What causes pneumonia pain in the back and ribs? What are the symptoms of this condition? How can it be treated? Get the answers to these questions and more in this comprehensive guide.

Pneumonia and Rib Pain: Exploring the Connection

Pneumonia, a serious respiratory infection, can often manifest with pain in the back and ribs. This is because the inflammation associated with pneumonia can affect the pleura, the thin membranes that line the lungs and chest cavity. The pain experienced in the back and ribs during pneumonia is often described as sharp, stabbing, or aching in nature.

Causes of Pneumonia-Related Rib and Back Pain

There are several reasons why pneumonia can cause pain in the back and ribs:

1. Pleural Inflammation: The pleura, which covers the lungs and lines the inside of the chest wall, can become inflamed due to the pneumonia infection. This inflammation can cause pain when breathing, coughing, or moving the chest.
2. Muscle Strain: The coughing and breathing difficulties associated with pneumonia can strain the muscles between the ribs, leading to localized pain and discomfort.
3. Lung Inflammation: The actual lung tissue affected by the pneumonia infection can also cause pain that radiates to the back and ribs.

Symptoms of Pneumonia-Related Rib and Back Pain

In addition to the characteristic rib and back pain, individuals with pneumonia may experience other symptoms, including:

• Cough (often productive with mucus or phlegm)
• Fever
• Chills and shivering
• Shortness of breath
• Fatigue and weakness
• Loss of appetite

Diagnosing Pneumonia-Related Rib and Back Pain

To diagnose the cause of rib and back pain in the context of pneumonia, healthcare providers will typically perform the following steps:

1. Medical History and Physical Examination: The healthcare provider will ask about your symptoms, medical history, and perform a physical examination, focusing on the chest and lungs.
2. Imaging Tests: Chest X-rays or CT scans may be ordered to visualize the lungs and detect any signs of pneumonia or other underlying conditions.
3. Laboratory Tests: Blood tests, such as a complete blood count (CBC) and inflammatory markers, may be used to confirm the presence of an infection.

Treatment for Pneumonia-Related Rib and Back Pain

The primary treatment for pneumonia-related rib and back pain focuses on addressing the underlying pneumonia infection and managing the associated symptoms:

1. Antibiotics: If the pneumonia is caused by a bacterial infection, the healthcare provider will likely prescribe antibiotics to fight the infection.
2. Antiviral Medications: In cases of viral pneumonia, antiviral medications may be prescribed to help the body fight the virus.
3. Pain Management: Over-the-counter pain medications, such as acetaminophen or ibuprofen, can help alleviate the rib and back pain associated with pneumonia.
4. Respiratory Therapy: Techniques like deep breathing exercises, coughing and clearing the lungs, and the use of a humidifier can help ease breathing and reduce pain.
5. Fluids and Rest: Staying hydrated and getting plenty of rest can support the body’s healing process.

Preventing Pneumonia-Related Rib and Back Pain

While it’s not always possible to prevent pneumonia, there are steps you can take to reduce your risk and potentially avoid the associated rib and back pain:

• Get Vaccinated: The pneumococcal vaccine and annual flu shot can help protect against certain types of pneumonia.
• Practice Good Hygiene: Washing your hands regularly, covering your coughs and sneezes, and avoiding contact with sick individuals can help prevent the spread of respiratory infections.
• Maintain a Healthy Lifestyle: Eating a balanced diet, exercising regularly, and managing stress can help boost your immune system and make you less susceptible to infections like pneumonia.

Seeking Medical Attention for Pneumonia-Related Rib and Back Pain

If you are experiencing persistent or severe rib and back pain in the context of pneumonia, it is crucial to seek medical attention. Untreated pneumonia can lead to serious complications, such as respiratory failure, sepsis, or even death. Don’t hesitate to contact your healthcare provider or go to the emergency room if you have any concerns about your condition.

Rib Pain from Coughing, Sneezing, Breathing or Laughing

Acute costochondritis (chest wall syndrome)

Acute costochondritis is the inflammation of the flexible cartilage that connects each rib to the breastbone. Costochondritis is caused by excessive coughing or by straining the upper body, as with weightlifti..

Normal occurence of chest pain

Sometimes chest pain is not a sign of a heart attack. The following symptoms are usually typical of more benign conditions:

If the pain is brief, like a short shock, and subsides right away, it is most likely from an injury such as a broken rib or pulled muscle in the chest.

Sharp pain in the chest that improves with exercise is probably from acid reflux or a similar condition, and will be eased with antacids.

A small, sharp pain anywhere in the chest that actually feels worse on breathing is probably from a lung inflammation such as pneumonia or asthma.

An actual heart attack involves intense, radiating chest pain that lasts for several minutes; worsens with activity; and is accompanied by nausea, shortness of breath, dizziness, and pain in the arms, back, or jaw. Take the patient to the emergency room or call 9-1-1.

If there is any question as to whether the symptoms are serious or not, a medical provider should be seen as soon as possible.

Rarity: Common

Top Symptoms: chest pain, rib pain

Symptoms that always occur with normal occurrence of chest pain: chest pain

Symptoms that never occur with normal occurrence of chest pain: being severely ill, shortness of breath, fainting, severe chest pain, crushing chest pain, excessive sweating, nausea or vomiting

Urgency: Phone call or in-person visit

Atypical chest pain

Atypical chest pain describes the situation when someone’s chest pain is unlikely to be related to heart or lung disease. There are many other possible causes that could explain chest pain, like sore chest wall muscles or psychological factors like stress and anxiety.

Rarity: Common

Top Symptoms: chest pain, shortness of breath

Symptoms that always occur with atypical chest pain: chest pain

Symptoms that never occur with atypical chest pain: fever

Urgency: Primary care doctor

Bronchitis

Acute bronchitis is an inflammatory reaction to an infection in the airways. Most cases of acute bronchitis are caused by a viral infection, although some cases may be due to a bacterial infection.

Symptoms include an acute-onset cough with or without sputum production, low-grade fever, shortness of breat..

Viral pneumonia

Viral pneumonia, also called “viral walking pneumonia,” is an infection of the lung tissue with influenza (“flu”) or other viruses.

These viruses spread through the air when an infected person coughs or sneezes.

Those with weakened immune systems are most susceptible, such as young children, the elderly, and anyone receiving chemotherapy or organ transplant medications.

Symptoms may be mild at first. Most common are cough showing mucus or blood; high fever with shaking chills; shortness of breath; headache; fatigue; and sharp chest pain on deep breathing or coughing.

Medical care is needed right away. If not treated, viral pneumonia can lead to respiratory and organ failure.

Diagnosis is made through chest x-ray. A blood draw or nasal swab may be done for further testing.

Antibiotics do not work against viruses and will not help viral pneumonia. Treatment involves antiviral drugs, corticosteroids, oxygen, pain/fever reducers such as ibuprofen, and fluids. IV (intravenous) fluids may be needed to prevent dehydration.

Prevention consists of flu shots as well as frequent and thorough handwashing.

Rarity: Uncommon

Top Symptoms: fatigue, headache, cough, shortness of breath, loss of appetite

Urgency: Primary care doctor

Pleurisy

Pleurisy is an inflammation of the pleura, the protective membranes which surround the lungs and line the inner chest cavity.

The inflammation is most often caused by a viral, bacterial, or fungal infection, such as influenza or pneumonia; by some medications; or by a rib fracture.

Symptoms include sharp, “pleuritic” pain in the chest, back or shoulders that gets worse with deep breathing, sneezing, or coughing; shortness of breath due to shallow breathing in an effort to ease the pain; and sometimes fever and/or cough.

Sudden, intense chest pain during breathing is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history; physical examination; and imaging such as x-ray, CT scan, or ultrasound. In some cases, a needle is used to withdraw fluid from the pleura for testing.

Treatment involves addressing the underlying cause, such as prescribing antibiotics for a bacterial infection. Over-the-counter pain relievers can be used, along with supportive care in the form of rest, fluids, and good diet.

Rarity: Uncommon

Top Symptoms: shortness of breath, muscle aches, fever, cough with dry or watery sputum, rib pain that gets worse when breathing, coughing, sneezing, or laughing

Urgency: Primary care doctor

Bacterial pneumonia

Bacterial pneumonia is an infection of the lungs caused by one of several different bacteria, often Streptococcus pneumoniae. Pneumonia is often contracted in hospitals or nursing homes.

Symptoms include fatigue, fever, chills, painful and difficult breathing, and cough that brings up mucus. Elderly patients may have low body temperature and confusion.

Pneumonia can be a medical emergency for very young children or those over age 65, as well as anyone with a weakened immune system or a chronic heart or lung condition. Emergency room is only needed for severe cases or for those with immune deficiency.

Diagnosis is made through blood tests and chest x-ray.

With bacterial pneumonia, the treatment is antibiotics. Be sure to finish all the medication, even if you start to feel better. Hospitalization may be necessary for higher-risk cases.

Some types of bacterial pneumonia can be prevented through vaccination. Flu shots help, too, by preventing another illness from taking hold. Keep the immune system healthy through good diet and sleep habits, not smoking, and frequent handwashing.

