Atypical pneumonia history. Types of atypical pneumonia and methods of treatment. Acute respiratory syndrome

SYSTEM OF PSYCHOPHYSICAL PREPARATION OF SHAOLIN MONKS

A.M. Kozlov

Kozlov A.M. The system of shaolin monks’ psychophysical training. The article reveals basic aspects of fighting monks’ training in the Shaolin monastery. The charter, way of life of the legendary cloister, the peculiarities of mental autoregulation with the object of self-perfection and abilities to generate higher levels of mental and physical activity in extreme situations are thoroughly considered.

The glory of the Shaolin mountain monastery in Henan, the cradle and center of development and training in the art of fist fighting (quan shu), spread throughout the cities and villages of the Celestial Empire.

Excellent physical training, delicate control of one’s body, hand-to-hand combat techniques and the monastic staff, cohesion, perseverance, courage and contempt for death increased the strength of the warrior monks. Hand-to-hand training was based on the results of training that was superhuman in difficulty, instilling the confidence that a usen (warrior monk) would always be able to repel an enemy attack and deliver a decisive retaliatory blow himself. The Shaolin Si self-defense system directly contrasted an unarmed adept with an armed adept's training, speed of reaction and instant concentration of physical power with the ability to wield a spear or sword. The feeling of strength, physical and moral superiority over the enemy gave the novices of the famous monastery confidence in their actions in any situation.

The founders and patriarchs of Shaolin developed a monastic charter, which subsequently, for centuries, was strictly observed in the holy monastery and numerous Buddhist communities. The monks got up early in the morning with the first rays of the sun and indulged in meditation for two hours at any time of the year in the open air, protected from the weather only by a canopy. Then there was a kind of warm-up, and a set of exercises was performed, bequeathed by the patriarch of martial arts Bodhidharma and supplemented by his successors. In conclusion, much attention was paid to body culture, water procedures and various types of massage.

The practice of mental self-regulation for the purpose of self-improvement occupies a central place in the system of psychophysical

training of the legendary monastery, which made the most significant contribution to the formation of the philosophical and methodological basis of oriental martial arts. Martial arts were considered, first of all, as a means and goal of such self-improvement, since the main idea of meditation is to get in touch with the internal processes of our being, to do this in the most direct way, without resorting to anything external, unnatural, and with the help of psychological self-attitude to produce contains an increased regime of mental and physical activity, which in many respects is qualitatively different both from its own state at the initial level and from the average statistical norms to which the majority of individuals who do not engage in special psychophysical training are subject. Thus, Buddhism is associated with the reality of human existence, practical methods of self-regulation and training of mental and autonomic systems, giving the adept the opportunity to consciously manage his neuropsychic state and increasing the ability to improve voluntary and involuntary functions of the body, making any socially significant practice more productive, which is an effective means mobilization of spiritual and physical strength to solve specific problems of martial arts.

It has long been noted that the nervous system, especially in extreme situations, has a great influence on the activity of all body systems: endocrine, cardiovascular, digestive and somatic. A trained, regulated, controlled nervous system can, under stress conditions, instantly mobilize all the internal resources of the body for specific

a significant action or complex of motor actions, causing a sharp increase in energy power and its productivity.

The art of mobilizing will and psychophysical processes, developed by the Shaolin patriarchs, has become an indispensable tool for martial artists. The state of concentration of maximum strength for victory is achieved:

Firstly, with the help of passive and active meditation, self-immersion in a kind of somnambulistic trance. In wushu (martial arts), a meditative state is absolute attentiveness and control of the situation, increased speed, agility and strength. Consciousness is unshakable, while the body is mobile and plastic in constantly changing circumstances;

Secondly, through the formation of a rational, perfect and variable technique, proven by centuries of experience and the consolidation of clear motor reflexes through many years of training of the neophyte, as a form of active-dynamic psychotraining, in which the main condition for success is instant reaction and error-free coordination of movements;

Thirdly, due to the ability to accumulate, control, stimulate and direct at will the flow of vital bioenergy of the quasi-material substance “qi” to activate physiological and psychophysical processes, implement the required dynamic structures at the level of maximum and transcendental capabilities of the individual. A similar position, in which there is a bizarre mixture of the most incredible mysticism with well-thought-out and well-founded research in the field of physiology, psychology, autogenic training and hypnosis, was developed by the theorists of Taoist yoga and adopted by adherents and masters of Shaolin martial arts.

