
• muffled heart sounds when listening;
• progressive convulsions.

Causes

Bilateral or unilateral pneumonia occurs from the first days of life, and can be either an independent disease or a complication of another chronic illness. It occurs in a complicated form, provoked by increased activity of viruses, bacteria, fungi, mycoplasma, chlamydia. In the fight against harmful pathogens of pneumonia, it is necessary to reduce the viability of streptococcal and staphylococcal microorganisms. Pathogenic factors preceding an acute attack in a newborn are presented below:

• insufficient oxygen supply to cells;
• asphyxia during labor;
• birth injuries;
• malnutrition;
• immunodeficiency states;
• hypo-, avitaminosis;
• congenital defects of the lungs and myocardium.

Intrauterine pneumonia in newborns

Progressive pneumonia is a consequence of intrauterine asphyxia, when the child suffers from oxygen starvation, and the expectant mother suffers from late toxicosis, gestosis. After birth, a baby is characterized not only by extensive breathing problems, but also by dangerous internal pathologies. Congenital pneumonia can be provoked by other pathogenic factors:

• immaturity of lung tissue, underdevelopment of the respiratory tract;
• acute viral diseases suffered during pregnancy;
• anatomical and physical features of the structure of the respiratory tract;
• heavy bleeding during pregnancy;
• chronic diseases of the mother during pregnancy;
• early discharge of amniotic fluid, leakage;
• genetic factor.

Stages

Through a clinical examination of the lungs, it is possible to determine the predominant stage of the pathological process, since the characteristic signs of pneumonia in an infant are different each time and are modified in the absence of timely therapy. Here is the established classification of a characteristic illness:

1. The mild form is accompanied by shortness of breath, intermittent and heavy breathing, moderate acidosis and cyanosis.
2. The pathology of moderate severity is characterized by generalized cyanosis, tachycardia, oxygen starvation, tachypnea, shortness of breath with wheezing.
3. The severe form of the disease is characterized by dangerous respiratory disorders, extensive damage to the central nervous system, convulsions, difficult sputum production, and the child develops pleurisy.

Forms

Signs of pneumonia in an infant are determined by the duration of infection and the nature of the prevailing symptoms. Doctors identify the following forms of characteristic illness and give differential diagnosis:

1. Congenital pneumonia. A low degree of adaptation prevails, a decrease in respiratory rate, and an enlarged liver. Since the virus penetrates the placental barrier, it affects internal organs.
2. Pneumonia in a newborn after cesarean section. The pathology is caused by birth injuries, there is a high probability of blood poisoning, lifelong disability, and contributes to brain swelling.
3. Aspiration pneumonia. It is caused by a long anhydrous period, transitioning through pregnancy with the most unexpected consequences for the health of the child.
4. Postnatal pneumonia. At the initial stage, the symptoms are not characteristic of the characteristic disease and are considered atypical. These are signs of dyspepsia, high fever, and central nervous system instability.

Complications

In the absence of intensive care, pneumonia in newborns is fraught with dangerous health consequences, and death is possible. In this clinical picture, newborns experience one of two forms of complications:

1. Pulmonary. These are pleurisy, pneumothorax, respiratory failure, bronchopulmonary dysplasia.
2. Extrapulmonary consequences. Sinusitis, otitis media, mastoiditis, heart failure.

Diagnostics

To avoid dangerous consequences of sepsis, it is necessary to promptly diagnose. The x-ray image shows extensive foci of pathology, the stage of a progressive pathological process. These are compacted areas of tissue in the structure of the affected lung. Additional diagnostic measures for pneumonia are presented below:

• general and biochemical blood test;
• sputum culture;
• general urine analysis;
• echocardiography;
• CT and MRI.

Treatment

The presence of nosocomial infections helps to promptly initiate intensive therapy with injectable antibiotics. With a community-acquired form of pathogenic flora, adults do not rush to the doctor, trying to treat the baby themselves, which worsens the clinical outcome. General recommendations from specialists if pneumonia is diagnosed in premature newborns are detailed below:

• the child needs to be hospitalized, ensure regular ventilation of the hospital room, and skin hygiene;
• control the body temperature, especially the breathing rate of the newborn;
• provide the baby with a full period of breastfeeding for the development and formation of children's immunity;
• use antibacterial drugs from the penicillin group and not only for the productive extermination of pathogenic flora;
• It is mandatory to carry out detoxification therapy, vitamin and oxygen therapy for a newborn in a hospital setting or hospitalization.

