Causes of purulent pleurisy, characteristic symptoms, possible consequences and methods of treatment. Purulent lung diseases: Classification, Symptoms, Diagnosis, Treatment Purulent process in the lungs
Definition 1
Purulent lung diseases are inflammatory processes in the lungs, accompanied by symptoms of severe intoxication of the body.
Purulent diseases of the lungs include: abscess and gangrene of the lungs, bronchiectasis.
Purulent diseases of the lungs develop as a result of the penetration of pathogens (staphylococci) into the bronchi (bronchiectasis) or into the lung tissue (abscess and gangrene of the lungs).
Bronchiectasis
Bronchiectasis is an acquired disease in which the bronchi irreversibly change as a result of a suppurative process.
Mostly bronchiectasis is localized in the lower sections of the bronchi.
Bronchiectasis in shape can be spindle-shaped, saccular, cylindrical, mixed. Bronchiectasis is localized unilaterally or bilaterally.
The causes of bronchiectasis can be:
- Chronical bronchitis;
- pneumonia;
- influenza, whooping cough, measles.
Bronchiectasis is accompanied by:
- dull pain in the chest;
- copious sputum when coughing in the morning;
- an increase in body temperature.
- headache;
- fatigue;
- irritability.
A clinical examination of the patient's blood reveals an increase in ESR, leukocytosis with a shift to the left.
On the radiograph of the lung - deformation of the pulmonary pattern.
For the treatment of bronchiectasis are prescribed:
antibiotics intramuscularly or aerosolly (oxacillin, gentamicin, penicillin, ampicillin,); removal of the affected lobe of the lung.
Additional treatment:
- expectorants;
- postural drainage;
- bronchial lavage;
- massage, exercise therapy;
- Spa treatment.
lung abscess
Definition 2
Lung abscess is a purulent fusion of lung tissue with the formation of one or more delimited cavities that are filled with pus and surrounded by an inflammatory ridge (infiltrate).
The causes of lung abscess disease can be:
- blockage of the bronchus;
- pneumonia (aspiration, bacterial);
- subphrenic abscess; cyst suppuration;
- hematogenous metastasis.
Contributing factors are: weakening of the immune system and senile age.
Clinical manifestations of a lung abscess have 2 phases.
In phase 1, an abscess is formed, which is accompanied by:
- chest pain;
- cough with scanty sputum;
- malaise;
- weakness;
- loss of appetite;
- fever (hectic).
In the blood in this phase, neutrophilic leukocytosis 15-20 109/L is detected.
On the radiograph of the lungs - large-focal blackout with jagged edges.
In phase 2, an abscess breaks into the bronchus, accompanied by:
- abundant separation of purulent sputum (up to two liters);
- improving the patient's well-being;
- decrease in body temperature.
In a clinical study of the patient's blood, a dynamic improvement in indicators (decrease in ESR, leukocytosis) is determined. An X-ray examination of the lungs reveals an enlightenment with a fluid level.
Complications of a lung abscess may include:
- pulmonary bleeding;
- breakthrough into the pleural cavity of the abscess;
- abscess metastases to the spleen, liver, brain and other organs.
For the treatment of a lung abscess, antibiotic therapy is prescribed, after sputum culture (determination of sensitivity): gentamicin, penicillin.
Antibiotics are administered both parenterally and intrabronchially (through a bronchoscope);
If improvement is not observed, then two months later, surgical intervention is performed.
Additionally: drainage position, oxygen therapy, when the process subsides, sanatorium treatment.
At its core, this is a secondary disease that occurs as a complication after suffering a croupous or influenza type of pneumonia.
Etiology and types of disease
There are two types of purulent pleurisy:
Parapneumonic pleurisy of the lungs is considered a kind of complication of pneumonia that occurs during its progression. The second type begins to develop after the pneumonia has ended. It is more common in medicine. In addition, their appearance almost always provokes the development of serous-purulent or purulent exudation.
Most often, the appearance of purulent pleurisy is due to the presence of staphylococci, streptococci, Pseudomonas aeruginosa or Escherichia coli. Often, in the process of analyzing crops of the contents of the pleura, the presence of pneumococcus, Proteus, Klebsiella and yeast is determined. Currently, the presence of anaerobic bacteria is very common in the test contents. They are more characteristic of putrefactive empyema, which complicates the course of pulmonary gangrene.
The data of domestic and foreign studies indicate that the number of staphylococcal diseases is rapidly increasing. At the same time, there is a progressive increase in the percentage of strains characterized by a high degree of resistance to antibiotics.
There has also been a significant increase in discharges containing penicillin-resistant bacteria. At the same time, the number of microorganism species present in the secretions is constantly increasing in the dynamics of the treatment of pneumonia with antibiotics.
Symptoms of the disease
Patients who have been diagnosed with purulent pleurisy most often complain of the following signs of the disease:
- the presence of pain and a feeling of heaviness in the lateral region, cough;
- difficulty breathing and inability to take full breaths;
- the appearance of shortness of breath;
- a significant increase in body temperature;
- appearance of weakness.
In the early stages of the onset of the disease, symptoms such as stabbing pain in the chest area occur. But with the expansion of the area of influence of inflammation and with the formation of exudate, they become less intense, a feeling of heaviness appears in the side.
Over time, shortness of breath becomes more pronounced. In many cases, a dry cough is present. If there is a development of secondary pleurisy, which occurs due to pneumonia or lung abscess, cough is accompanied by sputum. It has the appearance of mucus or purulent consistency.
With the development along with pleurisy of another disease, a change in the characteristic features of cough is observed. It becomes more intense and painful, often begins to occur at night. In some cases, it can have the character of seizures and is greatly enhanced when a person lies on the diseased side of the body.
Abscess rupture process
What will happen if the patient is not provided with timely medical care? Shortness of breath becomes pronounced. Strengthening it is observed, as in the case of cough, when the patient lies on his side. Therefore, the patient always has to take the same position of the body in order to avoid discomfort, to facilitate breathing and reduce pain in the chest.
Body temperature rises to a maximum and is characterized by a stable or hectic character. The pulse is beats per minute. This is affected not only by intoxication with purulent masses, but also by a shift in the cardiac and vascular position in the opposite direction from the accumulated exudate.
When a lung abscess ruptures, pus and air masses enter the pleural cavity. This provokes the onset of pleural shock. Intense cough, which practically does not stop, is the most basic precursor of a purulent impulse.
