Pneumonia affects almost two thirds of the children and it is most common among the immune compromised group. It is the first cause of mortality in children in India and other developing countries. Various programs are being implemented to prevent and reduce death caused by pneumonia, but still the incidence is high. Pneumonia can be prevented if people become aware of how it is spread and how we prevent it.
Pneumonia is defined as the infection and inflammation of the lung parenchyma. It occurs more commonly in infants and children less than 5 years. If treated promptly we can save the life of the child.
The risk factors of pneumonia are
1. Immuno compromised children(children on chemotherapy)
2. Malnourished children
3. Children with congenital heart diseases
4. Low socio economic status
5. Poor environmental sanitation
6. Overcrowding
Incidence:
Common in 1-5 years and also during winter and spring
Causes:
The micro organisms causing pneumonia can be of 3 types
1. Virus
2. Bacteria
3. Fungi
Types:
Based on the region affected it could be classified as
1. Bronchopneumonia
2. Bronchial pneumonia
3. interstitial pneumonia
Other types are
1. Aspiration pneumonia
2. lipoid pneumonia
3. loeffler's syndrome
Mode of transmission:
Through droplet and droplet nuclei of infected persons,fomites
Pathophysiology: There are 4 stages that occurs in this process
1. Red hepatisation
The micro organism enters the lungs and can cause inflammation which is seen as redness due to increased RBC'S and Platelets .This is called as red hepatization where the lungs look red.
2. Grey hepatisation:
Here the lungs appear pale due to the accumulation of WBC'S in response to any infection
3. Consolidation:
The lungs becomes hard and solidifies
4. Resolution:
The lungs return back to the normal state of appearance if treatment is properly administered ,if not it will continue to be consolidated and scarred and can cause various complications in the child.
Signs and symptoms of pneumonia:
It is important to identify the signs and symptoms of pneumonia so that treatment can be started immediately
· Cold and cough
· Fever
· Breathing difficulty
· Using accessory muscles
Signs:
· Tachycardia
· Tachypnea
· Cyanosis
· Grunting
· Signs of severe respiratory distress such as using intercostals and abdominal muscles
Treatment:
· This is based on the condition of the child
· If the condition is not so sick or if the child does not have a respiration more than 24/mt if child is more than 2 years and >50/mt if the child is 2 months to 2 years it can be treated at home with either anti histamines.steam inhalations and decongestants
· If the childs condition is very sick where the child has a high respiratory rate and when fever and breathing difficulty is more where the child uses his/her accessory muscles ,child has to be admitted for specialised care in a hospital
In the hospital the child will be treated with
1. Antibiotics
2. Oxygen given if needed
3. Nebulisation to liquefy the secretions
4. Child will be nursed in burp chair
5. Intravenous fluids will be administered
6. Antipyretics to reduce fever
7. Monitoring for respiratory distress is done
8. Nasal drops if nose blocked
Preventive measures:
1. Protect from infected persons
2. Avoid overcrowding
3. Keep children healthy
4. Vaccinate if possible
5. Use separate clothing for children to wipe secretions.
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