Here are the required medications during pre-hospitalization to significantly speed up the process of natural recovery for progressive pneumonia:

1. Glucose. The composition must be administered intravenously to maintain the natural life processes of the newborn body.
2. Saline solutions. Intended for intravenous delivery into the newborn body. Necessary for strengthening the immune system and removing toxic substances.

Medications

The main goal of the conservative treatment is to destroy pathogenic flora, restore the structure of the lung tissue and normalize the respiratory rate, and strengthen the immune system with prescribed vitamins. Pneumonia can be cured by representatives of the following pharmacological groups and their prominent representatives:

• immunostimulants: use antistaphylococcal, anti-influenza, anti-pseudomonas immunoglobulins;
• symptomatic drugs: mucolytics, antipyretics, antitussives, anti-inflammatory drugs;
• probitics: Simbiter, Bio Gaia, Bifidumbacterin;
• diuretics to remove excess fluid;
• saline solution to prevent dehydration of the newborn.

Antibacterial drugs

To treat pneumonia, doctors recommend penicillin antibiotics to newborns. These are medications Amoxiclav, Augmentin, Flemoxin Solutab, Flemoklav, Unazin orally. Mycoplasma pneumonia is successfully treated with macrolides: Azithromycin, Clarithromycin, Roxithromycin. Here is what is known about the proposed antibacterial therapy and its prominent representatives:

1. Augmentin. Produced in the form of a powder for the preparation of a suspension, it is approved for use by children already in the first year of life. The course of treatment is 7-10 days, additionally use probiotics. Daily dose – 125 mg/31.25 mg in a dose equal to 2.5 to 20 ml.
2. Flemoxin Solutab (125 mg). Tablets for oral administration that act systemically. A small child is supposed to take up to 3 pills per day for 7–10 days, a single dose is 1 tablet.

Consequences

Pneumonia is a dangerous disease that can be fatal for a newborn. Even if the child survives, the health consequences are not the most favorable. This:

• respiratory failure;
• pulmonary tissue dysplasia;
• risk of repeated relapse of severe bronchopulmonary diseases.

Prognosis of intrauterine pneumonia in newborns

The prognosis for newborns with meconium aspiration is accompanied by the risk of congenital intrauterine pneumonia and neurological disorders due to cerebral hypoxia. A third of such children have delayed physical and psycho-emotional development. In other clinical pictures, with a timely response to a health problem, the outcome is favorable.

Prevention

Parents must comply with sanitary and epidemiological standards to reduce the risk of pathogenic infection entering the newborn body. Among other preventive measures against pneumonia, doctors identify:

• planned pregnancy management;
• timely strengthening of immunity;
• prevention of infectious diseases;
• maintaining a healthy lifestyle;
• lack of contact with carriers of viruses, bacteria, and other pathogenic microorganisms.

Video

Very often, the result of a viral or bacterial infection in infants is complications affecting various organs. This is due to the fact that the nasal cavities and airways in infants are very narrow and underdeveloped. The mucous membrane of these organs is susceptible to pathogenic bacteria and swells quickly, making it more difficult to remove microbes. Pneumonia in infants is an inflammatory focus in the lungs.

Children with weakened immune systems are more susceptible to inflammation.

It's important not to skipHave scheduled preventive examinations with doctors. Even more important is the administration of vaccines if there are no contraindications. Vaccination can prevent the disease, and if infection occurs, the symptoms will be mild and will not lead to dangerous consequences for the body. There is a vaccine that prevents pneumonia.

Main manifestations of the disease

Pneumonia is most often a consequence of a respiratory disease.

If such symptoms appear, you should immediately consult a doctor. The baby's condition can worsen at any time.

Description of the disease

Lung disease can be caused by various viruses, bacteria, and fungi. The most common causative microorganism is pneumococcal infection.

There are cases when children are already born with pneumonia, or it occurs in the first days after birth. The symptoms are the same as for other pathogens of pneumonia. Those at risk are primarily premature babies, since one of the causes of premature birth is infection of the amniotic fluid. In the future, there is a high risk that the baby’s lower respiratory tract will suffer from a cold.