The person fails to take a deep breath, the face gradually turns pale, cold sweat appears on the skin. At the same time, the pulse rate increases and there is a significant decrease in blood pressure. The sensation of pain provokes the occurrence of shallow, rapid breathing. There is an appearance of acrocyanosis and an increase in shortness of breath.
The reasons for this - in the irritation of the pleura. It is the source of the appearance of pain, air pressure and purulent masses of the lung, changes in the position of organs and disruption of the heart.
After the acute manifestations of the disease subside and the patient is removed from the state of shock, the development of intoxication begins. It is characterized by a more dangerous form than with one of the types of pleural empyema.
If pleurisy is started, scarring, adhesions form, bronchiectasis develops, inflammation becomes chronic, and exacerbations occur from time to time.
Ways to treat the disease
The main task of the treatment of purulent pleurisy is to eliminate the infection and symptoms of emerging intoxication. In addition, it is required to restore the normal functioning of diseased organs.
First of all, you need to eliminate the purulent focus and straighten the lung after that. Only after the pleura sheets grow together and obliteration of the focus cavity occurs, it will be possible to talk about recovery. The most important thing is to start treatment on time, which prevents the appearance of moorings in the pleura and the transition of the disease to a chronic form.
Treatment of the patient consists in pumping out the exudate. The procedure is accompanied by the introduction of penicillin intramuscularly into the cavity. If indicated, transfuse plasma or red blood cells.
Difficult cases require surgical treatment, during which the rib is resected.
Possible consequences
Pleurisy of the lungs is an extremely serious disease. If it has been started or not completely cured, there is a high probability of complications that are dangerous to human health. This may be an adhesion that has appeared, a bronchopleural fistula, impaired blood circulation, which provoked exudate pressure on the vessels. In addition, there is a threat of the emergence and development of kidney disease.
The most dangerous consequence of this disease is pleural empyema. The essence of this pathological process is that pus accumulates in the lungs and under the influence of this a free cavity is formed. A kind of "pocket" is formed. After this, the pleura is scarred and completely immures one of the lungs.
Another serious consequence of purulent pleurisy is the appearance of amyloidosis of parenchymal organs. Almost ½ of all cases of this complication were fatal. The development of amyloidosis is typical for people with a weakened body, the elderly and children.
A small amount of exudate can be absorbed without intervention. After the underlying disease has been eliminated, exudation stops after a week. If the fluid has been removed, then sometimes there may be a persistent flow, and the effusion again accumulates in the pleural cavity. This is especially true for the infectious type of pleurisy. If the cause of the disease is an oncological nature, then the disease always progresses and the outcome is not favorable in almost 100% of cases. Purulent pleurisy has the same type of course of the disease.
Patients with a history of this disease are under long-term observation in the dispensary. In addition, among the recommendations of doctors in the first place is the rejection of fortified and high-calorie diets, the prevention of colds and hypothermia, limiting work in especially harmful conditions associated with chemicals.
The essence of the prevention of purulent pleurisy is the timely and high-quality treatment of those diseases that provoke its appearance and development.
Be sure to increase the resistance of your body to various infections.
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JMedic.ru
Purulent pleurisy, which can also be called "pleural empyema" or "pyothorax", is a variant of exudative pleurisy, in which the effusion is represented by purulent masses. Pus, in turn, is called effusion, which in large quantities contains fragments of dead white blood cells - leukocytes and pathogenic microorganisms. It has a thick consistency and a white-yellow color.
In the figure, the diagram of the pleural cavity is normal and with purulent pleurisy.
Acute purulent pleurisy is characterized by the rapid accumulation of pus in the pleural cavity, its effect on the body - intoxication, as well as the development of respiratory failure, which can also be combined with signs of heart failure.
Origin of pleural empyema
It is customary to single out purulent pleurisy as an independent disease, because the main symptoms that form the clinical picture of the disease and its possible consequences differ from those in other variants of exudative pleurisy. At the same time, the treatment of patients, as a rule, requires active efforts at the local level and must be accompanied by their stay in a surgical hospital.
By origin, this type of pleurisy can be the result of:
- Complicated pneumonia
- Purulent-destructive diseases of the lungs, the most common of which should be considered abscess and gangrene of the lung.
- Injuries and surgical interventions on the lungs
- Acute inflammatory processes in the abdominal cavity: for example, subdiaphragmatic abscess
- Spread through the bloodstream of infection from a distant purulent focus: for example, in cases of osteomyelitis - lesions of the vertebral bodies. In this case, an abscess of the lung is again formed. An abscess, in turn, leads to pleural empyema.
The figure shows the upper lobe of the left lung, in which an abscess has formed. At the same time, the pathological process has already melted the lung tissue and is ready to move into the pleural cavity.
Nowadays, an abscess in the lungs gives an incidence of pleural empyema of about 10%, while pneumonia is 5%. But in patients with lung gangrene, this frequency is about 97%. This is due to the fact that gangrene is a very formidable condition, which is characterized by the death of tissues in contact with the external environment. It is caused by a special group of microorganisms-pathogens, as a rule, characterized by particularly pronounced viability and pathogenic properties.
It is worth talking about abscesses in a little more detail. Most often, a lung abscess is a consequence of a general decrease in immunity, or a foreign body entering the respiratory tract. Often, an abscess is formed as a result of aspiration, that is, inhalation by the patient of vomit, food particles, or other foreign particles. Usually the abscess is surrounded by a dense capsule.
However, over time, pus can melt its wall: then the abscess breaks through, and nearby tissues melt. It is at the moment of the breakthrough of the abscess and the spread of inflammation through the lung tissue to the visceral pleural sheet that pleural empyema can form. Therefore, it is important to diagnose an abscess in a timely manner and prevent its complications.
It is important to remember that purulent inflammation in the lining of the lungs can be the consequences of a puncture of the pleural cavity or subclavian vein, if these manipulations are performed rudely and illiterately, in connection with which trauma to the pleural sheets occurs. However, nowadays such a complication is quite rare.
Microorganisms - causative agents of purulent inflammation of the lining of the lungs most often are the following bacteria:
- Staphylococcus aureus or Staphylococcus aureus.
Micrograph of Staphylococcus aureus. The bacterium has a spherical shape and is located in the form of grapes.
Micrograph of Streptococcus pyogenes. The bacterium has a spherical shape and is arranged in the form of chains.
Micrograph of Escherichia coli. The bacterium is rod-shaped. Arranged in groups.
Micrograph of Haemophilus influenzae. It has a stick shape. It is more scattered. Compared to E. coli.
