Atypical pneumonia
The content of the article:
- Causes and risk factors
- Forms of the disease
- Disease stages
-
Symptoms
- Atypical chlamydial pneumonia
- Atypical mycoplasma pneumonia
- Legionnaires' disease
- Acute Respiratory Syndrome
- Features of the course of the disease in children
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Atypical pneumonia is a group of infectious and inflammatory lung diseases that are caused by atypical pathogens and have an uncharacteristic clinical picture.
The term "atypical pneumonia" was introduced into medical practice in the late 30s of the XX century. It was used to name interstitial pneumonia, which is caused by non-coccal bacteria.
In 2002-2003, an epidemic of atypical pneumonia caused by the coronavirus broke out. During the outbreak, 8437 people were infected with the disease, of which 813 died, that is, the mortality rate was 10%. Cases of the disease were recorded in more than 30 countries around the world, but most of them were in China, Hong Kong and Vietnam. Pulmonologists have called this type of atypical pneumonia "severe acute respiratory syndrome" (SARS), or "acute respiratory syndrome" (SARS).
Each form of SARS has its own characteristics, depending on the pathogen
Causes and risk factors
Numerous infectious agents can cause SARS:
- chlamydia;
- mycoplasma;
- Epstein-Barr virus;
- influenza viruses A and B;
- respiratory parainfluenza viruses;
- respiratory syncytial virus;
- coronavirus;
- hantavirus;
- coxiella;
- legionella;
- causative agents of tularemia, leptospirosis.
These pathogens have different microbiological characteristics, and the infectious processes they cause also differ in epidemiology and in the pathomorphological picture. However, all of these microorganisms are highly resistant to beta-lactam antibiotics (penicillins, cephalosporins, carbapenems, and monobactams).
Numerous infectious agents become causative agents of atypical pneumonia
Infection with atypical pneumonia occurs by airborne droplets during close contact with a sick person. Young people suffer more often.
Forms of the disease
Depending on the type of pathogen, the following forms of atypical pneumonia are distinguished:
- acute respiratory disease syndrome;
- chlamydial pneumonia;
- mycoplasma pneumonia;
- legionnaires' disease;
- q fever.
Disease stages
For SARS, as, indeed, for most infectious diseases, a certain staging course is characteristic:
- Incubation period. It starts from the moment of infection and continues until the first signs of the disease appear. On average, it lasts 7-10 days.
- Prodromal period, or the period of precursors. Lasts 1-3 days. There are nonspecific symptoms of the disease, characteristic of most respiratory viral infections (headache and muscle pain, sore throat, slight malaise, dry cough).
- The peak period. There are characteristic signs of an infectious and inflammatory process in the lungs.
- Convalescence period. The activity of the inflammatory process in the lungs subsides, the condition gradually returns to normal.
Symptoms
The main symptoms of SARS at the height of
- an increase in body temperature up to 40-41 ° C;
- intense headache;
- severe general weakness;
- cough;
- dyspnea;
- profuse night sweats;
- pain in the chest area.
The main symptoms of SARS
These are common symptoms that are common to almost all SARS. But since they are caused by different microbial agents, each form of the disease has its own characteristics.
Atypical chlamydial pneumonia
The onset of chlamydial pneumonia resembles a banal respiratory viral infection with symptoms of rhinitis and pharyngitis. However, after 2-3 days, the patients' condition deteriorates rapidly. There are complaints of muscle pain, aching bones and joints, dry cough, shortness of breath, fever up to 38-39 ° C. Often there is an increase in cervical lymph nodes. Chlamydial pneumonia is characterized by a long course and severe allergization of the body.
Atypical mycoplasma pneumonia
For mycoplasma pneumonia, a sluggish course with a blurred clinical picture is characteristic. The first symptoms of the disease, as in the case of chlamydial pneumonia, are similar to those of ARVI (pain and sore throat, dry cough, weakness). On days 2-3 of the disease, the body temperature rises to 37-38 ° C.
Occasionally, mycoplasma pneumonia is difficult, with severe intoxication syndrome, high fever, and enlarged cervical lymph nodes.
A distinctive feature of the mycoplasma form of atypical pneumonia is the unproductive, paroxysmal cough that persists in patients for a long time.