The doctor must prescribe additional examinations to determine the pathogen. The further plan of treatment measures will depend on this. Even if pneumonia was caused by a virus, a bacterial infection is very often associated. That is why, especially when treating infants, antibiotics and antiviral drugs are immediately started.

Inflammation can affect a small area of ​​the lungs - then they speak of a focal lesion. In the case when the disease covers an entire lobe of the lungs, a diagnosis of lobar pneumonia is made. The symptoms of the disease in the latter case are much more pronounced.

During pneumonia, the gas exchange function of the lungs is disrupted. The body begins to lack oxygen, which is necessary for the normal functioning of all organs. In addition, waste products of harmful microbes poison the child’s body. Symptoms of intoxication occur: nausea, loss of appetite, pain in the head and abdomen, fever.

During illness, antibodies act to protect the body. One of the symptoms of “struggle” is an increase in temperature. If it remains high for several days, danger arises. Metabolism in the child’s body is disrupted, inflammation can spread to other organs. Changes occur in the brain that lead to seizures.

Diagnostic measures

Treatment of pneumonia should be carried out under the strict supervision of medical personnel in a hospital, where the necessary examination will be carried out.

• Blood and urine tests.
• X-rays of light.
• Ultrasound of the abdominal cavity.

Additional examination of all organs is necessary in order to determine the extent of the disease.

Features of therapeutic measures

• Antibiotics are the basis of all therapy. Infants are given injections.
• Inhalation using a nebulizer with the addition of medications that improve the functioning of the respiratory organs.
• IV drips with intravenous administration of medications containing glucose, saline solutions and other components may be prescribed.
• Antipyretic drugs.
• Antiviral drugs.
• Drugs that enhance immunity.
• Vitamin complex.
• Drugs that improve intestinal microflora.

The dosage and duration of taking medications is determined only by a doctor. Taking into account the child’s condition, the severity of the disease, and his age, he will determine the treatment plan.

Possible complications of the disease

If the treatment was prescribed correctly and on time, the disease gradually goes away. There is no risk of the acute form of the disease developing into a chronic one.

• All parts of the lung, including the pleura, can be involved in the inflammatory process. The pleura is the membrane that covers the lungs. Inflammation of the pleura is called pleurisy.
• Swelling of the tissue may occur, leading to the development of pulmonary failure.
• In rare advanced cases, tissue death occurs.

The acute course of the disease lasts approximately 1 month. Protracted pneumonia lasts more than 1 month.

Preventive measures

Pneumococcal bacteria can cause serious diseases: otitis media, pneumonia, arthritis, pleurisy, meningitis. This bacterium makes itself felt after illnesses (flu, measles). Vaccination, for example, Prevenar, is a preventive measure.

The vaccine is given as early as three months of a child’s life. In the future - at 4.5 months, 6 months. At 1.5 years - booster vaccination.

The vaccine combines well with other administered drugs, except BCG. By the age of two, a child develops immunity to the pneumococcal bacterium.

Side effects after receiving the Prevenar vaccine.

• There may be pain, swelling, swelling, and redness at the injection site.
• In rare cases, there may be an increase in temperature.
• Moodiness, refusal to eat, sleep disturbance.

All these signs pass quickly, leaving no consequences.

The vaccine should not be given in the following cases.

• Allergic reaction to vaccine components.
• Signs of colds.
• Exacerbation of chronic diseases.
• Slight increase in the child's temperature.

Vaccination against pneumococcal infection in these cases is postponed for some time. The exception is allergies. In this case, vaccination is canceled.

Pneumonia is a serious disease that is difficult for infants to tolerate. It is important for parents to protect their child from various types of infections. A properly organized daily routine will help avoid such a problem.

Ekaterina Rakitina

Dr. Dietrich Bonhoeffer Klinikum, Germany

Reading time: 4 minutes

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Article last updated: 02/13/2019

Pneumonia in newborns is an acute infectious disease characterized by an inflammatory process in the lung tissue and damage to the bronchial walls. 2% of full-term infants and up to 15% of premature infants are susceptible to pneumonia. The course of the disease in infants is usually severe; the disease occurs as a result of infection with pathogenic bacteria during childbirth or in utero - such pneumonia is called primary.