Quite often, the above microorganisms are in association with anaerobes, bacteroids, fusobacteria or prevotella. Anaerobes are called microorganisms that do not need oxygen for adequate life. In patients who are on mechanical ventilation for a long time, in general, anaerobes can be the only causative agents of a purulent pathological process in the cavity of the lung membrane.
Clinical picture of pleural empyema
In the first few tens of hours from the onset of the disease, signs of purulent pleurisy are usually masked. The patient mainly complains of symptoms characteristic of most pathological processes in the lungs: chest pain, weakness, lethargy, slight shortness of breath, fever.
By the third day of illness, the patient's condition usually deteriorates rapidly and significantly. There are severe pains in the chest, which increase or occur when breathing and coughing: the so-called "pleural pains". Body temperature rises to degrees. In this case, fluctuations in body temperature per day can reach 2 degrees. The patient experiences shaking chills, an increase in shortness of breath, becomes lethargic and gradually loses interest in reality, his face may be haggard, his eyes sunken, his features sharpened: all these are signs of intoxication syndrome, that is, the harmful effect of accumulated pus on the patient's body. Upon examination, symptoms such as rapid breathing, sweating, difficulty in inhaling and diffuse cyanosis, that is, cyanosis of the patient's skin, immediately attract the doctor's attention.
Accumulating, pus tends to spread: it simply melts nearby structures and passes to the soft tissues of the chest wall. This may lead to the formation of a fistula, that is, an anastomosis between the pleural cavity and the external environment.
If a fistula is formed between the cavity of the lung membrane and the bronchus, then spontaneous removal of purulent exudate from the pleural cavity occurs. In this case, the patient develops or significantly intensifies cough, a large amount of purulent sputum is separated, often containing an admixture of blood in its composition. Moreover, the cough with the separation of purulent masses becomes stronger in the position of the patient on a healthy side: the so-called "drainage position".
A blood test reveals an increase in white blood cells - leukocytes: up to a thousand per 1 microliter at a rate of up to nine thousand. The erythrocyte sedimentation rate increases domm/h, which is 4 times higher than the norm. Leukemoid reactions are possible. This means that the number of young and young forms of leukocytes significantly increases in the blood count.
Confirmation of the diagnosis of purulent pleurisy usually occurs during the study of the actual contents of the cavity of the membrane of the lungs, which is obtained by puncture. Purulent exudate is usually cloudy and viscous. It may have different colors. It depends mainly on the causative agent of the pathological process and its properties. If the causative agent was pneumococcus or staphylococcus, then the pus will have a yellow tint, if streptococcus is grayish. If the pathogens are mostly anaerobic, then the pus will differ in a dirty gray color and a sharp, very unpleasant odor.
Later, a bacteriological study of purulent effusion is performed. It allows you to accurately determine the pathogens of the process and their individual sensitivity to antibacterial drugs. This makes it possible to prescribe adequate treatment.
Warning
If the prevalence of the purulent process in the lungs is quite large, and the treatment is insufficient and untimely, then the acute inflammatory process in the pleura can turn into chronic pleural empyema. In this case, the pus in the pleural cavity eventually becomes surrounded by a kind of “bag”, the walls of which consist of dense and coarse connective tissue, poor in blood vessels. The reason for the transition of an acute inflammatory process in the lining of the lungs into a chronic one, as a rule, lies in the late detection and incomplete, “poor-quality” drainage of pleural empyema. Such an outcome is also an obstacle to the complete expansion of the lung tissue, previously compressed by purulent exudate.
Often, after the delimitation of the process that has become chronic, the inflammatory focus is completely replaced by connective tissue. This condition is called fibrothorax.
A striking external sign of fibrothorax is a visible decrease in the affected half of the chest and its lag in movement during breathing.
Necessary therapeutic measures
If the diagnosis of purulent pleurisy is confirmed in a patient, it is urgent to prescribe adequate treatment. This will avoid the transition of acute purulent inflammation into a chronic form and other complications, such as increasing respiratory failure, for example.
The patient should be given antibiotic therapy. The choice of a specific drug should be dictated by the results of a bacteriological study obtained during a puncture of the pleural effusion.
In addition, detoxification therapy should be carried out, aimed at reducing the harmful effects of the pathogen microorganism and the exudate itself on the patient's body. It consists in the introduction into the patient's body intravenously of solutions that improve the properties of blood and contribute to the accelerated work of the kidneys as a filter, that is, the accelerated removal of harmful waste products of the pathogen bacteria from the patient's body.
In addition to treatment aimed at the patient's body as a whole, it is important to conduct active and regular local therapy. The latter is to ensure regular pleural punctures, which will allow the evacuation of exudate from the pleural cavity. At the same time, the pleural cavity is washed with antiseptic solutions, a drainage tube is inserted into it, through which the newly formed exudate leaves, and drugs are introduced that accelerate tissue healing, and solutions for washing the pleural cavity.
Sometimes the drainage tube is connected to a special pump, which facilitates the work of medical personnel.
Causes of purulent pleurisy, characteristic symptoms, possible consequences and methods of treatment
The most complex and dangerous pathology of the lungs is pleurisy, and people of any gender fall into the risk group. With the progression of such a disease, an inflammatory process develops on the outer surface of the lung tissue, and pus accumulates inside the organ.
Acute purulent pleurisy causes an increase in body temperature and constant shortness of breath, and the patient is in an extremely serious condition.
The reasons for the development of such a pathology may be different, and in the absence of effective therapy, a fatal outcome is possible.
Causes of development and forms of the disease
Experts say that pleurisy is not an independent disease. Mostly such an ailment develops as a result of the progression of various ailments in other organs.
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All the causes that provoke pleurisy of the lungs are conditionally divided into:
Medical practice shows that the following pathologies can cause infectious pleurisy:
- the appearance of problems with the functioning of the gastrointestinal tract;
- diabetes;
- chronic pathologies of the lungs;
- alcoholism.
Causes of a non-infectious nature are various malignant tumors, and the outer surface of the lungs becomes their place of localization. In addition, various injuries and injuries of the connective tissue can cause pleurisy of the lung tissue.
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Experts distinguish several forms of pleurisy of the lungs, taking into account the clinical picture. The dry form of the disease is considered the initial stage of the development of the disease. For this form of pathology, damage to the circulatory system is characteristic, and infectious pathogens are not detected in the lung cavity.
