ZEYNULINA, Z.K. (2013) ACTUAL PROBLEMS OF SEVERE PNEUMONIA IN CHILDREN. Научно-практический журнал “Вестник КазНМУ” (3). ISSN 9965-01-300-4
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Abstract
Widespread acute pneumonia is very dangerous for children. Timely correct diagnosis of acute pneumonia in children, assessment of severity of disease in concomitant diseases, the correct choice of antibiotic therapy allows full recovery of children from pneumonia, reduce morbidity and mortality from pneumonia. Over the last 3 years pediatricians conducted early detection of acute pneumonia and timely admission to hospital. After being discharged from the hospital and rehabilitation activities are carried out clinical examination. Pneumonia can occur at any age, although it is more common in younger children. Pneumonia accounts for 13% of all infectious illnesses in infants younger than 2 years. Newborns with pneumonia commonly present with poor feeding and irritability, as well as tachypnea, retractions, grunting, and hypoxemia. Infections with group B Streptococcus, Listeria monocytogenes, or gram-negative rods (eg, Escherichia coli, Klebsiella pneumoniae) are common causes of bacterial pneumonia. Group B streptococci infections are most often transmitted to the fetus in utero. The most commonly isolated virus is respiratory syncytial virus (RSV). Cough is the most common symptom of pneumonia in infants, along with tachypnea, retractions, and hypoxemia. These may be accompanied by congestion, fever, irritability, and decreased feeding. Streptococcus pneumoniae is by far the most common bacterial pathogen in infants aged 1-3 months. Adolescents experience similar symptoms to younger children. They may have other constitutional symptoms, such as headache, pleuritic chest pain, and vague abdominal pain. Vomiting, diarrhea, pharyngitis, and otalgia/otitis are also common in this age group. Mycoplasma pneumoniae is the most frequent cause of pneumonia among older children and adolescents. See Clinical Presentation for more detail. The signs and symptoms of pneumonia are often nonspecific and widely vary based on the patient’s age and the infectious organisms involved. Observing the child’s respiratory effort during a physical exam is an important first step in diagnosing pneumonia. The World Health Organization (WHO) respiratory rate thresholds for identifying children with pneumonia are as follows: Children younger than 2 months: Greater than or equal to 60 breaths/min Children aged 2-11 months: Greater than or equal to 50 breaths/min Children aged 12-59 months: Greater than or equal to 40 breaths/min Initial priorities in children with pneumonia include the identification and treatment of respiratory distress, hypoxemia, and hypercarbia. Grunting, flaring, severe tachypnea, and retractions should prompt immediate respiratory support. Children who are in severe respiratory distress should undergo tracheal intubation if they are unable to maintain oxygenation or have decreasing levels of consciousness. Increased respiratory support requirements such as increased inhaled oxygen concentration, positive pressure ventilation, or CPAP are commonly required before recovery begins. The majority of children diagnosed with pneumonia in the outpatient setting are treated with oral antibiotics. High-dose amoxicillin is used as a first-line agent for children with uncomplicated community-acquired pneumonia. Second- or third-generation cephalosporins and macrolide antibiotics such as azithromycin are acceptable alternatives. Combination therapy (ampicillin and either gentamicin or cefotaxime) is typically used in the initial treatment of newborns and young infants. Hospitalized patients are usually treated with an advanced-generation intravenous cephalosporin, often in combination with a macrolide. Children who are toxic appearing should receive antibiotic therapy that includes vancomycin (particularly in areas where penicillin-resistant pneumococci and methicillin-resistant S aureus [MRSA] are prevalent) along with a second- or third-generation cephalosporin.
| Item Type: | Article |
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| Uncontrolled Keywords: | children, pneumonia, etiology, antibiotics |
| Subjects: | R Medicine > RJ Pediatrics |
| Divisions: | Научно-практический журнал "Вестник КазНМУ" > Выпуск №2 2013 год |
| Depositing User: | Mr Press KazNMU |
| Date Deposited: | 26 Jun 2013 08:24 |
| Last Modified: | 26 Jun 2013 08:24 |
| URI: | http://repository.kaznmu.kz/id/eprint/7305 |
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