Rarity: Common

Top Symptoms: fatigue, cough, headache, loss of appetite, shortness of breath

Symptoms that always occur with bacterial pneumonia: cough

Urgency: In-person visit

Rib bruise or fracture

Broken or bruised ribs are usually caused by a fall or a blow to the chest, although occasionally this can happen due to severe coughing. With a broken rib, the pain is worse when bending and twisting the body.

Rarity: Uncommon

Top Symptoms: rib pain that gets worse when breathing, coughing, sneezing, or laughing, rib pain from an injury, sports injury, rib pain on one side, injury from a common fall

Symptoms that always occur with rib bruise or fracture: rib pain from an injury

Urgency: Primary care doctor

Chronic costochondritis (chest wall syndrome)

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

Rarity: Uncommon

Top Symptoms: rib pain, chest pain, chest pain that is worse when breathing, rib pain when moving, pain when pressing on the chest

Urgency: Phone call or in-person visit

What Is Walking Pneumonia? | American Lung Association

“Walking pneumonia” is a non-medical term for a mild case of pneumonia. Technically, it’s called atypical pneumonia and is caused by bacteria or viruses; often a common bacterium called Mycoplasma pneumonia. Bed rest or hospitalization are usually not needed, and symptoms can be mild enough that you can continue about your daily activities, hence the term “walking.”

But don’t be fooled. Walking pneumonia can still make you miserable, with cough, fever, chest pain, mild chills, headache, etc. It feels more akin to a bad cold, and despite what the term “walking” implies, taking care of yourself is the best path to recovery.

“If you have the symptoms listed above, even if mild, you should see a doctor as soon as possible,” says Dr. Albert Rizzo, senior medical advisor to the American Lung Association. Rizzo notes that walking pneumonia is treatable with antibiotics if your doctor believes bacteria to be the cause. Over-the-counter medications can also be used to relieve symptoms, such as antihistamines for nasal congestion or cough medications to help ease the cough and loosen any mucus (sputum). “In addition, it’s important to get plenty of rest, drink plenty of fluids and take fever-reducing medicine if you have a fever,” he adds.

Most people start to feel better within three to five days, but a cough from pneumonia can last weeks or months after treatment. “Recovery time will vary from person to person and will depend on whether you have other medical problems, such as asthma or COPD,” says Rizzo. “Too slow of a pace of recovery and certainly any worsening of symptoms is information you should share with your doctor.”

Just like typical pneumonia, walking pneumonia spreads when an infected person coughs or sneezes. To reduce your risk of infection, follow these tips and learn more about avoiding pneumonia:

• Get a flu vaccine each year to help prevent getting pneumonia caused by the flu.
• Talk to your doctor about getting a pneumonia vaccine (there is no vaccine for viral or mycoplasma pneumonia, but certain individuals should get vaccinated for pneumococcal pneumonia).
• Exercise, eat a well-balanced diet and get adequate sleep.
• Wash your hands frequently and thoroughly with warm, soapy water.
• Don’t smoke.
• Cover your mouth when you cough or sneeze and encourage others to as well to help prevent spread of these infections.

Learn more: 5 questions about pneumonia to ask your doctor.

Kids Health Information : Pneumonia

Pneumonia is an infection in one or both of the lungs, and is sometimes called a chest infection. Pneumonia in children can be caused by viruses or bacteria.

Because of the infection, the small airways in the lungs become swollen and make more mucus (sticky fluid). The mucus blocks the airways and reduces the amount of oxygen that is able to get into the body.

Pneumonia often comes after another respiratory infection, such as a cold. Sometimes there may be complications associated with pneumonia, but these are not common, and your doctor will monitor your child for these.

Signs and symptoms of pneumonia

Signs and symptoms of pneumonia vary depending on your child’s age and the cause of the pneumonia. Children often have one or more of the following:

• high fever
• fast and/or difficult breathing – your child’s breathing will become hard work, and you may see the ribs or skin under the neck ‘sucking in’ or nostrils flaring when they are breathing; younger babies may bob their heads when breathing
• cough
• irritability or more tired than usual
• pain in the chest, especially when coughing
• abdominal (tummy) aches or pain.

When to see a doctor

You should see your GP if you think your child has pneumonia. Usually your child won’t need any tests, but sometimes a GP will order a blood test or X-ray to help diagnose pneumonia.

Treatment for pneumonia

Bacterial pneumonia

If your child’s pneumonia is caused by bacteria, they will be prescribed antibiotics. In mild cases of bacterial pneumonia, this medicine can be taken orally at home. Children with bacterial pneumonia usually improve within 48 hours of starting antibiotics. It is very important to complete the whole course of antibiotics, even if your child seems much better. Treatment
will continue for 3 to 7 days. Your child may continue to cough for up to three weeks after treatment, but this is nothing to worry about if they are otherwise getting better.

Children who are very unwell with bacterial pneumonia may be admitted to hospital for antibiotics given directly into a vein through a drip (intravenous or IV therapy). Some children may also need oxygen or extra fluids.

Viral pneumonia

Viral pneumonia is usually not as severe as bacterial pneumonia. However, recovery can be slower, taking up to four weeks. Antibiotics do not cure viruses and are not given for viral pneumonia.

Care at home

After a doctor has diagnosed your child with mild pneumonia, you can usually care for them at home.

• Your child will need a lot of rest.
• It is important to give your child fluids frequently to prevent dehydration. Offer small sips of water, and offer babies breastmilk or formula more often.
• Most children refuse to eat when they have pneumonia. This is not a problem, as long as they are drinking fluids.
• Follow the doctor’s instructions for giving antibiotics, if they have been prescribed.
• It may be more comfortable for older children to sleep propped up on a couple of pillows, rather than laying completely flat.
• If your child has chest pains or a fever and is feeling miserable, they may need some pain relief, such as paracetamol or ibuprofen. Do not give ibuprofen to children under three months old or to children who are dehydrated. Never give aspirin to children. See our fact sheet: Pain relief for children.
• Do not give cough medicines. They do not help children with pneumonia.
• Do not allow anyone to smoke in the home or around your child.
• Your doctor will tell you if you need to go back for review of your child’s recovery.

You should go back to see your GP if your child has pneumonia and:

• their breathing becomes more difficult, or they develop a grunt when they breathe
• they become more drowsy or sleepy, or are hard to wake
• they begin vomiting and are unable to drink much
• you are worried about your child at any stage during the illness or you have other questions.

Key points to remember

• You should take your child to see your GP if you think they have pneumonia.
• If your child has pneumonia they will need to rest and drink small amounts of fluid often to prevent dehydration.
• It is very important for your child to complete the full course of antibiotics if they have been prescribed.
• Cough medicines do not help children with pneumonia.

For more information

Common questions our doctors are asked

How can I prevent my child getting pneumonia?

Keep your child up to date with their immunisations and yearly influenza shots. The best way to avoid getting pneumonia is to avoid getting respiratory infections. Teach your child not to share food, drinks and eating utensils with other children. This can be difficult in younger children, especially those at child care or kindergarten, as they often put shared toys in their mouths. Immunised children will have a much smaller risk of becoming infected with pneumonia in these instances. Good hygiene is important for preventing the spread of pneumonia, so teach your child to wash their hands thoroughly after coughing orsneezing to prevent the spread of germs.

Developed by The Royal Children’s Hospital General Medicine and Respiratory and Sleep Medicine departments. We acknowledge the input of RCH consumers and carers.

Reviewed February 2018.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.

A cracked rib? The pain in my chest was potentially fatal pneumonia.

Shame my GP didn’t spot it

A cracked rib? The pain in my chest was potentially fatal pneumonia. Shame my GP didn’t spot it

By Lynne Wallis
Updated: 01:20 GMT, 24 October 2009

At risk: Pneumonia attacks weak lungs

A fortnight after catching flu last summer, I developed severe pain in my ribs on the left side.

I’d recently, rather forcefully, slung a heavy bag over my shoulder and assumed I must have damaged a rib.

When I was unable to draw a deep breath without pain, I assumed it was linked. Then the pain got so bad that simply breathing made me howl like a baby.

After listening to my chest, my GP said I had no respiratory problems and sent me away with painkillers, diagnosing a cracked rib or strained muscles.

The pain subsided, but my breathing became shallow and my left lung felt strangely blocked. Stairs were an effort, and I felt very hot, but it was July, I reasoned.

Then, one evening, I felt an acute pressure on the left side of my chest. I got frightened and leapt into a taxi to A&E.

I had a fever, which was a surprise, but the results of my chest X-ray were shocking. I had pneumonia, which had left me with fluid in the space between the lung and the chest wall.

I remembered a friend’s mother was admitted to hospital with fluid on the lung, only to be diagnosed with lung cancer.

Although I’ve now quit, I have a heavy smoking history. I was very frightened.

The next day I was cleared of lung cancer, but I had a litre of fluid on my left lung and a drain put into my upper back to take the fluid out.

Because the fluid had been there so long due to my late diagnosis, I was warned that it might have compromised my lung permanently.

The fluid on the lung squashes the organ, and there is a danger it won’t fully reinflate, reducing lung capacity permanently.

After eight days and a course of intravenous antibiotics, I was allowed home, 9lb lighter, gaunt and with no energy.

Three months later, I only just started to feel well again. The good news is that a recent X-ray has shown that my lung is healing nicely, with minimal scarring.