The dry form of the disease is accompanied by an increase in vascular permeability under the influence of anti-inflammatory components. In addition, the patient has leakage of liquid plasma, and the result of this is the appearance of fibrous filaments on the lung surface. Such pleurisy is characterized by a violation of the outflow of fluid, which causes strong friction of the pleural sheets. The consequence of this is the appearance of severe pain in the patient.
In the absence of timely effective therapy, the dry form of the disease passes to the next stage. There is an increase in the focus of inflammation and exudative disease develops.
At this stage of the development of the disease, the activity of enzymes is significantly reduced and a kind of cavity appears, where pus subsequently accumulates. The exudative form of pleurisy is accompanied by a significant increase in pleural fluid, and under its influence, the volume of the lung is significantly reduced.
In a situation where the disease enters an advanced stage, the patient begins to suffer from respiratory failure. There is a decrease in friction in the pleural sheets due to increased accumulation of fluid, which causes a decrease in pain.
The next stage in the development of the disease is purulent pleurisy or pleural empyema. This form of the disease is quite complex and poses a serious threat to the life of the patient. There is an accumulation of a large amount of pus in the serous membrane, and the general intoxication of the patient's body increases. Medical practice shows that empyema is most often formed with the progression of complex pathologies of other organs or in patients with impaired immune system functioning.
With purulent pleurisy in acute form, there is a rise in body temperature and the appearance of shortness of breath, and the general condition of the patient is diagnosed as extremely severe.
Symptoms of the disease
For purulent lung disease, the following symptoms are characteristic:
- the occurrence of acute pain and a feeling of heaviness;
- breathing problems when it is impossible to take a deep breath;
- there is a feeling of fullness in the side;
- rise in body temperature;
- severe cough and shortness of breath;
- weakness of the body.
With purulent pleurisy, the patient complains of the appearance of strong painful sensations, but with the accumulation of pus, they begin to decrease. Purulent pleurisy is accompanied by the appearance of a dry cough, which especially worries the patient at night. In a situation where pleurisy develops as a complication after inflammation or abscess of the lungs, sputum with an admixture of pus begins to be detected.
A characteristic sign of purulent lung disease is considered to be a temperature rise of up to degrees. Fever may persist all the time or appear intermittently. The pulse reaches beats per minute and the cause of this condition is purulent intoxication of the body, as well as a displacement of the heart to one side.
This condition of the patient is considered severe and requires immediate medical attention. If effective therapy is not carried out, a breakthrough of pus into the pleural cavity is possible. During the development of the inflammatory process in the pleural cavity, not only pus accumulates, but also air. Such a pathological condition in medical practice is called "pyopneumothorax" and is accompanied by the patient's severe shortness of breath and pain.
In the event that purulent pleurisy enters an advanced stage, the result is scarring of the tissue and the appearance of adhesions. In addition, bronchiectasis is diagnosed, and the inflammatory process becomes chronic with relapses.
Possible consequences and diagnosis
In the absence of effective therapy, pathology can pose a serious threat to the life of the patient. This is due to the fact that the progression of purulent pleurisy in the human body can result in the development of a lung abscess.
In the event that a breakthrough of a purulent pocket occurs, the infection spreads into the pleural cavity. The consequences of such a pathological condition are pneumonia, cystic formations and gangrene.
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Breakthroughs of a pocket with pus in a patient are accompanied by a rise in temperature, as well as an increase in cough and increased heart rate. In addition, breathing quickens and when the abscess breaks, hypoxia begins to develop.
If pleurisy enters an advanced stage, then this causes a significant increase in the affected area of \u200b\u200bthe chest. The progression of pleurisy in the human body causes its general intoxication, and the content of a large amount of pus provokes the expansion of the intercostal space and respiratory arrest.
In the absence of effective therapy, the consequences of such an ailment can develop in the form of adhesions and pleural calcification. In addition, there may be a restriction of lung mobility and the development of acute heart failure.
The main and only method for detecting purulent pleurisy is an X-ray examination of the chest. On the images obtained during the procedure, darkening of the lung tissue and an oblique upper level of fluid are observed. The location of the fluid accumulation is determined by its quantitative volume.
Another effective method for diagnosing purulent pleurisy is pulmonary puncture. The patient is taking fluid from the lungs, which is subsequently carefully studied. Thanks to this procedure, it is possible to diagnose the type of pathology and choose an effective course of treatment.
Features of the treatment of the disease
In the event that there are suspicions of purulent pleurisy, the patient is subject to mandatory hospitalization.
Treatment of such a pathology involves the solution of the following tasks:
- stabilization of the patient's condition;
- restoration of normal breathing;
- elimination of the cause that provoked pleurisy.
In most cases, this pathology is of an infectious origin, so drug therapy is carried out with the use of antibiotics and anti-inflammatory drugs.
In the fight against purulent pleurisy, the following antibacterial drugs are prescribed:
Taking antibiotics in the treatment of pleurisy helps to prevent the further spread of bacteria and cause their death.
It is possible to restore the water-electrolyte balance with the help of saline or glucose. Such drug treatment helps to speed up renal filtration and quickly get rid of decay products.
Therapy of purulent pleurisy can be carried out using the following drugs:
- diuretics help the body get rid of fluid and slow down the absorption of sodium and potassium;
- non-steroidal anti-inflammatory drugs help get rid of severe pain;
- glucocorticosteroids prevent the synthesis of anti-inflammatory components.
When dry pleurisy is detected, treatment involves adherence to bed rest. In addition, it is prescribed to take drugs that have an antimicrobial, analgesic and anti-inflammatory effect on the body. Banks and warm compresses help speed up the healing process.
When diagnosing such a form of the disease as purulent exudative pleurisy, the patient is placed in a hospital in a medical institution. Conservative therapy involves taking antitumor and anti-infective drugs on the body.
An important role in this form of the disease is the observance of a special diet with a sufficient content of vitamins and proteins. Special nutrition involves the complete elimination of salt from the diet and the consumption of a limited amount of liquid.
In the event that the appearance of an increased amount of fluid in the pleural cavity is diagnosed, then specialists make a decision to perform a puncture. To perform this procedure, a special needle is inserted to the side of the scapula, the pleura area. Thanks to the puncture, it is possible to remove excess fluid from the body, significantly reduce pressure in the lung cavity, and restore breathing. After the puncture, the patient is prescribed therapeutic exercises and physiotherapy.
Treatment of purulent pleurisy is carried out only in stationary conditions. Self-treatment of the disease at home can pose a threat to the patient's life and cause the development of serious consequences.