Causes of pneumonia in infants

• functional immaturity of the fetus;
• prematurity;
• developmental defects;
• chronic hypoxia;
• intrauterine infection;
• bleeding of a pregnant woman;
• surgical operations;
• threat of miscarriage;
• anhydrous period for a long time;
• entry of amniotic fluid into the respiratory tract.

Clinical picture of pneumonia in newborns

• vomiting or regurgitation;
• refusal to eat;
• weight loss;
• cyanosis of the nasolabial triangle, which intensifies during eating;
• dyspnea;
• tension of the wings of the nose;
• violation of the respiratory rhythm - breathing becomes grunting or groaning;
• sometimes - foam-like saliva on the lips;
• convulsions leading to loss of consciousness are possible.

With pneumonia of bacterial-viral etiology, signs of general intoxication of the body are observed, and meningeal symptoms are also common.

One of the tasks of diagnosing pneumonia in infants is to identify damage to the lower respiratory tract in a child with symptoms of acute respiratory infections, the second is to distinguish pneumonia from bronchitis. The diagnosis is made on the basis of x-ray studies, medical history and clinical manifestations. Differential diagnosis is carried out in infants with congenital heart and lung defects, aspiration.

Treatment of staphylococcal pneumonia is carried out by a pediatrician together with a surgeon - this is due to the frequent occurrence of pleural complications that require surgical intervention - drainage of the pleural cavity or puncture.

Treatment of pneumonia in newborns should be comprehensive, with an important role played by:

• compliance with the regime;
• competent child care;
• good nutrition;
• early gymnastics;
• maintaining home hygiene.

Drug therapy is based on the use of antibiotics, most often a combined administration of penicillin and streptomycin (intramuscular). In case of complicated pneumonia, broad-spectrum antibiotics are prescribed: erythromycin, oletethrin or oleandomycin. Staphylococcal pneumonia can be treated with semisynthetic antibiotics: oxacillin and methicillin. For viral pulmonary inflammation, it is advisable to use tetracycline antibiotics.

The course of antibiotic therapy, as a rule, reaches 10 days, then it is necessary to replace it with other groups of drugs.

Long-term treatment with antibiotics requires the prescription of nystatin; additionally, the following are used:

• detoxification therapy (intravenous plasma administration);
• vitamin therapy and administration of gamma globulin;
• blood transfusions;
• cardiovascular drugs - according to indications;
• symptomatic remedies.

The prognosis of pneumonia in newborns with adequate and timely therapy is favorable. With pneumonia in premature babies, there is a risk of dysplasia of the lung tissue, which leads to the recurrence of severe pulmonary infections. If therapy is not started in a timely manner, there is a high risk of developing respiratory failure and toxicosis, which can lead to death.

Read further:

Everyone knows about the danger in adulthood and childhood, but there is also a special condition associated with the neonatal period. This is congenital pneumonia, which manifests itself immediately after birth or during the first three days. Pathology can occur in both full-term babies and premature babies of different ages; naturally, the more pronounced it is, the more severe the pneumonia and the more dangerous its prognosis. It is important to recognize such a condition immediately and actively treat the baby, otherwise such a condition threatens his life and future condition.

Table of contents:

Features of congenital pneumonia

Based on statistics on cases of congenital lung damage, the most common cases are births from mothers who had a severe and complicated pregnancy and signs of infections, including intrauterine infection of the fetus. In addition, infection of the lung tissue is also possible among premature infants or those babies who were born with aspiration of meconium or amniotic fluid (swallowing them due to the first breath being taken too early). According to statistics, congenital pneumonia occurs in such children almost twice as often as in healthy, full-term infants.

The name “congenital pneumonia” is used because infection with pathogenic pathogens and inflammation develops in the child during pregnancy or during childbirth, so external factors play an extremely insignificant role in its formation.

The main cause of such pneumonia is an infectious agent that was initially present in the female body and became active during pregnancy, or its activity became significant for infection during childbirth.

In this regard, all congenital pneumonia of infants is divided according to the time of their formation into two large groups:

• antenatal infection, that is, the pulmonary system suffers and becomes inflamed even before birth, in utero.
• intrapartum infection, pathogenic objects penetrate the infant’s lung tissue during labor, which is usually protracted or complicated.

Each episode of pneumonia has its own typical pathogen, which can be microbial or of origin, and it is important to accurately and quickly identify it so that treatment measures are correct and as effective as possible.