But I was one of the lucky ones. It’s a sobering fact that the UK has the highest mortality rate from pneumonia in the whole of Europe, with about 280,000 new cases every year.

The UK has the highest mortality rate from pneumonia in the whole of Europe, with about 280,000 new cases a year

One in 20 people who gets it in Britain dies from it, and one in six is ill enough to be hospitalised.

More women in the UK die from pneumonia than from breast, ovarian and cervical cancer combined, and from any other respiratory disease.

More UK males die from it than prostate cancer. Globally, it’s the biggest killer of under-fives. And yet, worryingly, some people who develop it might not, like me, know they have it until it’s quite advanced.

A misdiagnosis such as mine isn’t uncommon, according to Keith Prowse, former chairman and one-time Vice-President of the British Lung Foundation.

That’s because the kind of pain caused by pneumonia feels the same as damage caused by a cracked rib.

Pneumonia typically attacks the lungs when they have been weakened by other illness, commonly flu.

‘It is the worst end of a very bad cold, and it’s far more common in winter,’ explains Professor Stephen Spiro, chair of the British Lung Foundation.

‘But any infection reduces resistance to pneumonia. It gets you when your resistance is down.’

The germs that cause it can be bugs that live in the throat permanently, usually doing no harm, or by bacteria that is inhaled. Pneumonia causes inflammation of the lungs when the tiny air sacs within them, called alveoli, become filled with fluid.

This is what causes breathing difficulty. In some cases, you develop fluid between the lung and the chest, as I did.

When there is a lot of fluid, a drain is required. In rarer instances, the liquid in the pleura (the tissue which lines the inside of the chest cavity) becomes infected.

When this happens, surgery may be needed to scrape out infected pus.

Typical signs of pneumonia are shivering fits, fever, chest pain and coughing, dry at first then phlegmy within a couple of days and often bloody.

Men and women carrying excess weight are most at risk

Breathing becomes fast and shallow and if it becomes painful, the infection has probably spread to the membrane covering the lungs.

The elderly and young children are most at risk, as are asthmatics, smokers, alcoholics, diabetics and those with weakened immune systems.

And once they get it, ‘obese people are more at risk, as they will find it even harder to take deep breaths,’ says Professor Spiro. Anyone who has had their spleen removed is at higher risk.

Pneumonia was always believed to be more common among underweight people, but there is now evidence to suggest that men and women carrying excess weight are most at risk.

Researchers at Harvard University assessed l00,000 people over six years and found that men and women who gained more than 40lb during adulthood were almost twice as likely to develop pneumonia than those whose weight had remained stable.

This is possibly because the strain on the immune system caused by excess weight makes it easier for germs to invade the body.

The risk was lower among women who remained physically active.

Following a bout of pneumonia, rest is absolutely critical to recovery, advises Dr Robert Wilson, a respiratory specialist and head of the lung unit at London’s Royal Brompton Hospital.

He said: ‘People forget that it is a life-threatening illness, and it can take two months, or even longer, to get well. Those who don’t rest run into trouble, as they can develop pneumonia again with chronic symptoms.’

A simple X-ray early on would have put me at less risk of the permanent lung damage I could have sustained through late diagnosis.

Meanwhile, instead of trusting doctors, I will now question everything I am told about my health, as a result of being misdiagnosed-So I now join that resource-draining group we call ‘the worried well’ — I didn’t appreciate before I was ill they might have reason.

Finally, anyone who kids themselves that they can get away with smoking should quit this instant.

‘To learn you might die early from something entirely of your own making is very, very hard news to hear.

Pleural Diseases | Michigan Medicine

The chest (thoracic or pleural) cavity is a space that is enclosed by the spine, ribs, and sternum (breast bone) and is separated from the abdomen by the diaphragm. The chest cavity contains the heart, the thoracic aorta, lungs and esophagus (swallowing passage) among other important organs. The wall of the chest cavity is made up of the rib cage and diaphragm. The chest cavity is lined by a thin shiny membrane called the pleura, which covers the inside surface of the rib cage and spreads over the lungs as well.  Normally, the pleura produces a small amount of fluid which serves as a lubricant to the lungs as they move back and forth against the chest wall during respiration.

A variety of conditions involve the pleura and pleural cavity, each with different causes, symptoms, and treatments.

Types of Pleural Diseases

Hemothorax: Accumulation of blood in the pleural cavity.

• Causes: Most chest trauma; other causes include lung/pleural cancer and chest/heart surgery
• Symptoms: Chest pain, shortness of breath, anxiety/restlessness, increased heart rate, respiratory failure if large

Pleural effusion:  Accumulation of excess fluid in the pleural cavity; this accumulation pushes against the lung and prevents full expansion with breathing. This is one of the most common problems associated with the pleura.

• Causes: Congestive heart failure, lung cancer, pneumonia, tuberculosis, liver disease, pulmonary embolism, lupus, adverse reaction to specific medications

• Symptoms: May be asymptomatic (no symptoms), or produce shortness of breath and cough

Empyema: The accumulation of pus in the pleural cavity. This is a type of pleural effusion that is usually associated with pneumonia (an infection in the adjacent lung). The symptoms are those of the pneumonia (cough, fever) in addition to shortness of breath and impaired breathing.

Pleural tumors: Malignant tumors arising from the pleura (e.g. mesothelioma) or spreading to the pleura (metastatic) from another site, and benign tumors arising from the pleura.

• Symptoms: Shortness of breath, chest pain, cough, unexpected weight loss

Pleurisy: Inflammation of the pleura

• Causes: Infection of the respiratory system by a virus or bacteria, leak of air into pleural cavity from a punctured lung, chest injury, tuberculosis or other infection, tumor in the pleural cavity, rheumatoid arthritis, lupus, sickle cell crisis, pulmonary embolism, pancreatitis, complications from heart surgery

• Symptoms: Chest pain on taking a deep breath, shortness of breath, fever and/or chills, joint swelling and/or soreness, unexpected weight loss

Pneumothorax: Accumulation of air within the pleural cavity between the outside of the lung and the inside of the rib cage.

• Causes: Injury to the lung causing a leak of air, chronic obstructive pulmonary disease or other lung disease, tuberculosis, ruptured air blisters (blebs), mechanical ventilation

• Symptoms: Shortness of breath, rapid breathing, chest pain when taking a deep breath (pleurisy), cyanosis (bluish discoloration of the skin), respiratory distress if large

Diagnosis

Pleural disease may be suspected on the basis of a medical history and findings on a physical examination. It is confirmed with a chest x-ray, which shows the interior of the  chest cavity, and a CT scan—a series of images of the inside of the body, taken from different angles and depths, to reveal a high level of detail. To ensure that the blood vessels and organs show up clearly in these scans, dye may be swallowed or injected into a vein during performance of the scan. Certain blood tests may also be useful in determining the cause and severity of the pleural disease.

Treatments

The treatment of pleural disease is dictated by the condition and may vary from placement of a chest tube to evacuate air, draining fluid with a needle (thoracentesis) or a chest tube, or opening the chest to remove the diseased pleura (decortication).

Abrading the pleural surface to achieve adherence of the lung to the chest wall may be required for recurrent pneumothorax.

In some cases of malignancy (mesothelioma), removal of all of the pleura as well as the underlying lung (extrapleural pnemonectomy) may be indicated.

Your physician will discuss with you the diagnosis and surgical and non-surgical options for treatment.

To make an appointment, please see our locations page for the phone numbers.

An unusual course of disease in two patients with COVID-19: pulmonary cavitation

Patient 1

A 59-year-old man was admitted to our institution on 20 March 2020 with a 3-week history of fever, dry cough and sore throat starting 1 March after a holiday in Northern Italy. In the following weeks, he reported a weight loss of 10 kg due to reduced appetite and altered sense of taste. Other than for psoriasis vulgaris, his medical history was unremarkable, and he took no medication, especially no immunosuppressant. He had a smoking history of 38 pack-year but stopped 9 years ago.

On physical examination, vital signs were normal except for oxygen saturation (SpO₂) of 91% breathing ambient air (table 1). Pulmonary examination revealed distant breath sounds on the right side of the chest, with unremarkable cardiac, abdominal and neurological examination. Laboratory studies showed normal leucocyte count with borderline lymphopenia, C reactive protein (CRP) 162 mg/L and low procalcitonin (PCT). Nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 were negative on 2 consecutive days. Blood cultures showed no growth. Chest radiography on admission displayed extensive bilateral peripheral patchy and irregular infiltrates with subpleural sparing. CT of the chest (figure 1A) demonstrated small patches of paraseptal emphysema. Some of the infiltrates included small areas of minor ground-glass change. There was relative sparing of the anterior and central parts, as well as the basal parts of both lungs, but neither enlarged lymph nodes nor effusion.

Figure 1

CT of the chest of patient 1 on 20 March (A) and 2 April (B), days 20 and 33, after symptom onset. The cavity with air-fluid level (B, arrow) was situated anterior to a previously present consolidation patch.