The main task in the treatment of such a pathology is the prevention of the process of tissue destruction. A daily puncture is performed, the cavity is washed with antiseptic agents, and drainage is applied.
With purulent pleurisy, drug treatment may not bring the desired result, so they resort to surgical intervention. During the operation, specialists remove dense scars of the pleura or its parietal sheets, and this is determined by the degree of lung damage.
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BRONCHIOECTATIC DISEASE.
Chronic suppurative process in pathologically altered and functionally defective bronchi.
Men are more often ill.
Causes:
1. congenital weakness of the bronchial wall (insufficient development of smooth muscles, cartilage tissue)
2. frequent bronchopulmonary infections.
Pathogenesis: The inflammatory process in the bronchi leads to the death of elastic fibers . Under the influence of intrabronchial pressure, the bronchus wall protrudes, where a purulent secret accumulates. The bronchus is deformed, which leads to a violation of the draining and ventilation functions.
Clinic:
Cough with purulent sputum, especially in the morning with a "full mouth" and when taking a drainage position
Symptoms of intoxication
Hemoptysis
Objectively:
Skin is pale cyanotic
The shape of the fingers "drumsticks", the shape of the nails "watch glass"
Barrel chest
Percussion - a sound with a box tone or dullness
Auscultatory: wet rales in the same areas of the lungs, dry scattered rales.
Additional methods:
KLA: anemia, leukocytosis with a shift to the left, increased ESR.
OAM: proteinuria
Sputum OA: purulent, many leukocytes
Rg of the lungs: cellularity and deformation of the lung pattern.
Bronchography: normally, the bronchial tree has the appearance of a “tree in winter”, and with BEB, “a tree with leaves”, “honeycomb”, “bird's nests”.
Bronchoscopy: endobronchitis
Complications:
Pulmonary bleeding
lung abscess
Pleurisy (empyema)
Pulmonary heart
Treatment:
Surgical: remove segment or lobe with bronchiectasis
With an exacerbation of a / b, taking into account the tank. sputum culture
Mucolytics
Bronchodilators
vitamin therapy
Detoxification therapy
Cardiovascular agents
Drainage position 2-3 times a day in combination with mucolytics, bronchodilators and vibration massage
Therapeutic bronchoscopy
Breathing exercises, massage, exercise therapy
Oxygen therapy.
Dispensary observation: at the pulmonologist.
ABSCESS OF THE LUNG.
Purulent fusion of lung tissue in the form of a limited focus (abscess) and the formation of one or more cavities filled with pus and communicating with the bronchus and emptying through it.
Etiology:
Bacterial pyogenic flora: Staphylococcus aureus, Streptococcus, Klebsiella, etc.
Injuries: bruises, compression, penetrating wounds
The infection penetrates bronchogenically (aspiration of mucus, pus), hematogenously, lymphogenously, by spreading from neighboring organs.
Clinic:
1 period - before the breakthrough of the abscess in the bronchus:
Intoxication syndrome (fever, chills, heavy sweats, weakness)
Dry cough
Chest pain associated with breathing, coughing
Percussion - dullness of sound on the side of the lesion
Chest lagging on the side of the lesion
Auscultatory - weakened breathing on the side of the lesion
2 period - after the breakthrough of the abscess in the bronchus:
- An attack of coughing with discharge of purulent fetid sputum in the amount of 100-500 ml.
With good drainage (emptying) of the abscess, the state of health improves, the temperature decreases
Percussion - dullness of sound on the side of the lesion, less often - tympanitis
Auscultatory - moist rales.
Additional methods:
KLA: leukocytosis with a shift to the left, increased ESR
OAM: proteinuria
Sputum OA: purulent, many leukocytes
Rg before breakthrough: pneumonic infiltration with clear contours, after: cavity with horizontal fluid level
Bronchoscopy
Puncture with biopsy.
Complications:
Pulmonary bleeding
Pleural empyema
Pneumothorax
Development of new abscesses during aspiration of pus
Ulcers in distant organs
Exodus:
Recovery
pneumosclerosis
Chronic abscess (after 2-3 months)
Treatment:
Hospitalization in the pulmonology department or in the department of thoracic surgery.
A diet rich in proteins and vitamins.
Postural drainage and bronchial lavage.
Antibiotics
Detoxification therapy
Cardiovascular agents
vitamins
Immunotherapy (plasma, Ύ-globulin…)
Bronchodilators, expectorants
oxygen therapy
Surgical treatment (lobectomy, pulmonectomy)
GANGRENE OF THE LUNG.
purulent-putrefactive necrosis of the lung tissue without clear boundaries.
Caused by anaerobic infection.
The current is heavy. Lethality is high.
Sputum is foul-smelling with pieces (sequesters) of lung tissue. Treatment in thoracic surgery.
PLEURITIS.
- inflammation of the pleura.
Dry pleurisy
Exudative (exudative)
Causes:
1. Pneumonia, lung abscess
2. Tuberculosis
3. Lung cancer
4. Rheumatism
6. Thromboembolism of the pulmonary artery, etc.
Pathogens (bacteria, viruses, fungi, etc.) penetrate the pleura by contact (pneumonia, tuberculosis), hematogenously, lymphogenously, from the external environment (injuries, wounds).
Purulent diseases constitute a large group of pathological processes that develop in the lung tissue. They are diverse depending on the causes of occurrence, morphological changes, clinical manifestations. There is no microflora specific for purulent diseases. They can be caused by streptococcus, staphylococcus, diplococcus, proteus, fusobacilli and other types of microflora.
Non-clostridial bacteria of the Bacteroides group (B. fragilis and others), Peptostreptococcus anaerobicus, etc. are of great importance in the development of purulent lung diseases. 80-90% of patients with purulent lung diseases.
Bacteroids are insensitive to widely used antibiotics, sensitive to metronidazole and similar drugs.
There are the following forms of purulent lung diseases.
- Infectious destruction of the lungs:
b) gangrene of the lung. Abscesses by localization are peripheral and central, single and multiple, unilateral and bilateral. Depending on the presence of complications, they can be uncomplicated and complicated (pyopneumothorax, pleural empyema, bleeding, sepsis).
- Staphylococcal destruction of the lungs.
- Festering cysts of the lungs (with a characteristic due to localization and the presence of complications).
Abscess and gangrene of the lung are qualitatively different pathological processes.