Causes of congenital pneumonia in newborns

The most common causes of congenital pneumonia are viral infections, since children in utero and immediately after birth are most vulnerable to their influence. For infectious inflammation of the lung tissue to develop, the virus must enter the third trimester. If it is activated earlier, it threatens congenital malformations, termination of pregnancy or intrauterine fetal death .

The most common causative agents of pneumonia in this group of children are considered to be. This is a group of the most detected pathogens capable of provoking defects, intrauterine infections, including damage to lung tissue. These are pathogens such as, and. It is also possible that there is an influence of other pathogens, which have their own characteristics in the structure and formation of the infectious process, and characteristics of treatment.

Features of TORCH complex infections

If speak about toxoplasmosis , it is provoked by a special pathogen, Toxoplasma (a group of protozoa). The infection is transmitted through domestic animals, mainly cats, which often act as asymptomatic carriers. It is also possible that Toxoplasma enters the body through poorly cooked meat. If infection occurs for the first time during pregnancy, especially in its last weeks, the pathogen can cause damage to the fetal lung tissue and congenital pneumonia.

If a woman becomes infected with toxoplamosis before pregnancy, she already has antibodies to the pathogen, and in this case, this infection is not dangerous to either herself or her baby.

The clinical picture of the most acute toxoplasmosis in a woman is nonspecific, so it is often mistaken for a cold or fatigue.

Development rubella It is also dangerous if the mother does not have antibodies to it (if the woman did not have this disease before pregnancy). This is an acute viral infection, transmitted by airborne droplets, which poses a potential threat to the fetus from early gestation due to the high risk of congenital malformations. The virus can lead to the formation of pneumonia in the fetus if infection occurs in the last weeks of pregnancy.

Defeat cytomegalovirus infection also dangerous. This is an airborne viral infection that can also enter a woman’s body through sexual and contact contact. About 60% of the adult population is infected with this virus, but clinical infection manifests itself only in isolated cases. If the expectant mother is infected, the virus is capable of penetrating the placenta, inducing inflammatory processes in many tissues and organs of the fetus - the brain, liver tissue or lungs.

Formation herpes possible at any stage of pregnancy, this is a particle with an affinity for nerve cells, but it may well affect the skin and internal organs, including lung tissue with the development of pneumonia. There are two types of herpes that are dangerous for women - the first and second types (labial and genital). The first type is transmitted primarily through airborne droplets or through kissing, close contact, or sharing utensils. The second is predominantly transmitted through sexual contact (of any type).

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Herpes of the first type can most often form antenatal pneumonia (intrauterine infection), and the second type most often affects during childbirth (intranatal). This is due to the fact that during childbirth the fetus passes through the infected genitals of the mother, on the surface of which there may be a herpes virus.

The group of TORCH infections is the most dangerous in terms of provoking such pneumonia, especially when it comes to the last stages of gestation or childbirth. But these are not the only causes of pneumonia in infants.

Features of intrauterine pneumonia of other etiologies

The influence of many other pathogens, either microbial in nature, related to fungi or protozoa, is also possible. Congenital pneumonia can often be caused by infection, or, a possible role, or. They mainly affect just before childbirth, in the last weeks or during the birth of the baby. Trichomoniasis and ureaplasmosis belong to the group of sexually transmitted infections; they very rarely can cause the development of pneumonia in completely healthy and full-term children. Typically, the infection, along with candidiasis, occurs in premature infants or those with congenital immunodeficiency.

Infection with chlamydia or mycoplasma, as intracellular pathogens, is typical for children immediately after birth and in the first hours after birth. But this requires a combination of special circumstances.

Generally speaking, for congenital pneumonia, the role of both viruses and microbes, protozoa, is great, but usually for such a problem the presence of additional factors is also necessary. In healthy full-term infants, such lesions are not typical.

The mechanism of pneumonia in each specific case depends not only on the cause affecting the baby, but also on many additional factors.

Special conditions for provoking congenital pneumonia

To form pneumonia, any infectious agent must penetrate the placental barrier in utero, have a certain affinity for the lung tissue, and penetrate through the bloodstream into the fetal lung area. Before birth, a baby’s lung tissue has specific characteristics; the alveoli are in a collapsed state and can become a breeding ground for viruses or microbes. An inflammatory process is formed, which only after birth, against the background of the onset of pulmonary respiration, manifests itself as symptoms of pulmonary insufficiency, incomplete opening of all areas, and the formation of silent zones. Typically, the inflammatory process against the background of pulmonary respiration is activated, and additional manifestations are formed.