Table 1

Changes in key indicators of laboratory results and vital signs—patient 1

With the presumptive diagnosis of atypical pneumonia, an empirical antibiotic therapy with levofloxacin was initiated. A high clinical and radiological suspicion of COVID-19 pneumonia remained. Until 23 March, the day of discharge, SpO₂ improved and CRP declined to almost normal. Levofloxacin was discontinued after a total of 7 days.

Follow-up consultation with the primary care physician on 30 March was unremarkable, laboratory studies displayed normal values. One day later, the patient developed a sudden thoracic pain, worse during inspiration, localised at the lower frontal right-sided rib cage with accompanying dyspnoea. Following an episode of haemoptysis in the morning of 2 April, he was readmitted to our hospital. Conventional radiography of the chest showed a roundish cavity with an air-fluid level in the right lower lobe. On physical examination, vital signs were normal except for an elevated respiratory rate (RR) and slightly impaired SpO₂. Pulmonary examination revealed distant breath sounds at the bases bilaterally, with the remainder of the physical examination being unremarkable.

Laboratory studies showed normal leucocyte count and CRP 37 mg/L. Screening for vasculitis (antinuclear and antineutrophil cytoplasmic antibody) and HIV was negative but antibody testing for SARS-CoV-2 was positive for IgM and IgG. CT of the chest (figure 1B) showed a thin-walled cavity, 7.3×4×2.5 cm, with an air-fluid level in the anterior segment of the right lower lobe, bordering the minor fissure. The previously present bilateral infiltrates showed minor progression but there was no association between the new cavity and previous areas of consolidation or emphysema and no pulmonary embolism.

Antibiotic therapy with levofloxacin was re-established and on 3 April bronchoscopy with bronchoalveolar lavage was performed. Macroscopically, no specific abnormalities were detected, and the cytological and microbiological results were negative for Mycobacteria, Mycoplasma, Chlamydia, Legionella, Aspergilla and a respiratory virus panel, including SARS-CoV-2.

One day after initiation of antibiotic therapy, the patient started feeling better and the thoracic pain disappeared. CRP dropped to almost normal on 5 April. He received intermittent supplemental oxygen up to a maximum of 2 L/min and on 6 April, the day of discharge, his SpO₂ breathing ambient air and RR were back to normal.

Antibiotic therapy with levofloxacin was continued for a total of 4 weeks until 29 April. Follow-up chest radiography (figure 2) in the primary care setting on 4 May showed mild enlargement of the cavity in the right lower lobe with an increase in fluid content. Thereupon, the patient was readmitted to the hospital for further investigations. He reported mild exertional dyspnoea and mild fatigue. Physical examination was unremarkable, vital signs normal and laboratory studies showed no signs of inflammation.

Figure 2

Posteroanterior (A) and lateral (B) chest radiography of patient 1 on 4 May, day 65, after first symptoms and following a 4-week therapy with levofloxacin. Despite the antibiotics, the cavity (arrows) showed mild enlargement with an increase in fluid content.

CT-guided puncture of the cavity revealed 20 mL of red-brownish, turbid liquid, with pH of 7.23 and a cell count of 10×10⁹/L with predominantly neutrophil granulocytes (more than 50%), scattered monocytes (25%) and few lymphocytes (10%). Microbiological results, including Ziehl-Neelsen stain, were negative, cultures showed no growth and RT-PCR for SARS-CoV-2 was negative. Diluted material was sent for further cytological analysis, disclosing degenerated blood with foam cells and blood residues, resembling an organising haematoma. No malignant cells were detected. Pre-emptive antibiotic therapy with amoxicillin/clavulanate was administered for a total of 7 days. The patient left the hospital on 12 May.

Patient 2

A 59-year-old man was admitted to our hospital on 26 March 2020 with a 10-day history of fever, cough and shortness of breath. Nasopharyngeal swab for SARS-CoV-2 was positive 8 days prior. He had a history of arterial hypertension and gastro-oesophageal reflux, taking a calcium-channel blocker for hypertension, atorvastatin and ezetimibe for hypercholesterinaemia, as well as a proton pump inhibitor. He had a smoking history of 20 pack-year but stopped 5 years prior. On physical examination, blood pressure and pulse were normal, temperature was 38.6°C, RR was 27 breaths/min and SpO₂ was 93% breathing supplemental oxygen at a rate of 4 L/min (table 2). Pulmonary examination revealed crackles at the right lung base, with the remainder of the physical examination being unremarkable. Laboratory studies showed increased leucocyte count with lymphopenia and CRP 157 mg/L. Liver enzymes and parameters for cholestasis were elevated. Blood cultures showed no growth and serological testing for HIV and hepatitis B and C was negative. Chest radiography on admission showed bilaterally diffused and discretely increased density of the lung parenchyma.

Table 2

Changes in key indicators of laboratory results and vital signs—patient 2

We diagnosed COVID-19 pneumonia and, according to the national recommendations at time, experimental therapy with hydroxychloroquine was administered for 5 days. While fever resolved within 3 days, dyspnoea worsened, and an increasing amount of supplemental oxygen with a flow rate of up to 15 L/min administered by non-rebreather reservoir mask was required. CT of the chest (figure 3A) on 9 April showed bilateral confluent irregular infiltrates with varying density and subpleural sparing. Neither emphysema, nor pulmonary embolism, nor enlarged mediastinal lymph nodes were visible.

Figure 3

CT of the chest of patient 2 on 9 April (A) and 22 April (B), days 25 and 38, after symptom onset. The cavity with air-fluid level (B, arrow) was situated anterior and lateral to a previously present consolidation patch.

On 13 April, the patient described a sudden onset of right-sided chest pain, worse during inspiration. After 4 days, the pain dissolved spontaneously, and SpO₂ and RR started improving. CRP levels decreased without further treatment. He was discharged for pulmonary rehabilitation on 17 April with continuous oxygen therapy at a flow rate of 2 L/min.

Five days later. the patient was readmitted after radiological detection of a right-sided pulmonary cavity with air-fluid level and rising CRP. Leucocyte count remained normal. The patient, however, denied worsening of his symptoms. On physical examination, vital signs were normal except for RR of 25 breaths/min and SpO₂ of 91% breathing supplemental oxygen at a rate of 2 L/min. Pulmonary examination revealed rales over the right upper lung zone with the remainder of the examination being unremarkable. Additional laboratory studies showed normal PCT. Sputum was RT-PCR negative for Mycobacterium tuberculosis and SARS-CoV-2, and showed no bacterial growth. Antibody testing for SARS-CoV-2 was positive for IgM and IgG. CT of the chest (figure 3B) confirmed a thin-walled cavity, 3.8 cm in diameter, with air-fluid level centred in the apical segment of the right lower lobe, bordering the major fissure. The previously present dense infiltrates had significantly improved but widespread ground-glass opacities in both lungs remained. There was no association between the new cavity and previous areas of consolidation.

Amoxicillin/clavulanate was administered for a total of 2 weeks. CRP declined and the patient’s respiratory status improved continuously with no further requirement of supplemental oxygen after the third day of readmission. He returned to pulmonary rehabilitation on 28 April.

Lung cancer symptoms | Cancer Research UK

Lung cancer doesn’t always cause symptoms in its early stages. Many of the signs and symptoms can also be caused by other medical conditions but finding lung cancer early can mean that it’s easier to treat. So if you notice any symptoms or changes get them checked out by your GP as soon as possible.  

The most common symptoms of lung cancer are:

• having a cough most of the time
• having a change in a cough you have had for a long time – it may sound different or be painful when you cough
• getting out of breath doing the things you used to do without a problem
• coughing up phlegm (sputum) with blood in it
• having an ache or pain in the chest or shoulder
• chest infections that keep coming back or a chest infection that doesn’t get better
• losing your appetite
• feeling tired all the time (fatigue)
• losing weight

A cough is also a symptom of coronavirus. It is still important to contact your GP if you have a new or worsening cough.

They can speak to you over the phone or by a video call and arrange for tests if you need them.

There are a number of symptoms of lung cancer but they can also all be caused by much less serious conditions. These symptoms include:

• having a cough that won’t go away or a change in a cough you have had for a long time
• being short of breath
• coughing up phlegm with signs of blood in it
• chest or shoulder pain when breathing or coughing
• loss of appetite or unexplained tiredness or weight loss

If you think you have any of these symptoms go and see your doctor. If lung cancer is diagnosed at an early stage, treatment is more likely to be successful.

Lung changes that show on an x-ray

Sometimes doctors might find some unusual changes on your chest x-ray. Your doctor might have arranged an x-ray for other reasons and you might not have any symptoms.

Changes on a chest x-ray don’t always mean that you have lung cancer. There can be other causes, such as an infection. But your doctor might arrange other tests to look further at the changes.

Less common or rare symptoms

Some people have swollen fingers and nails (finger clubbing). They may also have pain and swelling in their joints. This condition is called hypertrophic pulmonary osteoarthropathy (HPOA).

Hormone related symptoms

It is rare but some types of lung cancer cells produce hormones that go into the bloodstream. These hormones can cause symptoms that don’t seem related to the lung cancer. Doctors call them paraneoplastic syndrome.

These hormone symptoms might include:

• pins and needles or numbness in the fingers or toes
• muscle weakness
• drowsiness, weakness, dizziness and confusion
• breast swelling in men
• blood clots

Pancoast tumours

A very rare type of lung cancer growing right at the top of the lung is called a Pancoast tumour. These tumours cause very specific symptoms.