Lung abscess is a limited purulent-destructive process in the lung tissue. Limitation of the inflammatory focus indicates a pronounced protective reaction of the body, while widespread gangrene of the lung is the result of progressive necrosis due to weak reactivity or complete unresponsiveness of the body.
Among the patients, men aged 30-35 years predominate: women get sick 6-7 times less often, which is associated with the peculiarities of the industrial activity of men. more common among them is the abuse of alcohol and smoking, leading to a violation of the drainage function of the upper respiratory tract.
Etiology and pathogenesis. The development of abscesses and gangrene of the lung is due to inflammation of the lung tissue, followed by its necrosis and purulent fusion; airlessness of the lung tissue due to bronchial obstruction and atelectasis: a circulatory disorder in it, aggravated by toxins on the airless lung tissue.
There are aspiration (bronchopulmonary), hematogenous-embolic, lymphogenous and traumatic ways of occurrence of pulmonary abscesses and gangrene.
Aspiration (bronchopulmonary) way. One of the most common causes of abscesses and gangrene of the lung is a violation of the patency of segmental and lobar bronchi, due to the ingress of infected material from the oral part of the pharynx into their lumen (in unconsciousness, intoxication, after anesthesia). In severe infectious diseases, the cough reflex is suppressed, the function of the ciliated epithelium of the bronchi is impaired, the infected material (food particles, tartar, saliva) can be fixed in the bronchus, causing the development of atelectasis and inflammation in the corresponding area of the lung. As a rule, abscesses in these cases are localized in the posterior segments (II, VI) and more often in the right lung.
Similar conditions arise when the bronchus is blocked by a tumor, a foreign body, when its lumen is narrowed by a scar (obstructive abscesses). Removal of a foreign body and restoration of bronchus patency often lead to a rapid cure of the patient.
Postpneumonic abscesses occur in 1.2-1.5% of patients with pneumonia. Their development is favored by a decrease in the reactivity of the body, pronounced disturbances in ventilation and blood supply to the lung, often due to previous pulmonary diseases, and insufficiently active treatment of the inflammatory process.
The hematogenous-embolic route of infection causes the development of 7-9% of lung abscesses. Infection enters the lungs due to the transfer of infected emboli by blood flow from extrapulmonary foci of infection during septicopyemia. osteomyelitis, thrombophlebitis, etc. Infected emboli clog small vessels of the lung, resulting in a lung infarction, the affected area undergoes necrosis and purulent fusion. Abscesses of hematogenous-embolic origin (usually multiple) are more often localized in the lower lobes of the lung.
The lymphogenous pathway for the development of pulmonary abscesses and gangrene is rare. The introduction of infection into the lungs is possible with angina, mediastinitis, subdiaphragmatic abscess, etc.
trauma path. The development of abscesses and gangrene is the result of penetrating wounds and blunt trauma of the chest with damage and necrosis of the lung tissue.
Pathological picture. In the lung tissue against the background of morphological changes,
characteristic of pneumonia, one or more areas of necrosis appear. Under the influence of bacterial proteolytic enzymes, purulent fusion of necrotic masses occurs - a cavity filled with pus is formed (Fig. 13). The destruction of the wall of one of the bronchi located in the zone of necrosis causes the flow of pus into the bronchial tree. In the future, morphological changes are determined by the state of the reactivity of the patient's body, the conditions for drainage of the abscess and its size, the course of the inflammatory process in the surrounding lung tissue.
With single purulent abscesses, the cavity is quickly freed from pus, its walls are gradually cleared of necrotic masses and covered with granulations. a scar or a narrow cavity lined with epithelium is formed at the site of the abscess.
With large, poorly draining abscesses, prolonged purulent fusion of necrotic tissues, the presence of an inflammatory process in the surrounding parts of the lung, the cavities are released from necrotic masses slowly, dense scar tissue is formed in the abscess wall, which prevents the cavity from shrinking and healing. A chronic abscess is formed.
Multiple abscesses are usually preceded by a widespread inflammatory process in the lung. Against this background, necrosis of the lung tissue occurs in several areas. Areas of necrosis undergo purulent fusion at different times, the breakthrough of abscesses into the bronchial tree does not occur simultaneously.
With multiple abscesses, the acute period may end with the formation of several cavities. Lung tissue between abscesses usually does not restore its normal structure.
Lung gangrene is characterized by the absence of delimitation of the altered lung tissue from the healthy one. An area of dead tissue without sharp boundaries turns into softened dark-colored lung tissue, which also passes into healthy tissue without clear boundaries.
Clinical picture and diagnosis. With typically occurring forms of abscess, two periods can be distinguished in the clinical picture: before the breakthrough and after the breakthrough of the abscess into the bronchus.
The disease usually begins with symptoms characteristic of acute pneumonia: fever up to 40 ° C, pain in the side with a deep breath, cough. Physical examination reveals a delay in breathing of the part of the chest corresponding to the affected section of the lung, pain on palpation; here they determine the shortening of the percussion sound.
On radiographs and computed tomography, a dense shadow is visible, larger or smaller. Despite the ongoing treatment, pneumonia is not resolved, it becomes protracted. High body temperature is accompanied by chills and profuse sweat. Sometimes patients notice a putrid smell from the mouth. A blood test reveals high leukocytosis, a sharp shift of the leukocyte formula to the left.
The second period begins with the breakthrough of the abscess into the bronchial tree. The emptying of the abscess cavity through a large bronchus is accompanied by the discharge of a large amount of pus, sometimes with an admixture of blood. The patient's condition improves rapidly. However, more often the emptying of the abscess cavity occurs through a tortuous course formed by a small bronchus, starting in the upper part of the abscess. Therefore, his release from pus is slow, the patient's condition remains severe. Pus, getting into the bronchi, causes the development of purulent bronchitis with abundant sputum (up to several hundred milliliters per day). Sputum with a lung abscess has an unpleasant odor, and when standing in a jar, it is divided into three layers: the lower one consists of pus, the middle one - from serous fluid and the upper one - foamy - from mucus. Sometimes in the sputum you can see small pieces of altered lung tissue (pulmonary sequesters). Microscopic examination reveals a large number of leukocytes, elastic fibers, many bacteria.
As the abscess cavity is freed from pus and the perifocal inflammatory process is resolved, the zone of percussion sound shortening disappears. Over a large pus-free cavity, a tympanic sound may be detected. It comes to light more distinctly if at percussion the patient opens a mouth. With a significant size of the abscess, amphoric breathing over the cavity and various wet rales are heard, mainly in the adjacent parts of the lung.