There are a number of factors that can make an infant more likely to develop an infection. These include:

• A difficult pregnancy and maternal illness, which led to defects in the structure of the placenta and its protective role
• infectious lesions of the mother herself, especially those related to the TORCH complex group. They increase the risk of infection of the placenta and penetration of pathogens through it into the fetal tissue.
• state of prematurity, weakening of immune defense against this background.
• the course of labor and complications in it, a long anhydrous period, protracted labor and various interventions by doctors for the purpose of obstetric care.

How does congenital pneumonia manifest?

For congenital pneumonia, symptoms typically appear immediately after birth or during the first three days. If symptoms occur during the first days, we are talking about infection during childbirth, if immediately, during pregnancy.

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When pneumonia caused by certain viruses of the TORCH group develops, manifestations from other systems and organs often develop against the background of respiratory symptoms. It is important for doctors to take this into account when diagnosing lung lesions and approaching the treatment of pneumonia and all other manifestations.

It is also important to determine whether the infection is viral or microbial in nature; symptoms and treatment approaches vary greatly.

The first signs appear after birth; the baby’s general condition can be very serious due to respiratory disorders developing immediately after the first breath. Babies may be born with bluish or gray, pale skin on the body and face, and a possible rash in the form of red dots and hemorrhages due to intoxication. The baby's cry will be weak, reflexes will be suppressed due to the lack of oxygen that nourishes the nervous system during the infectious process. As a result, Apgar scores will be low, and the children are immediately taken to the NICU by neonatologists.

In some situations, they need intubation and artificial ventilation, oxygen therapy to saturate the organs with oxygen and normalize metabolic processes. This is especially important against the background of severe respiratory failure.

The main symptoms of pneumonia are breathing disorders with shortness of breath, retraction of the spaces between the ribs and areas under the sternum and above the collarbones, with active participation in breathing from the abdomen. Against the background of shortness of breath, there is increased breathing and heart rate, exceeding the norm by 20-30% or more. This indicates problems with the lungs and requires immediate examination.

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For children, the staged pattern that develops with pneumonia in adults is not typical; it is important to know that inflammation spreads quickly, and infection, for example, with the influenza virus, pneumocystis, or, leads to necrosis of the lung tissue.

Congenital pneumonias differ in the form of the pathogen into microbial, viral, fungal and caused by atypical flora, and can also be divided into specific, nonspecific, complicated. This is important for making a diagnosis and selecting the correct treatment.

Clinic of specific TORCH pneumonia and bacterial

If pneumonia is provoked by pathogens from the group of TORCH infections, a generalized infection may also be present against the background of pulmonary symptoms. Doctors know about this, simultaneously with the treatment of pneumonia, examining the child with an eye on possible damage to other systems and organs.

Yes, when cytomegaly Damage to the tissues of the brain and liver also develops, which aggravates the overall course of the pathology. When exposed to the fetus, the virus leads to serious brain damage with the formation of ischemic zones and cystic formations, enlargement of the liver with the development of severe jaundice, increased bilirubin with the formation of encephalopathy. Therefore, pneumonia will be only one of the symptoms of a viral infection.

Pneumonia with congenital rubella will be accompanied by rashes throughout the body and lesions in all other parts of the respiratory tract.

Microbial pneumonia in newborns also has special properties, since the nature of the inflammation is purulent.

They often develop in the first three days, with a sharp deterioration in the child’s condition, progressing literally by the hour. Against the background of severe shortness of breath, symptoms of intoxication are formed - a sharp fever, or in case of prematurity, a paradoxical decrease in temperature to severe hypothermia. There is a refusal of the breast or bottle, weight loss and severe anxiety, cyanosis or severe pallor, wheezing when breathing.

Consequences of congenital pneumonia

Such processes are much more dangerous for newborns than for adults; complications depend on the types of pathogens and are both immediate and delayed. If, due to the pathogen, destruction is formed in the area of ​​​​the lung tissue, this threatens the spread of infection beyond the respiratory tissue. This threatens the breakthrough of the infectious agent into the vessels and the formation of sepsis with bacteremia (microbes in the blood) and the formation of secondary purulent foci in tissues and organs.