Legionnaires' disease
Its causative agent is a gram-negative aerobic bacterium that lives in air conditioning and water supply systems.
Legionella pneumonia mainly affects the elderly and is characterized by a severe course, with pronounced symptoms of intoxication, and a strong unproductive cough. The infectious and inflammatory process covers not only the lung tissue, but also the bronchioles.
Acute Respiratory Syndrome
The most severe form of atypical pneumonia, accompanied by high mortality. It starts with symptoms of a flu infection (headache, fever, weakness, weakness). A few days later, they are joined by tachycardia, dry cough, shortness of breath.
Further development of the clinical picture is determined by the immune status of the patient's body. With a good immune response, the patient recovers. If the immune system is weakened, the condition deteriorates dramatically, and respiratory distress syndrome develops. Against the background of increasing acute respiratory failure, a lethal outcome is possible.
Features of the course of the disease in children
Atypical pneumonia in children often occurs with a poorly expressed temperature reaction. However, despite the normal or subfebrile temperature, the general condition quickly and strongly worsens. Appear:
- drowsiness;
- lethargy and apathy;
- decreased or complete lack of appetite;
- dyspnea;
- excessive sweating;
- vomiting;
- diarrhea.
Mycoplasma pneumonia in children is often accompanied by an increase in the spleen and liver, the appearance of a polymorphic rash on the skin.
Children with atypical pneumonia may develop a polymorphic skin rash
Children with SARS try to lie on their side on the side of the affected lung, because this position reduces chest pain. Often, they have violations of the depth and frequency of respiratory movements, there are periodic short-term apnea (respiratory arrest).
In newborns, atypical pneumonia is rapidly complicated by the development of pulmonary emphysema. In this age group, the disease is extremely difficult and difficult to treat.
Diagnostics
SARS can be suspected on the basis of the clinical picture of the disease and the examination data of the patient. To confirm the diagnosis, an X-ray of the lungs is performed in two projections, which makes it possible to determine the presence of an inflammatory focus. To identify the causative agent of the disease, bacteriological, immunological and microbiological studies are carried out.
It is quite difficult to diagnose viral atypical pneumonia. This is due to the fact that currently there are no test systems for widespread use in clinical practice.
Treatment
Treatment of atypical pneumonia includes etiotropic and symptomatic direction. Etiotropic therapy is aimed at destroying the causative agent of the disease. For this purpose, antibiotics are prescribed, taking into account the sensitivity of pathogenic microflora to them, for a course of at least 10-14 days. Moreover, antibiotic therapy is also justified in case of viral atypical pneumonia - with the aim of preventing (or treating) secondary bacterial infection. However, the etiotropic treatment in this case will be the use of antiviral drugs.
Antibiotics are the main treatment for SARS
Symptomatic therapy is aimed at eliminating the symptoms of the disease, for which antipyretic and anti-inflammatory drugs, expectorant drugs, mucolytics, etc. are used.
With a significant deterioration in the general condition, an increase in respiratory failure, the patient is transferred to the intensive care unit, where they are connected to a ventilator.
Possible complications and consequences
Complications of atypical pneumonia can be divided into two large groups: pulmonary and extrapulmonary. Pulmonary complications include:
- lung abscess;
- pleurisy;
- empyema of the pleura;
- gangrene of the lung;
- acute respiratory failure.
Extrapulmonary complications:
- myocarditis;
- infectious toxic shock;
- encephalitis;
- meningitis;
- acute psychosis;
- Iron-deficiency anemia.
Forecast
The prognosis is favorable with a strong immune status of the patient and timely treatment.
The outcome of SARS can be:
- complete recovery;
- fatal outcome;
- the transition of the disease to a chronic form with the formation of pneumosclerosis.
Prevention
Prevention of atypical pneumonia consists in a healthy lifestyle that allows you to maintain the body's defenses in an active state. It is also recommended to observe the following rules:
- during the peak of seasonal viral diseases, refrain from visiting places with a large crowd of people;
- when in contact with a patient, wear a protective mask, wash hands regularly and treat them with antiseptic liquids;
- the room in which the patient is located should be often ventilated, regularly wet cleaning with the obligatory use of disinfectants. Disinfect items, dishes by boiling in a baking soda solution for 15-20 minutes.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
