Definition and causes
Pneumonia is an infection of the lower airways (bronchial tubes) and in the lungevævet (see Lungerne ), Which may be caused by many different bacteria, viruses and fungi.
Virus is the most common cause in children. The most common virus is RSV . But influenza, parainfluenza and adenovirus can give pneumonia.
The most common bacterium ispneumokokker(80%).Group B, streptococci , May give pneumonia in newborns. Stafylokokker and Chlamydia-bacteria gives in pneumonia in 1. life.Mykoplasma- bacteria can also cause pneumonia, but usually not until school age.
Pneumonia caused by fungi seen rarely and only by severely impaired immune systems. Detection of fungi that cause pneumonia should lead to a thorough explanation, including HIV test.
Symptoms of the pneumonia
- Fever, which occurs quickly and is typically over 40 ° C.
- Shortness of breath with quick and offensive breathing. The big vejrtrækningsarbejde shown by næsefløjene vibrates and know that the skin is drawn into between the ribs, neck and under the ribs (indtrækninger), when the weather is drawn into.
- Pain in the chest. If these are exacerbated during inhalation, may indicate that betændelsesreaktionen have spread to lungehinden and where pleurisy .
Children with fever has, in addition to the above, often non-specific symptoms in the form ofabdominal pain, diarrhoeaorvomiting. Very small children. a few months old, has also often only scant signs with a little cough and fever.
Forholdregler and diagnosis
All children under ½ years with fever and all children with breathing difficulties should be evaluated by a doctor.
- Sløvhed or apathy.
- The lack of desire to drink and a lack of urination (dry diapers).
- Irritability: irritation or tears by impacts with sound, light or touch.
- Besværet breathing.
- Gråbleg skin or blålige lips and neglelejer.
In the case of one or more of these danger should the child be seen by a doctor right away.
Not all children with fever are seriously ill. A child who is happy, interested and playing, fails rarely serious, although it has fever. In these cases, one should observe the above danger and see how the condition develops.
The doctor makes the diagnosis of pneumonia in the medical history and examination of the child with special emphasis on how the lung sounds in stetoskopet. Indlæggelse is required if the child is very bad (see above danger), or there is a need for special observation or further studies.
At the hospital will often take X-ray of the lungs. On this we can see a liquefaction, where inflammation sit. It will take blood samples to try to determine whether lungebetændelsen caused by a virus or a bacterium. We will cultivate a blood sample to determine the bacterium that might be the cause. You can also grow to secrete sucked up from the airways.
RSV and Mycoplasma can be detected in luftvejssekret by a special method called PCR. In some cases, the virus or bacteria identified by the detection of specific antibodies from the immune system in the blood.
Treatment of pneumonia
Pneumonia caused by bacteria must be treated with antibiotics. Virus the other hand, can not be treated with antibiotics. It may take days to identify the cause of lungebetændelsen, and often never. Therefore, the doctor forced to take a position on the choice of treatment before he / she know the answer. The decision to be given antibiotics or not, is often on an estimate. Early onset of symptoms and high fever in a bad child speaks for bacteria and thus for antibiotikabehandlin
- Antibiotics:Penicillin is the first to pneumonia caused by bacteria. Severe sick children to have it intravenously (into a vein through a drip) during hospitalisation. Less affected can be treated with tablets. Treatment is 7-10 days. The detection of specific bacteria which Mykoplasma or Chlamydia will often select a different type of antibiotics.
- Oxygen:Children with breathing difficulties and reduced oxygen saturation in the blood given oxygen at næsekateter or mask
- Liquid:It is important to children with fever will have plenty of fluids, because they easily become dehydrated. If necessary, the liquid is given directly into a vein, if the child will not drink or have severe væskemangel.
Select and complications
The forecast is good. A pneumonia is often completed in a few weeks. Most of the patients are healthy without injury.
In severe cases, the bacteria can be spread to the blood and cause sepsis (blood poisoning), which is a potentially life-threatening condition.
Lungeafsnit can clap together because the airways and lungevævet is infected and blocked with cells, bacteria and secrete. If these are not corrected, may cause chronic lung damage. Sammenklappede lungeafsnit can be seen on X-ray of the lungs and treated with a special method called PEP, which ensures the right lungeafsnittet out again.
Stafylokok-bacteria can cause lungeabsces , Which is an abscess in the lung.
The influence of lungehinden can ansamles liquid in lungehulen. It reduces the space and makes it harder for the lung to unfold in full. The result is vejrtrækningbesvær. The liquid can be found at the doctor's examination and be seen on X-ray. The liquid must be emptied out through a needle to stikkes through the chest wall. This must be done in hospital.