When X-ray examination after incomplete emptying of the abscess, a cavity with a liquid level is determined. Initially, it has fuzzy contours due to perifocal inflammation. As the abscess empties further and the perifocal inflammatory process subsides, the abscess borders become
clearer. Multiple lung abscesses are more severe. Usually they are metapneumatic and occur against the background of inflammatory infiltration of large areas of lung tissue. The breakthrough of one of the formed abscesses into the bronchial tree does not lead to a significant decrease in intoxication and an improvement in the patient's condition, since foci of necrosis and purulent fusion remain in the lung tissue. The condition is aggravated by developing purulent bronchitis with copious separation of fetid sputum. Physical examination determines the delay in breathing of the chest on the side of the lesion, dullness during percussion, respectively, one or two lobes of the lung: during auscultation, a lot of wheezing of various calibers is heard. X-ray examination first reveals extensive darkening in the lung; as the abscesses are emptied against the background of darkening, cavities with fluid levels become visible. Recovery of the patient, as a rule, does not occur. The disease is progressing. Cardiopulmonary insufficiency, stagnation in the pulmonary circulation, degenerative changes in parenchymal organs develop. All this without timely surgical treatment quickly leads to death.
The most severe form of purulent lesion of the lung is gangrene. Absorption of putrefactive decay products formed during lung gangrene, and 
bacterial toxins leads to a sharp intoxication of the patient's body. With gangrene of the lung, a large amount of fetid, foamy sputum begins to separate early, which has a purulent-bloody character due to the admixture of blood from arrosed pulmonary vessels. As a rule, the pleura is involved in the purulent process, which leads to the development of putrefactive empyema or pyopneumothorax. When examining a patient, pronounced shortness of breath, pallor of the skin, cyanosis, a significant zone of shortening of percussion sound above the affected lung are noted: during auscultation, a lot of moist rales of various calibers are heard. X-ray reveals extensive blackout in the lung, which increases every day (Fig. 14). Before the advent of antibiotics, patients with lung gangrene usually died in the first days of the disease. Treatment. Acute purulent lung diseases require complex treatment aimed at increasing the body's resistance, improving the conditions for abscess drainage. the fight against infection, the normalization of cardiac activity and the function of internal organs.
Conservative treatment: an increase in the resistance of the body is achieved by an appropriate hygienic regimen, enhanced nutrition. Patients lose a large amount of protein with sputum, primarily albumin, so the diet should make up for these losses. To compensate for energy costs, calorie content
daily diet should be 3500-4000 cal: it is also necessary to provide full parenteral and enteral (including tube) nutrition.
To improve the conditions for drainage of an abscess, expectorants are used; solutions of proteolytic enzymes, mucolytic agents are injected into the bronchial tree in the form of an aerosol or by pouring into the abscess cavity through a bronchoscope, as well as when an abscess is punctured in case of its subpleural location: physiotherapy exercises are prescribed in combination with postural drainage.
Rational antibiotic therapy is carried out taking into account the sensitivity of the microflora. sown from sputum. In the absence of data on the sensitivity of microflora, it is advisable to use broad-spectrum antibiotics (aminoglycosides, cephalosporins, etc.) in combination with metronidazole. sulfa drugs.
In addition to intravenous, intramuscular or oral administration of antibiotics. it is advisable to introduce them directly into the bronchial tree in the form of an aerosol or through a bronchoscope, as well as into the abscess cavity during its puncture.
To detoxify the body and improve microcirculation, hemodez should be used. reopoliglyukin.
Immunocorrective therapy is of great importance. Repeated transfusions of blood, plasma, the introduction of gamma globulin, therapeutic sera increase the body's immunological reactivity. Some drugs also contribute to this: levamisole, thymalin, T-activin. prodigiosan, etc.
It is also necessary to introduce drugs for parenteral nutrition. Fat emulsions introduced into the bloodstream bind bacterial enzymes and reduce their destructive effect on the lung tissue.
Surgical treatment is indicated for gangrene of the lung (pneumonic or lobectal 
Rice. 15. Drainage of a subpleural abscess a - puncture of the chest wall with a trocar, b - dre- 
abscess formation
wall. as well as the introduction of drainage into the abscess cavity using a trocar (Fig. 15). Aspiration of pus and the introduction of proteolytic enzymes and antibiotics into the cavity of the abscess usually lead to a cure in 80% of cases.
Conservative treatment is futile for abscesses with a diameter of more than 6 cm, a very thick abscess capsule, detected by x-ray; with general intoxication of the body, not amenable to a full-fledged complex
rapia. In these cases, surgery can be recommended - lung resection already in the acute period.
Disease outcomes. With timely and proper treatment, recovery occurs in more than 80% of cases.
Distinguish the following outcomes of the disease.
- Complete recovery: along with the disappearance of clinical symptoms, radiographic signs of a lung abscess also disappear.
- Clinical recovery: complete disappearance of the clinical manifestations of the disease, however, a dry cavity is determined radiographically in the lung.
- Clinical improvement: by the time of discharge of the patient remains subfebrile body temperature, the patient emits a small amount of mucopurulent sputum. X-ray reveals a cavity with lung tissue infiltration along the periphery.
- Without improvement: the acute phase of the disease without any remission passes into the chronic form. The general intoxication of the body rapidly increases, a decompensated cor pulmonale develops, and dystrophy of parenchymal organs appears.
- Fatal outcome: currently rare.
Therapeutic measures are determined by the nature of the complications: a) with the development of tension pneumothorax, urgent drainage of the pleural cavity is necessary; b) in case of bleeding into the bronchial tree, urgent intubation with a double-lumen tube is indicated, which helps prevent blood from flowing into the bronchi of a healthy lung. Subsequently, hemostatic therapy is carried out. In the presence of appropriate conditions, endovascular surgery is advisable - embolization of the bronchial arteries of the affected lung, the erosion of which most often causes bleeding into the respiratory tract; c) newly formed abscesses in the lung are treated in accordance with the above principles for the treatment of lung abscesses: d) metastatic abscesses are treated according to the generally accepted scheme (early abscess opening, rational antibacterial therapy, immunotherapy, etc.).
Lung abscess is a non-specific inflammatory disease of the respiratory system, as a result of the progression of which a cavity with thin walls is formed in the lung, inside which purulent exudate is contained. This disease more often begins to develop if inadequate treatment of pneumonia has been carried out - melting is observed in the area of \u200b\u200bthe lung, followed by tissue necrosis.
