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HYPOSTATIC PNEUMONIA - focal pneumonia that occurs with prolonged stagnation of blood in the pulmonary circulation, developing against a background of heart disease or other chronic pathological processes that cause patients to stay in bed for a long time.

The clinic of such pneumonia is characterized by a sluggish course. The onset of the disease is hardly noticeable, without any particular complaints. Sharp weakness prevails, characterized by increased shortness of breath, sometimes a cough is added. Body temperature rises to subfebrile numbers, but often remains normal due to a decrease in the overall reactivity of the body. Leukocytosis is poorly expressed or absent.

The physical diagnosis of hypostatic pneumonia requires particularly close attention. Percussion should be both deep and superficial so as not to miss the foci of various sizes. Auscultatory symptoms are not always detected due to weakness of breathing and the serious condition of such patients. The most characteristic is a weakening of breathing and an insignificant amount of finely bubbled moist rales. X-ray detect gentle, cloudy, spotty blackouts in the lower parts of the lungs.

Pneumonia of such a genesis should be thought of in the case when a patient who is in bed suddenly worsens, there is a sharp weakness, shortness of breath, and especially an increase in body temperature. The course of such pneumonia is long.

ASPIRATED PNEUMONIA - due to the ingestion of any foreign substances (pieces of food, vomit, dental fillings, etc.) into the respiratory tract. The localization of the pneumatic focus depends on the position in which the patient was at the time of aspiration.
So, if the patient was sitting, the lower lobes of the lungs are affected, mainly on the right, if aspiration occurred in the supine position, in addition to the lower lobes, the posterior segments of the upper lung lobes are affected.

Often lobular pneumonia develops. The disease proceeds with clinical manifestations of limited bronchitis and reflex bronchospasm, wet cough and chest pain. Body temperature is always elevated, blunting of percussion sound, bronchial breathing, sonorous moist rales of various calibers are characteristic. An X-ray examination reveals foci of infiltration or extensive drainage dimming. Of the complications, atelectasis is most common. The disease is most often caused by pneumococci and streptococci.

PNEUMONIA IN PATIENTS WITH CHRONIC BRONCHITIS - usually occur during exacerbation of the latter, especially in connection with a viral infection.

The clinical picture is polymorphic. A change in the symptoms of exacerbation of chronic bronchitis is characteristic: malaise increases, cough intensifies, chills are often noted, severe sweating of the neck and shoulders at night, the temperature rises significantly, sputum becomes purulent. With systematic observation, it is possible to trace the development of the inflammatory focus, the appearance of moist rales in a limited area, dullness of percussion sound can be very difficult to register, and pulmonary emphysema interferes. An important diagnostic criterion is an X-ray examination, which allows you to determine the appeared areas of infiltration. The most common pathogens are: pneumococci, hemophilic bacillus and staphylococcus.
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