The most common symptom is severe shoulder pain, or pain that travels down the arm.

Pancoast tumours can also cause a collection of symptoms called Horner’s syndrome. These are:

• drooping or weakness of one eyelid
• a small pupil in the same eye
• loss of sweating on one side of the face

The symptoms of Horner’s syndrome are caused by the tumour pressing on or damaging a nerve that runs up from the neck to that side of the face.

Lung cancer story: Anne’s diagnosis

In this video Anne tells her story about her diagnosis. The video is 2 minutes long.

Anne: I’m Anne Long, I live in Thornby. My husband died from lung cancer 36 years ago. I was diagnosed 9 years ago.

I was just brushing my teeth one morning and I saw this tiny thing in my sputum and I thought that shouldn’t be there.

So I went to see my doctor and she said, oh don’t worry about it I’ll send you for an x-ray. Which she did, and it came back that I had a shadow on my lung.

My appointment was at Southport hospital and we went in, and a gentleman told me that I had lung cancer.

I was very shocked because it hadn’t crossed my mind really. And I thought how am I going to tell the children?

On the morning of the operation they took half of my left lung and that was it. I didn’t need anything and I haven’t needed anything since.

When I just realised how fortunate I was that I did actually look at my body and took care of myself. It’s very important to look after ourselves.

I appreciate that my cancer was diagnosed early. That’s why I’m here. That’s why 9 years on I’m still here and every single day is a bonus to me.

Symptoms of advanced lung cancer

You might have other symptoms if you have advanced cancer.

This video explains the importance of going to your GP if you notice any possible cancer symptoms. It lasts for 42 seconds.

If you notice any possible cancer symptoms or any changes that are unusual for you, contact your doctor because early cancer diagnosis saves lives. Due to coronavirus fewer people are contacting their doctor. Your local surgery is ready to help you safely. They can talk to you by phone or video link and can arrange for tests. Whatever happens, tell your doctor if your symptoms get worse or don’t get better. Early diagnosis saves lives. Contact your GP now or go to CRUK.org/coronavirus for more information.

90,000 recovery from pneumonia caused by COVID 19

What is coronavirus infection?

Symptoms of “light” course:

• temperature 37.1 – 38.8
• dry or wet cough, feeling like sputum in the chest, sore throat
• headache, eye pain, lacrimation, redness of the eyes, pain in the face, spasms of the muscles of the neck and back
• weakness, fatigue, no strength to do even ordinary household chores
• shortness of breath, feeling short of breath, dizziness
• a feeling of heaviness in the chest, pain in the chest, pain between the ribs, pain in the neck and back

What happens at this moment in the body?

while lung damage reaches 30-50%, the so-called “frosted glass effect” is observed on computed tomography. What it is?
This term was coined by radiologists to describe vascular changes in lung tissue.

The most unpleasant thing is that even after the immune system has defeated the virus itself, complications remain, and the person suffers pain, weakness and discomfort. Added to these are the side effects of antibiotics and statins used in covid 19 therapy

This is what our patients have to say:

Dmitry, 42 years old, architect:
“At first I thought I was just catching a cold.A slight fever, a runny nose, stayed at home. But when the next day I could not get out of bed in the morning, I realized that something was wrong. The head was splitting, the legs were “wadded”. The temperature rose to 38.8. Eyes hurt, it was unpleasant to look at the light. The doctor from the clinic said that this is a common ARVI, but I decided to get tested for COVID 19 just in case and called a laboratory at my house. After 3 days, the answer came – the coronavirus was detected.

On the 5th day, the temperature dropped to 37.3 – 36.9, but shortness of breath and weakness appeared.For 2 weeks I could not even work, sitting at the computer, without interruptions to “lie down”. A month after the onset of the disease, I still feel its effects. No appetite. My head hurts almost every day, the weakness is terrible, I can’t concentrate. At any, even light loads, the head begins to spin. Feeling that there is not enough air. The ribs hurt, the heaviness in the chest has become constant. “

It is possible and necessary to help with such complications!

Doctors of the “Workshop of Health”, relying on the methodological recommendations of the Ministry of Health of the Russian Federation, successfully cope with the complications of covid pneumonia.

How to Defeat Complications of COVID 19 Pneumonia:

1. Pass all the necessary tests:
clinical blood test to assess the general condition of the body
extended biochemical blood test – to assess how much the disease has affected the functioning of the liver, kidneys, heart.
coagulogram – to evaluate how blood coagulability has changed

2. Droppers with active oxygen eliminate oxygen starvation in tissues, thin thick blood, helping it deliver oxygen to muscles, brain, and other organs.

3. Droppers with hepatoprotectors restore the liver and eliminate the effects of antibiotic and statin treatment. This group of drugs fights the consequences of intoxication, that is, poisoning of the body with the decay products of the virus, and other substances that are formed due to prolonged inflammation.

4. Vascular preparations restore normal cerebral circulation, eliminate weakness and headache.

5. Reflexology and pharmacopuncture – relieve muscle spasms in the chest, back and neck.In some cases, massage and manual therapy, physiotherapy will be more effective.

6. Respiratory and therapeutic exercises helps to restore normal breathing and body muscles weakened during the illness.

The complex of procedures and examinations is selected by the doctor after examination at the initial appointment. It cannot be the same for everyone, because after covid 19, people who have recovered have completely different complications.

If you have had a coronavirus and are feeling unwell, do not postpone seeing a doctor.Now there is an opportunity to quickly put you on your feet, thanks to modern and effective methods. At the same time, we use a minimum of drugs so as not to overload the body.

Authors of article:

Lisina Elena Arkadyevna, neurologist, candidate of medical sciences

Tyshchuk Veronika Anatolyevna, doctor of the highest category, therapist, rheumatologist, rehabilitologist

Date of publication: 18.09.2020

90,000 Treatment of complications of pneumonia in Tyumen

Department of Anesthesiology and Reanimation No. 2 Pneumonia is a severe infectious disease of the lungs.It usually affects people with weakened immune systems (eg, people with diabetes, alcoholism, HIV infection) or develops as a result of infection with a highly pathogenic strain of influenza virus. Also, pneumonia can occur as a result of prolonged horizontal lying in chronically ill patients. Pneumonia can be complicated by an acute viral infection in the legs.

Causes of pneumonia

Often the cause is bacterial flora, especially streptococci, or viruses.Bacterial pneumonia can develop after an upper respiratory infection, such as a cold or flu. In about 50% of cases, pneumonia is caused by a virus.
In some cases, the causative agents are mycoplasmas – microorganisms with the properties of both viruses and bacteria.
Fungi and parasites can be other causative agents of pneumonia, but this happens much less frequently.

Pneumonia symptoms

Symptoms of pneumonia can be similar to those of a cold or flu.Symptoms of bacterial pneumonia can appear both acutely and gradually. These include: fever, tremors, sharp chest pain, heavy sweating, cough with thick, reddish or greenish phlegm, rapid pulse and rapid breathing, cyanotic lips and nails. The feeling of shortness of breath is a common symptom of pneumonia.
Viral pneumonia is characterized by fever, dry cough, headache, muscle pain, weakness, fatigue, and severe shortness of breath.
Symptoms of mycoplasma pneumonia are often similar to those of bacterial and viral pneumonia, but are usually less severe.

Complications of pneumonia

Pneumonia can be complicated by inflammation of the pleura (pleurisy), pulmonary edema, lung abscess (a cavity in the lung filled with pus), and breathing disorders.

What can you do

If you have symptoms similar to pneumonia, consult your doctor immediately. Before that, you can take an antipyretic agent, cough medicine.

See a doctor immediately or call your home in the following cases:

• persistent cough, chest pain, fever;
• a sharp deterioration in the general condition after a cold or flu;
• chills, shortness of breath.

If you suspect pneumonia in people over 65 years of age, in people with chronic diseases or with weakened immunity, children and pregnant women, you should immediately call a doctor who is likely to offer hospitalization.

What a doctor can do

A chest x-ray is taken to confirm the diagnosis. The pathogen is determined using a special blood and sputum test. If a bacterial or fungal infection is detected, antibiotic therapy and antifungal drugs are prescribed.With a viral nature – antiviral drugs.
In severe cases, the patient is admitted to the intensive care unit. In severe respiratory failure, oxygen therapy or artificial ventilation of the lungs with special breathing apparatus is performed.
Pneumonia also requires infusion-transfusion therapy (sometimes transfusion of blood components), artificial nutrition, and sometimes renal replacement therapy.

Branch services and prices

Prolonged cough may be pneumonia! How to recognize?

Pneumonia is an acute inflammation of the lung tissue caused by viruses, bacteria and fungal infections.If pneumonia is not treated promptly, it can lead to life-threatening complications, irreversible damage to the lungs, or become chronic. In the treatment of pneumonia without the help of a doctor and antibiotics, it is usually impossible to do, so it is important to diagnose it as soon as possible. One of the typical symptoms of pneumonia is a cough, which sometimes patients do not pay attention to for a long time and see a doctor late. Ilze Morozova, a pneumonologist from Veselības Centrs 4, advises on how to recognize pneumonia, what are the most frequent pathogens of pneumonia and how to reduce the likelihood of getting sick.

