Prolonged pneumonia is an acute inflammation in the lung tissue, in which, according to clinical and roentgenologic data, the pneumonic infiltration is resolved slowly, over extended periods (over 4-6 weeks). In contrast to chronic inflammation of the lungs, prolonged pneumonia usually results in a patient’s recovery. About 30% of acute pneumonia take a protracted nature of the course. The reasons for this include chronic intoxication or a weakened state of the body, irrational antibiotic therapy, concomitant bronchial drainage dysfunction, old age and prematurity complicated by the course of acute pneumonia. The therapeutic algorithm for prolonged pneumonia consists of carefully selected rational antibiotic therapy, mandatory restoration of the drainage function of the bronchi, general strengthening and immunocorrective treatment.
Causes of protracted pneumonia
The main role in the development of protracted pneumonia belongs to the decrease in the immune response of the organism, which includes changes in specific and nonspecific protective factors: a decrease in T and B lymphocyte activity, a decrease in interferon synthesis, suppression of complement and phagocytosis, a disturbance in macrophage activity. As a result, the anti-infection protection of the body weakens, which contributes to a protracted, sluggish resolution of the inflammatory focus in the lung.
Symptoms of protracted pneumonia
Monosegmentary lingering pneumonia has a relatively smooth flow in comparison with polysegmentary, which is characterized by relapses, severe manifestations, a long regression of the focus of inflammation.
When the inflammatory foci merge, the patient’s condition is aggravated 2-3 weeks after the initial manifestations of the disease. Again increases subfebrile temperature, sweating, fatigue, general weakness, lethargy, cough. A distinctive feature of prolonged pneumonia is the scarcity of manifestations with pronounced radiological changes in the lungs.
Treatment of lingering pneumonia
The principles of treatment of prolonged pneumonia have their own peculiarities. The question of the expediency of continuing antibiotic therapy for prolonged pneumonia is resolved after analyzing the methodology and results of the previous one. The need to continue antibiotic therapy occurs in the case of persistence of severe infiltrative changes in pulmonary tissue, changes in peripheral blood and signs of intoxication. Antibiotics are selected taking into account the data of bacteriological analysis of sputum.