If we talk about other immediate complications, these include the formation of bleeding due to hemorrhagic syndrome or, circulatory disorders and tissue hypoxia, and the development of cardiovascular failure against the background of respiratory failure. If we talk about purely pulmonary complications, these include the formation of lesions of the pleura (acute) and (air in the chest), as well as (collapse areas).

Methods for diagnosing congenital pneumonia

Difficulties always arise regarding the rapid diagnosis of congenital pneumonia. This is due to the fact that respiratory failure at this age is typical not only for pneumonia, but also for many other conditions. If pneumonia is suspected, it is also important to accurately identify its causative agent, since treatment tactics for protozoa, viruses and microbes vary, as does the range of drugs selected.

The data obtained from the mother or her exchange card is important - how the pregnancy, childbirth proceeded and whether there were any complications, whether there were signs of infections in the third trimester, whether she was tested for the TORCH group of infections, what were the results.

The peculiarity of congenital pneumonia, especially when it comes to premature babies, is unclear objective data, difficulties in listening to wheezing and noise, similar data, both against the background of pneumonia and respiratory distress syndrome. In this case, data from laboratory tests and instrumental diagnostics are very important.

Through instrumental examinations, it is possible to accurately determine lung damage and clarify where it is localized. Particularly important for the newborn, with it, the types of typical signs of the inflammatory process are a decrease in the airiness of the lungs with an increase in the pattern of blood vessels at the beginning of pneumonia, and then the manifestation of inflammatory infiltrative changes with a tendency for them to merge. If a child is premature, x-rays cannot provide accurate information about whether it is pneumonia or hyaline membrane disease. The changes are very similar in both pathologies, so tests are necessary.

Features of baby tests for suspected pneumonia

When diagnosing pneumonia in newborns, a number of tests are performed, but they have their own characteristics due to the physiological characteristics associated with birth. Thus, a baby typically has an increase in leukocytes and erythrocytes to fully ensure tissue respiration, and by the 5th day a physiological crossover in the level of leukocytes and lymphocytes occurs.

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These data can confuse the doctor and mask the features of inflammation. It is important to note changes in the dynamics daily, then an increase in leukocytes will be noticeable, and there may be a lack of physiological crossover.

Based on the level of leukocytes and lymphocytes, the nature of pneumonia is determined - viral or microbial, but mixed infection with the simultaneous influence of viral-microbial association is also possible.

If there is no effect from the treatment of the baby, the mother is examined, which reveals the presence of a specific pathogen. This is due to the fact that the mother will be the main source of infection for the fetus and newborn, and the child’s antibodies to the infection have not yet formed and cannot be determined.

Mothers carry out serological diagnostics, determining antibodies to certain infections with the level of immunoglobulins of class G and M. The level of antibodies to the most likely types of infections is assessed, and with an increase in the level of class G antibodies, this pathogen is not dangerous in terms of pneumonia, since this is evidence of an old infection or the presence immunity. And here the presence of class M may indicate an acute process, and this pathogen probably caused pneumonia.

Vaginal smears may be indicated for sexually transmitted infections, especially with bacterial pneumonia of a child; they can be used to determine the sensitivity of pathogens to antibiotics.

How to treat congenital pneumonia in a child?

It is necessary to treat the child immediately after diagnosis, and complex treatment regimens are used, taking into account both the type of pathogen and the characteristics of its development, in parallel with methods of caring for the baby and routine measures.

Children with pneumonia are placed in incubators to create an optimal temperature and humidity regime for them - this is 32-34 degrees with 80-90% humidity; it is also important to carry out oxygen therapy, often right in the incubator conditions.

If there is such a possibility, children are fed with mother's breast milk or donor milk, it is important to slightly reduce the total calorie intake, but increase the frequency of feedings.

Oxygen therapy is required; it is selected taking into account the child’s capabilities and condition. This is important in order to correct metabolic disorders and support the functioning of the cardiovascular system. In an incubator, this can be a direct supply or the use of a mask; if the baby is weak and premature, it is possible to correct the respiratory act by connecting an oxygen supply apparatus (with constant positive pressure), and, if necessary, transfer the baby to a ventilator. Against the backdrop of all these measures, medicinal influence is already carried out.