Less commonly, a thin-walled cavity is formed after a small bronchus is blocked by an embolus. As a result, oxygen ceases to flow into this area, it subsides, and infectious agents easily penetrate into it. Against the background of all this, an abscess begins to form. In more rare clinical situations, a cavity with pus is formed as a result of the introduction of infection into the lung tissues by the hematogenous route (from the focus of inflammation, which is already present in the human body).
Etiology
Lung abscess is an infectious process. Its development is facilitated by pathogenic bacteria or fungi. Usually the disease progresses due to the pathological activity of pneumococci, fungi. Microorganisms penetrate into the lung tissues through the bronchi or with the blood flow from the foci of inflammation.
Most often, a lung abscess develops:
- as a complication of previously transferred pneumonia;
- when it enters the airways of the contents of the stomach;
- due to the overlap of the bronchus by an embolus;
- because of . This is a serious illness of an infectious nature, which is characterized by the occurrence of foci of purulent inflammation in the vital organs of the human body.
Risk factors:
- smoking;
- the use of alcoholic beverages in large quantities;
- hypothermia;
- decrease in the reactivity of the body.
Forms
In medicine, several classifications of lung abscess are used, which are based on the causes of the pathological process, its location in the organ, the duration and nature of the course.
From location:
- central lung abscess;
- peripheral. In this case, the focus of inflammation is located closer to the periphery of the lung.
From the causes that provoked the progression of the disease:
- primary. In this case, the main reason for the formation of the pathological focus is trauma to the sternum;
- secondary.
From the duration of the course of the pathological process:
- acute lung abscess. The duration of the progression of the pathological process is no more than 6 weeks. As a rule, this is followed by a period of recovery;
- chronic lung abscess. The duration of the disease is more than 6 weeks. This disease is characterized by alternating periods of exacerbation and remission.
From the nature of the course of the disease:
- light flow. The characteristic symptoms of a lung abscess (shortness of breath, cough) are not pronounced;
- moderate. Symptoms are expressed moderately;
- heavy. Symptoms of the disease are pronounced, it is also possible the development of dangerous complications.
Symptoms
The symptomatology of an abscess directly depends on what form of pathology (acute or chronic) has developed in a person. It should be noted that if a small pathological cavity with purulent exudate is formed on the periphery of the organ, then the characteristic symptoms of the pathology may not be observed, which greatly complicates the diagnosis. This leads to a chronic inflammatory process.
acute form
This disease has two clinical stages:
- the period of formation of a thin-walled cavity with pus;
- opening period.
During the formation of an abscess, the following symptoms are observed:
- symptoms of severe intoxication are noted;
- heat;
- loss of appetite;
- dyspnea;
- headache;
- the patient's condition is rapidly deteriorating;
- cough;
- pain of varying intensity in the sternum.
The severity of the course of the pathology depends on the number and size of the formed abscesses, on the type of pathogen that caused their formation. The specified period lasts up to 10 days. But it is worth noting the fact that its course can be both rapid - up to 2-3 days, and slow - up to 2-3 weeks.
After this, the period of opening the abscess begins. It breaks through its shell, and pus begins to stand out through the airways. At this time, the patient's condition worsens greatly. The main symptom indicating this process is a wet and sudden cough, during which a large amount of purulent sputum is released. Clinicians characterize this condition as "sputum expectoration with a full mouth." Its volume can reach one liter.
As soon as the abscess breaks through, the patient's condition gradually begins to improve. Symptoms of intoxication decrease, temperature normalizes, appetite is restored. But it is worth noting that shortness of breath, weakness and pain in the sternum persist. The duration of the course of the disease directly depends on the state of drainage, as well as on the right therapy.
Chronic form
It is worth talking about the development of this form of the disease if the acute process lasts more than two months. Also, the progression of the pathology is facilitated by the large size of the purulent formation, its localization in the lower part of the organ, as well as poor sputum discharge. In addition, it is worth highlighting the following reasons:
- decrease in the reactivity of the body;
- chronic pathologies;
- improper treatment of acute lung abscess.
The main symptoms of this form of the disease:
- dyspnea;
- cough, during which there is a release of sputum with a fetid odor;
- the period of deterioration of the state is replaced by a period of its stabilization;
- weakness;
- exhaustion;
- increased sweating.
Diagnostics
When the first symptoms appear that indicate the progression of a lung abscess, you should immediately contact a medical institution to undergo a complete diagnosis and establish an accurate diagnosis. The standard diagnostic program includes:
- collection and analysis of complaints;
- general examination of the patient;
- . This diagnostic method is necessary, as it makes it possible to detect signs of inflammation in the body;
- sputum analysis. With the help of this diagnostic method, it is possible to identify the true causative agent of the disease, as well as to determine its sensitivity to antibiotics;
- chest x-ray - a method by which you can detect the location of formations with pus;
- CT is the most informative diagnostic technique. Allows you to determine the location, as well as the size of the abscess;
- fiberoptic bronchoscopy is a diagnostic method that makes it possible to examine the respiratory tract in detail and determine the presence of abnormal formations in them.
Only after receiving the results of the diagnosis, you can begin to treat a lung abscess.
Treatment
Drug therapy is based on the use of such drugs:
- antibiotics;
- mucolytics;
- antiseptics;
- expectorant drugs;
- immunomodulators;
- detoxification agents;
- oxygen therapy.
Also, during conservative treatment, methods are used to quickly remove purulent sputum from the respiratory tract:
- postural drainage;
- breathing exercises;
- vibration chest massage;
- sanitation bronchoscopy.
Surgical intervention is indicated if drug therapy has not had the desired effect. The following methods are applied:
- puncture. The abscess is pierced with a special needle. The purulent contents are removed, the cavity is washed with antiseptic solutions, after which antibiotics are injected into it;
- thoracocentesis and drainage of the abscess cavity;
- removal of a certain part of the lung (lobe).
Complications
- empyema of the lungs;
- pyopneumothorax;
- septicopyemia;
- secondary bronchiectasis.
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Diseases with similar symptoms:
Inflammation of the lungs (officially pneumonia) is an inflammatory process in one or both respiratory organs, which is usually infectious in nature and is caused by various viruses, bacteria and fungi. In ancient times, this disease was considered one of the most dangerous, and although modern treatments allow you to quickly and without consequences get rid of the infection, the disease has not lost its relevance. According to official figures, in our country every year about a million people suffer from pneumonia in one form or another.