After meditation and a short breakfast in the refectory, it was time for cult ritual actions, philosophical conversations, kuan1, wenda2, sanzen3, which contributed to the insight into the light of the Buddha’s mind.

1 Kunan (koan - Japanese) - illogical dialogues and statements.

2 Wenda (mondo - Japanese) - genre of dialogue, precedent

enlightenment.

The training methods of the Shaolin Monastery are still completely unknown, but it is known for certain that classes were divided into joint and individual. Martial arts classes took place in the courtyard of the holy monastery, in bad weather, under a meditation tent. The entire community lined up in rows in a strictly defined order, in accordance with their position in a rigid system of hierarchy. The chief instructor of martial arts and four assistants came out to the ranks of monks. The teacher and novices bowed in ritual bow. Having uttered magic spells-mantras, they began to repeat combat techniques and master new ones, then the movements were combined into “links” and complete tao complexes, performed amicably, rhythmically and harmoniously, accompanied at decisive moments by guttural cries, howls or hisses. Martial arts, which occupied an important place in the lives of the inhabitants of Shaolin, were considered as a continuation of religious practice, as active meditation, as knowledge of the heart of the Buddha. Throughout the 1st-15th centuries. The monastic system of self-defense developed successfully, enriched by innovations. Basically, such modifications were the result of studying the combat experience of the founding fathers, the strongest masters of the community and the bionics of the animal world. In the life of the monastic monastery, increasing importance was attached to the issues of strengthening the body, aimed at purifying the spirit, general hardening of the body, and careful development of fighting techniques.

Lunch at noon. In the diet: rice, soybeans, legumes, vegetables, fruits, healthy roots and herbs, medicinal infusions and tonic decoctions. It was believed that vegetarian food allows not only to sacredly observe the commandments of the Buddha, but also creates ideal conditions for the “cultivation” and circulation of “qi” (vital energy).

After a short rest, wushu classes resumed, but this time the entire flock was divided into three groups: neophyte beginners, old masters and middle management. Beginners, “girdled with rope” (a thick white rope - an indispensable attribute of a monk), in small groups under the leadership

3 Sanzen - private conversations with the teacher.

“elder brothers” - experienced mentors (shifu) diligently studied the basics of quan shu: stances, movements, strikes, blocks, combinations of techniques, etc., spending weeks, months and years to perfect each element. And only after 3-4 years were they allowed to begin mastering sparring with a partner.

The middle level - warrior monks continued to persistently polish the technique of complex structures of defense and attack of combat techniques, paying special attention to practicing Tao and free combat with one or more opponents, and in later years mastering the technique and tactics of combat with weapons and unarmed versus armed warrior .

The old masters comprehended the secrets of the natural activation of human biological capabilities, the mysteries of acupuncture and acupressure, the “deadly touch” technique - pinpoint impact and destruction in a combat situation of the vital activity of a specific organ that causes paralysis or death, methods of resuscitation, treatment of ailments, and much, much more.

By evening, everyone lined up together again to demonstrate their successes and achievements to the martial arts mentor. At the same time, excessive self-confidence and

Arrogance was not encouraged. Having called the braggart forward, the mentor easily proved the imperfection of his knowledge. The ethics of the legendary monastery ordered the master to remain in shape until old age and be able to contrast combat experience and fortitude with the passion of the young.

In the evening light dinner. Much time was devoted to education, studying philosophical and other sciences, reading books, and practicing the arts. Work within the monastery. Rest. Next, not as long as in the morning, meditation and again water procedures, massage and sleep.

Wu-shu training in Shaolin was based on principles that later formed the foundation of most martial arts schools:

Gradual increase in complexity and volume of mastered material;

Following the destined path-Tao throughout life, practicing diligently and constantly;

Maintaining moderation in food, abstaining from eating meat, wine and abstaining from debauchery;

Observance of ritual, following the traditions and commandments of the Buddha.

Received by the editor on November 30, 2006.

Accepted for publication on December 1, 2006.

LEGISLATION ON THE DAILY WORK OF OFFICIALS

IN THE FIRST QUARTER OF THE XVIII century.

I'M WITH. Cheremisina

Cheremisina Y.S. Legislation on officials’ duties of service in the first quarter of the XVIII century. This article depicts the main legal acts which regulate the activity of state officers in the central administration apparatus during the time of Peter the Great. Analyzing the content of the General Regulations, Table of Ranks and some other legal documents, the author reveals the whole picture of an official’s working day and describes the new order of career development. The article enables the reader to have an outlook on the way of state officers’ life and work during the time of Peter the Great.