What usually causes pneumonia?

The most common causative agents of pneumonia enter the lungs through the upper respiratory tract, that is, by inhalation. Lung inflammation is most often caused by bacteria – mycoplasma, chlamydia, staphylococcus, legionella and pneumococcus. Pneumococcal bacteria are the most common cause of pneumonia in all age groups of patients and a common cause of death in severe pneumonia. The good news is that you can get vaccinated against this bacterium.

A prolonged cough is one of the symptoms

During the rainy season in the fall, a slight cold, sore throat and cough can occur in anyone, but if the cough does not go away within one to two weeks, you should definitely schedule a visit to the doctor: it can be one of the symptoms of pneumonia.The following signs or their combination may indicate pneumonia:

• Elevated temperature – it is worth worrying if the temperature exceeds +38 degrees. However, pneumonia in the early stages can occur with a slightly elevated temperature or even without it.
• Cough – both dry and productive (with phlegm). It’s worth worrying if it doesn’t go away within 1-2 weeks.
• Noises in the lungs – crackling sounds, wheezing when inhaling and exhaling.
• Chest or back pain – Chest pain can occur when inflammation develops near the lining of the lungs. However, if the inflammation is deeper in the lungs, there is usually no pain and the patient is unaware of the presence of pneumonia.
• Like other diseases, pneumonia can be accompanied by increased fatigue and a deterioration in general well-being . These general symptoms are especially common in mycoplasma and chlamydial pneumonia.

Why is timely treatment important?

Pneumonia is a dangerous disease that can lead to dangerous complications and death. In its treatment, usually, one cannot do without the help of a doctor and an appropriate course of antibiotics. Inflammation of the lungs through listening to the airways, blood tests, sputum culture, x-rays, and other methods are diagnosed by a doctor. When pneumonia is detected, it is very important to simultaneously determine its causative agent – pneumonia is treated with antibiotics, which are prescribed to each patient depending on the causative agent of the disease.

In the case of severe, untreated and neglected pneumonia in the lungs, deformities of the bronchi – bronchiectasis – may develop. These are small pockets in the walls of the lungs, which then collect pulmonary secretions. When this happens, inflammation and suppuration can develop in the pockets, which again cause pneumonia to recur.

Attention – a common mistake! Patients tend to use methods such as thermophore and warming patches to facilitate the discharge of mucus in the event of a severe cough, but this is dangerous in the event of pneumonia.If the inflammation is caused by bacteria, as is usually the case with pneumonia, the heat encourages the growth of bacteria, so this is not recommended.

What is the most common causative agent of pneumonia – pneumococcus and how does it get into our body?

Streptococcus pneumoniae is a very common bacteria that occurs around us. As in the case of other infections transmitted by airborne droplets, they can most often be contracted through household contact, especially in public places where there are many people.Pneumococcal bacteria enter the body by inhalation or by touching the nose and mouth with unwashed hands.

Pay attention! Sometimes pneumococcal bacteria can also live in the mouth and respiratory tract of a person, but this becomes especially dangerous when a person’s immunity is weakened or when it enters the deep respiratory tract and lungs. This should also be taken into account when taking a sputum culture to identify the cause of pneumonia – the collected secretions must come from the deep airways and lungs, and not from the throat and mouth.

Pneumococcal bacteria are not only the most common causative agents of pneumonia, but also many other deep respiratory tract infections. Pneumococcal bacteria can also cause otitis media (especially in children), severe sinus infections, meningitis or meningitis, and life-threatening conditions such as sepsis.

Infants and children need special protection against pneumococcal bacteria, which is why pneumococcal vaccination is now included in the childhood vaccination schedule.Adults can get the pneumococcal vaccine of their choice, and adults only need one dose of vaccine to protect them for life. Vaccinated people who have become infected with pneumococcal bacteria during their life overcome the disease in a mild form.

Who needs to get vaccinated?

Vaccination against pneumococcus is recommended for everyone, but doctors especially strongly recommend:

• People with immunodeficiency, weakened immunity and who are taking any immunosuppressive medications.
• Patients with chronic diseases – the natural defenses of the body weaken any chronic disease, but special care should be taken in patients with chronic respiratory diseases such as COPD, bronchiectasis, asthma, as well as patients with diabetes mellitus and cancer;
• People over 65 years old.

Be careful if pneumonia recurs regularly! Recurrent pneumonia can be caused by an undiagnosed pneumococcal infection or if it is not completely cured in a timely manner.At the same time, for people with frequent relapses of pneumonia and respiratory diseases, it is important to take care of strengthening the immune system. This is facilitated by a healthy diet and sports, as well as a balanced work and rest regime. Unfortunately, people tend to forget about the latter in their stressful everyday life, although stress and overwork are very important factors that weaken our immunity.

Photo: Adobe

signs, symptoms, diagnosis and treatment

What is pneumonia?

Pneumonia is the general name for a group of inflammatory lung diseases.The disease can be primary or a consequence of another disease. Regardless of the cause, pneumonia is a serious illness that should not be treated on your own. At the first suspicion, it is necessary to consult a doctor as soon as possible.

The disease can be determined using radiography or computed tomography of the lungs. The picture will show whether the organ is affected.

Types of pneumonia

• Primary . This means that the disease is independent.
• Secondary . Pneumonia is a complication from another illness.
• Radiation . The inflammation developed during chemotherapy.
• Post-traumatic . The disease has arisen as a result of trauma.

Types of pneumonia

The disease differs in several ways.

According to the source of the disease:

• viral,
• infectious,
• fungal,
• mixed.

During the course of the disease:

• chronic,
• acute,
• subacute.

Disease symptoms

Symptoms can vary depending on the type of disease, individual characteristics of the body, or your age.

The main common signs of pneumonia are:

• general weakness,
• drowsiness,
• cough,
• fever,
• difficulty in breathing.

Risk groups

The risk group includes infants, children under 5 years old, the elderly 65 and older, people suffering from asthma and other lung diseases, diabetes mellitus, cardiovascular diseases.

Smoking and other bad habits also increase the likelihood of getting sick.

Facts about the disease

1. Vaccination in 70% of cases protects against pneumonia.
2. Before the advent of antibiotics, mortality from pneumonia was 85%.
3. The fight against pneumonia has its own holiday – November 12th.
4. The detailed study of pneumonia began in the early 18th century.

Common myths about pneumonia

Myth # 1: with the right treatment, you can be cured in a few days.

In fact: in a few days you can get rid of the symptoms, but you will not be able to completely overcome the disease during this time. The treatment will take at least 21 days.

Myth number 2: warming up will help to get rid of cough in case of pneumonia.

In fact, this myth is dangerous. Warming up will not only not help, but also worsen the condition.

Myth No. 3: with inflammation, there will certainly be a cough and fever.

In fact, the disease can be almost asymptomatic. This can happen due to weakened immunity or individual characteristics of the body.

Myth No. 4: the disease is dangerous only for children and the elderly.

In fact: yes, these categories are at risk, but the disease is dangerous for everyone.Especially if you have chronic medical conditions.

How to distinguish pneumonia from acute respiratory viral infections, influenza and bronchitis?

1. Sweating increased noticeably. You feel hot and cold. Moreover, this condition may not be associated with changes in body temperature.
2. You feel better, and after a few days your condition worsened. This is the body’s response to inflammation.
3. You have completely or partially lost your appetite. Moreover, the sight and smell of food can start to cause disgust and even gagging.
4. You have chest pain. This, like difficulty breathing, can be a sign of pulmonary edema.
5. The mucous membranes have acquired a blue or purple hue. This can happen due to a lack of oxygen in the blood.
6. The pulse has become more frequent or “jumping”. This symptom is also associated with a lack of oxygen.

When should I see a doctor right away?

It is necessary to urgently call a doctor against the background of general symptoms if you have the following symptoms:

• Breathing quickened (more than one breath in 2 seconds).
• The pressure has dropped to a value of 90 by 60 or more.
• Body temperature exceeded 38.5.
• Confusion of consciousness appeared.
• Your eyes darken and you feel light-headed.

Treatment of pneumonia

Treating pneumonia with folk remedies is not only useless, but also life-threatening. Only a qualified doctor will select the right drugs that will help you recover.

You will be prescribed antibiotics and medications to treat the condition symptomatically. To determine which medications to prescribe, you will be asked for the following tests:

• general blood test,
• general urinalysis,
• clinical sputum analysis.

Causes of pneumonia

Primary pneumonia can be caused by a virus, fungal disease, infection, or a combination of these factors. Infection from another carrier occurs through airborne droplets, usually from sneezing or coughing.

Complications

• Lung abscess.
• Meningitis.
• The appearance of fluid in the lungs.
• Shortness of breath.
• Infection of other organs.

Prevention

An overall strengthening of the immune system will help reduce the risk of infection. Also, in order not to get sick, try to lead a healthy lifestyle: adhere to proper nutrition, play sports, temper.

What if you have pneumonia?

