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Acute management at an acute pneumonia

Acute pneumonia — group various on an etiology, a pathogeny and morphology of the diseases caused by inflammatory process in lungs with preferential defeat of respiratory departments.
Symptoms. The clinical picture is various and is defined by character of the activator In one cases the clear clinic of an acute pneumonia comes to light: fever to 38 — 39 With, a congestion in breasts, cough with a phlegm, symptoms of intoxication, a dullness, strengthening of voice trembling listening of various rattles over a defeat zone restriction of mobility of pulmonary edges. In other cases symptoms of an acute bronchitis or an exacerbation of chronic bronchitis prevail (difficulty of breath unproductive cough), it is necessary to pay attention to asymmetry of above-mentioned physical data. In the third group the clinic can be shown only by persistent cough and symptoms of intoxication (subfebrile condition with periodic rises in temperature, astenisation). Fizikalno can come to light only rigid breath with a bronchial shade and dry rattles on a limited site.
On a clinical picture it is possible to judge approximately the activator that somewhat helps with selection of antibiotics if the patient for any reason is not hospitalized at a blood spitting more often staphylococcus is allocated, in the presence of exudative pleurisy — the streptococcus is more often, at patients with a diabetes mellitus the gram-negative flora comes to light more often, at the pneumonia which arose against chronic bronchopulmonary diseases — the mixed flora, at the weakened patients and abusing alcohol — the anaerobic flora, a klebsiyella and a legionella is more often, at postgrippal pneumonia — staphylococcus and pneumococci.
Diagnosis. To differentiate first of all with tuberculosis (exudative pleurisy).
Complications: sepsis, empyema, pleurisy, pheumothorax, pneumorrhagia, heart and respiratory failure.
Acute management. If the patient is not hospitalized, then without definition the Veda of the activator apply antibiotics: ciprofloxacin on 50 mgkh2 time, or zinnat on 250 — 500 mgkh2 time, or roksitromitsin 150 mgkh2 time, or ofloxacin 200 mgkh2 time, or Amoxiclav on 05 — 1 tablet each 8 h orally. Appoint also expectorants: Acetylcysteinum on 200 mg 3 times, Ambroxol on 30 mg 2 times or Bromhexine on 8 — 16 mg 2 times a day. At the severe exhausting cough — libexinum on 0,1 g or Tusuprexum on 10 — 20 mg 3 — 4 times a day. Also fortifying therapy is appointed.
Hospitalization  in pulmonary department.

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