It is important to accurately establish the nature of the pathogen; therapy is selected only for it:

During therapy with powerful antibiotics, the intestinal microflora suffers, and it is important to correct it, especially when the intestines have not yet been populated by microbes. Reception in the form of compositions with lactobacilli and bifidoflora is indicated. The drugs are selected in such a way that they are not exposed to antibiotics and take root in the intestines.

As the condition improves, vitamin therapy and physical therapy are indicated, a transition to breastfeeding and care for the baby by the mother herself, which improves the prognosis for his recovery.

What is the prognosis for babies?

If pneumonia is recognized at the very beginning and its causative agents are accurately identified, active treatment is started, full care of the baby is organized and all measures are taken, the chances of recovery are high. But often congenital pneumonia occurs in utero, is combined with multiple lesions of tissues and organs, the nervous system, and threatens problems. Often, severe course and atypical pathogens can lead to residual effects and disability.

Alena Paretskaya, pediatrician, medical columnist

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 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, intra-alveolar exudate is formed. The infection affects the respiratory parts 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 type of infection on its own. But, unfortunately, it is in children that doctors most often diagnose bilateral pneumonia.

Typically, in children, pneumonia develops against the background of bronchitis or ARVI. At the initial stage of the disease, the child exhibits the following signs:

In infants, double pneumonia is much more severe than in adults. This is due to some characteristics of the child’s body:

• the pulmonary type of tissue occupies too small an area;
• there is no naturally acquired immune reserve;
• the trachea is of insignificant length;
• the pleural sinuses are not fully opened.

Pneumonia in children is accompanied by mixed or respiratory acidosis, hypercapnia and hypoxia. Due to respiratory disorders during pneumonia in young children, disruptions in homeostasis occur. This in turn leads to deterioration of external respiration. The shape, depth, and frequency of breathing changes. The baby is breathing with wheezing and whistling.

The initial stage of the disease in full-term infants is much more acute than in premature infants. 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 clinical observation.

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

Pneumonia is considered a polyetiological disease. Each age group is characterized by certain pathogens of this infection:

• Viruses;
• Bacteria;
• Fungi.

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

1. Immunodeficiency state.
2. ARVI.
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 acquired during childbirth. Against the background of a simple ARVI, pneumonia usually develops in newborns with hypertrophy.

Infants 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 who has pneumonia must be hospitalized. 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 infants, the development of pneumonia is much more acute than in premature newborns. The body temperature rises sharply, and parents cannot bring it down. The child has a fever and suffers from a severe cough. The baby turns pale, noticeable shortness of breath appears, and breathing becomes difficult.

In premature babies, the symptoms of the disease are not so pronounced. Body temperature does not rise above 38 degrees, the cough is dry, without sputum. The baby is capricious and crying due to muscle pain and headaches tormenting him. Diagnosing such gradually developing pneumonia is quite difficult. A doctor can make an accurate diagnosis only after undergoing x-rays and passing all tests.

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

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

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 suffered from acute respiratory viral infection shortly before giving birth. The development of the disease can also be provoked by prolonged or premature labor.

Pneumonia in a newborn up to one year old must be treated in a hospital setting. Doctors recommend that not only infants, but also young children undergo treatment under the constant supervision of a doctor. This is due to the fact that children under 3 years of age cannot adequately assess their condition, and parents do not always have time to quickly react 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 admitted to the hospital. Pneumonia in children is treated with antibiotics. The child is prescribed intramuscular injections, since a baby under six months of age cannot swallow a tablet. Having identified the causes of the disease and familiarized itself 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 required level of oxygen and stabilize breathing, doctors use some oxygen therapy methods. Treatment of the disease must be comprehensive, therefore, in addition to taking antibiotics, specialists also prescribe a number of general strengthening measures to young patients.

During treatment of pneumonia in newborns, parents should strictly follow all doctor's advice. While you are in the hospital with your child, 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 should be turned over to the other side. The baby's chest should be tapped regularly, as this helps speed up the release of mucus.

If a baby was diagnosed with pneumonia at birth, he will be discharged from the hospital only after all symptoms of the disease disappear and remission occurs. Doctors usually do not make predictions regarding 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 developmental characteristics;
• congenital diseases;
• infant immunity.

Pneumonia in newborns is usually treated within 4 weeks. Regardless of what reasons 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 left to chance. If you notice the first signs of pneumonia in your baby, you should immediately seek help from a doctor.