1. Try to be outdoors more often and walk more.Jogging is also recommended.
2. Do breathing exercises: hold your breath while taking a deep breath. It is best to do the exercise while sitting in a well-ventilated area or outdoors and repeat it 5-10 times in a row.
3. Include fresh fruits and vegetables in your diet.
4. Drink more water – from 1.5 to 2.5 liters per day, depending on body weight.
5. Try not to overheat or overcool.
6. Avoid stress and get enough sleep, it is better to sleep at least 8 hours a day.

How to recover the lungs after pneumonia and COVID-19: advice from a rehabilitation therapist – Tips

One of the most serious complications of coronavirus infection is pneumonia, that is, pneumonia. Even after recovery, a person cannot immediately return to their usual life. The chief specialist in medical rehabilitation of the Medsi group of companies Elizaveta Koneva told RIAMO in Krasnogorsk how the specialists of the rehabilitation center work in the context of the COVID-19 epidemic and what exercises will help restore lung function.

“For the vaccine – salvation”: the director of the Krasnogorsk hospital on the third wave of COVID-19 >>

Rehabilitation Center

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From personal archive

The Medsi Rehabilitation Center is based in Clinical Hospital No. 1 on Pyatnitskoye Highway in Krasnogorsk. Here they work with both outpatients and inpatients. In addition, telemedicine is widely used – remote rehabilitation is now in demand.

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The rehabilitation center includes two large divisions – physiotherapy and sports medicine and physiotherapy.There is also a rehabilitation department here.

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Services are provided under contracts according to the price list, as well as within the framework of VHI and OMI. The latter option is available exclusively to hospital patients, subject to a number of conditions.

In a 35-bed inpatient facility, patients receive round-the-clock medical assistance and drug treatment, and, if necessary, undergo additional examination. The department has its own traumatologist, neurologist, therapist.

“The patient has a procedure all day. According to the profile of his disease, he receives rehabilitation treatment on condition of accompanying diagnostic and therapeutic assistance, ”explained Koneva.

In addition, the specialists of the center provide assistance to patients of a multidisciplinary hospital. If necessary, they go to the patients of neurology, surgery, therapy, gastroenterology and even intensive care.

“All patients undergoing treatment at the multidisciplinary clinic also receive treatment at the rehabilitation center.This is a huge part of our job, ”added Koneva.

How to get vaccinated against coronavirus in Krasnogorsk >>

Team with 15 years of experience

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From personal archive

“The rehabilitation team under my leadership has been working for over 15 years. The team is young and very energetic. For 15 years, certain traditions have developed and, which is very important, our own school. We train young specialists who come to us, guided by proven methods, technologies, culture, ”explained Koneva.

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She added that her team traditionally collaborates with multidisciplinary hospitals. The team has been working in the Medsi group of companies for about 3.5 years.

The rehabilitation center currently employs about 100 employees. A large number of doctors allows you to personally manage many patients at once.

“There are no diseases that we would not undertake to rehabilitate. These are severe resuscitation patients in the most acute period of the disease, and oncological and palliative patients, this is the whole spectrum of neurological and therapeutic diseases.Traditionally, we work a lot with orthopedic and trauma patients. The spectrum is huge, and we use all innovative technologies, ”said Koneva.

According to her, the center is well equipped with the most modern equipment. There are, among other things, robots for restoring walking, hand motility, as well as various simulators and biofeedback devices.

How to care for a coronavirus patient at home >>

Distance-based rehabilitation

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From personal archive

Clinical Hospital No. 1 “Medsi” has now been redesigned to work with patients with coronavirus infection.In “peacetime” time, outpatients can come to the rehabilitation center seven days a week from 8:00 to 20:00. However, movement therapy, the help of speech therapists and neuropsychologists are often required for patients with limited mobility.

“Telemedicine is moving by leaps and bounds across the world. Remote sensing technology is advancing rapidly, especially with the coronavirus pandemic. Thus, the Medsi group of companies together with MTS have developed the SmartMed application, through which the patient gets access to his electronic medical history and can receive procedures via video conferencing.Rehabilitation doctors dynamically observe and advise patients in a convenient schedule, ”explained Koneva.

She noted that after discharge, people who have had coronavirus should be in quarantine for two weeks. During this period, they can use telerehabilitation services and remotely engage in breathing exercises with instructors.

Where to complain if a free coronavirus test was denied >>

Breathe in the lungs

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From personal archive

The Medsi multidisciplinary hospital in Krasnogorsk was redesigned from April 1 to treat patients with coronavirus infection.

“Rehabilitologists, of course, did not stand aside. Patients in the “red” zone require increased attention. With COVID-19, the lungs are mainly affected, viral pneumonia – breathing exercises, activation of patients are needed. It is also important to work in intensive care, where it is necessary, among other things, to carry out passive techniques with severe patients so that secondary complications do not develop – bedsores, congestion, ”said Koneva.

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According to her, patients are admitted to the clinic in severe and moderate severity.In addition, people of age, as a rule, have concomitant pathology, chronic diseases are exacerbated in the hospital.

“It is very difficult to work in personal protective equipment. We have selected the hardware technologies of massage, physiotherapy, electro-phototherapy, which can be used in these suits. All one hundred percent of patients who went through the hospital in these two months received rehabilitation assistance, ”Koneva emphasized.

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In addition, rehabilitation therapists train patients in therapeutic exercises before they are discharged.Koneva explained that those who have had pneumonia must do breathing exercises regularly. Gymnastics is aimed primarily at reducing areas of fibrosis – this is scar tissue that is excluded from the active breathing process.

“After pneumonia, especially with extensive damage to the lung tissue, it is very important to” breathe “the lungs, to return the lung volume, which was before the disease. It is necessary to improve blood circulation and maximize the activation of the compensatory respiratory muscles, which can increase the lung volume, ”said the doctor.

According to her, it is necessary to teach patients to breathe correctly so that the previously affected respiratory zones are included in the act of breathing as quickly and actively as possible.

“Thus, we reduce the risk of disability for a patient after suffering pneumonia,” Koneva emphasized.

“The whole family got infected”: how a resident of Krasnogorsk suffered a coronavirus >>

Lung Exercise

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From personal archive

The rehabilitation specialist told me what exercises for the lungs you can do yourself at home.You need to perform them at a slow pace, repeating each 4-6 times. For best results, you should devote 10-15 minutes to breathing exercises twice a day.

Inhale through the nose, exhale through the mouth. The exhalation should be one and a half to two times longer than the inhalation. You can control this by counting to yourself: inhale 1-2-3, exhale 1-2-3-4-5.

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At the end of each exercise, the muscles of the shoulder girdle should be relaxed. Please note: breathing exercises should not cause severe discomfort and even more pain.

Exercises to be performed while lying down:

Inhale – through the nose, exhale – elongated, through the mouth, lips with a tube. You can also exhale through closed teeth to pronounce the sounds “zhzh”, “sss”, “shshsh”.

Leaning on your elbows, raise the chest – inhale, relax – exhale.

Bend your legs at the knees, stretch your arms along the body. At the same time, raise your arms up, your feet towards yourself – inhale, hands down, lower your feet to the floor – exhale.

Hands to the shoulders, spread the elbows to the sides – inhale, lower the elbows and press against the chest – exhale.

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Raise both hands up – inhale, slowly lower – exhale.

Spread your arms to the sides – inhale, hug yourself by the shoulders, pressing your hands tightly to the chest – exhale.

Bend your knees. Raise the pelvis while inhaling, lower it while exhaling.

To train the diaphragm on inhalation, you should inflate, protrude the stomach, and on exhalation, on the contrary, draw in.

Exercises to be performed while seated:

Fold the brushes into the lock on the chest – inhale, palms away from you, stretch – exhale.

Legs apart shoulder-width apart, lower arms – inhale, tilt the body to the side – exhale.

Spread your arms to the sides – inhale, pull your knee to your chest – exhale. You can also, while exhaling, tilt the body forward and hug your knees.

Take the elbow back – inhale, reach the opposite knee – exhale.

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Return to active life

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From personal archive

Another task of a rehabilitation therapist when working with a patient who has undergone a coronavirus is to return to those physical activities to which a person was accustomed to before the illness.

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“You cannot leave the hospital after suffering bilateral pneumonia and say:” I am healthy. ” Damage to the lungs leads to a decrease in the patient’s motor activity and performance, and this is again associated with a decrease in respiratory capacity, “explained Koneva.

At the same time, she noted that it is necessary to return to physical activity gradually, dosed.

If a patient develops a large zone of fibrosis after suffering pneumonia, the task of rehabilitators is to select the so-called threshold physical activity on which a person will now live and engage in amateur sports.

The doctor recommends training on cyclic type simulators – stationary bike, treadmill, ellipse. It is beneficial for both the respiratory and cardiovascular systems. In this case, the load must be increased gradually.

“Ideally, this should be done under the supervision of a specialist, especially after extensive bilateral pneumonia with severe pulmonary fibrosis,” Koneva emphasized.

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Return to scheduled operation

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From personal archive

According to the rehabilitation specialist, in the last 10 days there has been a decline in the number of patients admitted to hospital with pneumonia and COVID-19.

“It is planned that by June 1, a part of the clinic will be re-profiled for scheduled work. Surgeons, cardiologists, traumatologists will start working. Our team will have two vectors of work: some of the rehabilitation specialists will continue to deal with infected patients in the “red” zone, and some of the employees will return to their planned work, ”said Koneva.

She also added that from July 1, it is planned to reopen the department of rehabilitation. Rehabilitation therapists will, as before, provide planned assistance to specialized patients in the hospital.

What you need to know about COVID-19 pneumonia

Why is pneumonia dangerous in COVID-19? What symptoms cannot be ignored? How to restore lung health after coronavirus pneumonia? Can I inhale if I get sick with COVID-19? The journalist of the information portal “Healthy People” asked these and other questions to the chief freelance pulmonologist of the Ministry of Health, head of the department of pulmonology and surgical methods for treating respiratory diseases of the Republican Scientific and Practical Center for Pulmonology and Phthisiology, Ph.M.Sc. Elena Davidovskaya.

How is pneumonia caused by coronavirus different from normal?

Coronavirus-associated pneumonia (COVID-19 pneumonia) is a specific type of lung injury that more accurately reflects the term pneumonitis. This implies the involvement of the interstitial tissue of the lungs, alveolar walls and blood vessels in the pathological process. That is, inflammation develops in all structures of the lungs involved in gas exchange, which prevents the normal saturation of blood with oxygen.

Is it possible with covid to have asymptomatic inflammation of the lung tissue, when, despite changes in the lungs, patients have no cough, no shortness of breath or fever?

Asymptomatic or oligosymptomatic course is more typical for forms of the disease without lung involvement. Indeed, computed tomography (CT) of the chest organs in patients with mild COVID-19 may show CT signs of mild viral pneumonia. At the same time, the gas exchange function of the lungs does not suffer, the amount of oxygen delivered to the blood remains normal, and no change in therapeutic tactics is required.

When do symptoms of coronavirus, such as respiratory discomfort, shortness of breath, usually appear?

The incubation period of infection caused by the SARS-CoV-2 virus is on average 5-7 days (from 2 to 14), which means that symptoms may appear during these periods. The course of the disease can be different – from mild manifestations of ordinary ARVI (fever, cough, weakness, headache) to severe pneumonia with respiratory failure. It is always worth paying close attention to such manifestations of the disease as shortness of breath (increased breathing rate), feeling short of breath, pain or feeling of tightness in the chest during any period of the illness.

Do lung changes appear in most COVID-19 survivors?

In most cases – up to 80% – coronavirus infection is mild, without lung involvement. COVID-19 pneumonia develops in about 20% of cases, of which 2 to 10% can be severe. The duration of the course and the consequences of the disease depend on many factors: the volume of lung damage, concomitant diseases, the timeliness of seeking medical help, adherence to treatment recommendations, the possibility of complications, etc.

When should CT scan for severe covid pneumonia? Is there a need for re-examination?

Indeed, due to its high sensitivity, CT is the main method for detecting changes in the lungs characteristic of COVID-19. In a comprehensive assessment, together with the history of the development of the disease, epidemiological data and the clinical picture, CT scans with a high degree of probability confirm a case of coronavirus infection. However, there are several important points to note :

– the use of CT for screening (i.e.that is, identifying pathology in the absence of symptoms) both pneumonia in general and with COVID-19 (including with positive laboratory tests) is inappropriate;

– in relation to coronavirus infection, changes detected on CT scan in patients with asymptomatic or mild forms of the disease without risk factors do not affect treatment tactics;

– with a mild course of COVID-19, CT diagnostics is carried out according to clinical indications in the presence of risk factors or for the purpose of differential diagnosis with other pathological conditions;

– it is advisable to carry out a CT scan no earlier than 3-5 days after the onset of symptoms;

– assessment of the dynamics of the course and outcome of previously identified COVID-19 pneumonia is carried out according to clinical indications, the timing is determined individually.

Is the CT scan of a patient with coronavirus pneumonia different from conventional pneumonia?

Radiation diagnostic methods, including CT, do not replace complex clinical diagnostics. The presence of characteristic CT signs allows you to determine the likelihood (with a gradation of “high-medium-low-abnormal signs”) of COVID-19 pneumonia and establish the extent of the lesion.

What are the treatments for coronavirus pneumonia?

Approaches to the treatment of COVID-19 have evolved and changed as information about the course of infection appears, understanding the mechanisms of its development and possible consequences based on the analysis of a large number of international publications and research results, accumulating clinical experience.A year after the start of the pandemic, there is still no etiotropic therapy with proven efficacy in the arsenal of drugs used.

In case of COVID-19 pneumonia, an important place is occupied by non-drug methods – prone position (prone position) as an independent therapeutic measure, oxygen therapy, options for hardware respiratory support. In all cases of coronavirus infection, it is necessary to monitor the amount of fluid consumed.

Taking into account the mechanisms of the development of the disease, in the algorithm for the pharmacotherapy of COVID-19 pneumonia includes antiviral drugs, drugs for the prevention of thrombus formation, hormonal anti-inflammatory therapy, if there are signs of bacterial infection, antibiotics.

Despite the algorithmicization of therapeutic approaches, which is undoubtedly important in epidemic conditions, the volume of pharmacotherapy and the choice of specific drugs from each group is determined by the doctor, and only based on the specific clinical situation and individual characteristics of the patient.

Do patients with pneumonia caused by coronavirus infection always need to be treated in a hospital?

At home, it is possible to treat non-severe pneumonia in a person without risk factors, provided there are conditions that ensure isolation and adherence to treatment recommendations, as well as medical (including remote) control.

Can inhalation be done for coronavirus pneumonia?

In case of coronavirus infection, inhalation (steam inhalation, nebulizer therapy), as aerosol-forming procedures, should be abandoned. The exceptions are dosing inhalation devices – aerosol and powder, used for constant basic therapy and emergency care for chronic diseases – bronchial asthma and chronic obstructive pulmonary disease.

Nebulizer therapy should be used only for health reasons in compliance with precautions for the spread of infection through the aerosol (isolation of the patient during inhalation, ventilation after inhalation, surface treatment with antiseptics).

How to recover the lungs after coronavirus pneumonia? For example, breathing exercises. When can I start? Immediately after recovery, or is it worth the wait?

The recovery period after COVID-19 pneumonia, like the “set” of recovery procedures, depends on the severity of the pneumonia suffered and the changes that remained in the lungs after the disease. In addition, concomitant diseases, weight, level of physical fitness before illness, etc., are important to determine the recovery program.

Rehabilitation after COVID-19

Rehabilitation measures can be started after stopping an acute inflammatory process – normalizing body temperature, improving or normalizing laboratory parameters (a doctor’s assessment is required!) And in the absence of signs of decompensation of concomitant diseases.

Rehabilitation programs include breathing exercises, physiotherapy exercises, therapeutic massage, balanced nutrition, drinking regimen, physiotherapy procedures.

In cases where, after severe pneumonia, large areas of post-inflammatory changes, shortness of breath, blood oxygen saturation (saturation – SpO2) according to pulse oximetry data are below 95% and the need for oxygen support remain in the lungs, rehabilitation may take several months.

Information prepared on the basis of materials from the website 24health.by

These symptoms of pneumonia should never be ignored

Doctors have voiced a list of symptoms characteristic of pneumonia.

Since pneumonia most often occurs against the background of colds or as a complication after a seasonal infection, autumn is the time when it is worth getting to know the first symptoms of pneumonia in absentia.

Pneumonia is an inflammatory process in the lungs caused by the ingestion of viruses and harmful bacteria. Once people tried to treat pneumonia on their own, but their attempts ended in disappointing mortality statistics among patients.This continued until antibiotics appeared that could cure pneumonia and raise a person to their feet after an illness. Therefore, today people do not need to be treated at home and experiment on themselves, if a diagnosis of “pneumonia” is made, it is indisputable to follow the recommendations of the attending physician.

By these signs, you can understand for yourself whether there is pneumonia:

1. High body temperature.

2. Increased fatigue and aches in bones, muscles, body as a whole.

3. Pain in the chest area in front and behind.

4. Lack of appetite.

5. Respiratory failure, which manifests itself in the form of shortness of breath. With pneumonia, the patient may feel short of breath even in a calm state.

6. Cyanosis of the mucous membranes of the lips and skin of the face, as well as “bruises” under the eyes, but this symptom is more related to patients under 1 year of age, although it may appear at a different age.

7. Increased sweating.

8. Severe cough with sputum discharge of green and “rusty” shades.

9. Headache.

In some cases, pneumonia is asymptomatic or symptoms of the disease are not typical for it. If you have any doubts about your own well-being, then you can always ask the therapist if your guesses are groundless.

Inflammation in the lungs, as we have already found out, develops due to the ingestion of a virus in the respiratory system and the symptoms may be similar to the underlying disease.For example, you fell ill with acute respiratory viral infections and pneumonia, and it is extremely difficult to determine your second ailment, because the symptoms are “erased”. At least, if anyone can do it, then most likely it is a therapist or pulmonologist.

How to help your body wake up faster

It is extremely unsafe to postpone a visit to the doctor, since pneumonia affects the lung tissue, and self-medication may be in vain or if you seek medical help too late.

When the first signs of pneumonia appear, do not be too lazy to undergo an examination of the lungs and bronchi for inflammation, if everything is fine, you can sleep well, but when the diagnosis is confirmed, feel free to go to inpatient treatment.

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