The history of the Russian civil service goes back several centuries. It is inextricably linked with the creation of a Russian centralized state, the survival of which in difficult geopolitical conditions was largely determined by the service of all social groups (estates) for the benefit of their own.

countries. It is no coincidence that ideas about Rus' emerged in the 16th-11th centuries. as a “service state”. Laws of the 16th-11th centuries. they determined exactly what service each serviceman had to perform. Evasion from it was strictly punished.

Shaolin monks have always been closed to the world. The once humble monastery, founded in the Henan province of China, has been pushing the boundaries of human mind, body and spirit for centuries. After a terrible fire in 1929, most of the records in the monastery were lost. But a monk named Jin Jing Chun managed to collect the surviving knowledge. With the blessing of the head of the monastery, he was able to create a method of teaching the 72 arts of Shaolin. Today we will talk about how monks manage to achieve their superhuman abilities.

1.Ripping out nails

You need to drive a nail into a board of wood, and then rip it out with three fingers. Students practice this for several months. When they manage to easily pull out the nail with their thumb, index and middle fingers, the task is made more difficult for them, and the monks begin to try to pull out the nail with their thumb, ring finger and little finger. The enormous strength of even the weakest members of the body is an axiom of Shaolin training. Each finger on both hands should have equal strength and muscular endurance. When the complicated procedure becomes easy, the piece of wood is moistened with water before driving a nail into it so that the nail rusts and is more difficult to remove.

2. Kicks

You just have to imagine: you come to study martial arts in the famous Shaolin, and they send you... to kick stones. But this is actually one of the disciplines of Shaolin. Beginners begin learning this technique by kicking small rocks with bare feet. The goal of this skill is not to develop strength and elasticity of the leg muscles, but to “stuff” the leg until the kick on the stone is almost not felt.

3. The skill of “lightening the body”

Although "light body mastery" is considered a popular martial arts movie stereotype, it is a very real Shaolin practice. Monastic records contain references to men weighing 50 kg who balanced on branches like butterflies or bees. This is a truly fascinating Shaolin practice that was based on a unique and seemingly impossible training routine. The training began with placing a massive clay basin filled with water on the floor.

The students were forced to walk along the edge of this basin with a load so that it did not tip over. This went on every day for several hours. On the 21st day of each month, a ladle of water was scooped out of the basin, and the load was made heavier for the student. At the end, the monk had to walk along the edge of the empty basin without turning it over. Once the student had mastered the process, the large clay basin was replaced with a large wicker basket filled with iron filings.

4. Golden Cicada Skill

The golden cicada's skill is also commonly known as the "iron crotch" and it's no joke. The training began with intense meditation aimed at clearing the mind of all worries. One of the goals of this mental training is the ability to independently cause an erection during meditation, and by doing this purely through the concentration of qi at the base of the navel. The second stage of training consisted of the student being hit in the crotch with hands, feet, and even weapons in order to reduce the pain of the blow.

5. Method of revealing the truth

At its core, this method is a series of complex avoidances and rolls. Falling face down on a stone floor, somersaults that deform the spine, and even stands in which the student “jumps” to his feet from a lying position are all steps on the path to mastery. When a person has mastered these “eighteen somersaults,” he can continue to improve his skills by learning the following 64 acrobatic techniques. The great masters who perfected this technique were able to do countless somersaults in countless ways. Moreover, it “strengthened the qi” as well as the skin, bones and muscles.

6. Tree hugs

This unusual training required the monk to hug a tree and pull it towards himself until he collapsed from exhaustion. Progress began to appear only after the first year. The first step to mastery is to be able to shake a tree so that a few leaves fall off it. After another year, the student had to shake leaves from the tree without stopping. This practice had to be continued throughout life. If a master of this practice grabbed his opponent, as he had done for years with a tree, then fatal injuries were inevitable.

7. Iron Head

There is a good reason why headbutting is prohibited in sports such as mixed martial arts - the risk of traumatic brain injury. But the iconic Shaolin “iron head” technique not only recommended these types of strikes, but prescribed them as a normal training regimen. Students strengthened the frontal bones and the upper part of the skull to almost superhuman strength. And they achieved this very simply - they threw stones at the heads of the monks for many years to strengthen the bones of the skull.

Having survived dozens of microcracks that healed, the bone could become incredibly strong. Such head training began with the monks wrapping their heads in silk and carefully starting to beat their heads against a stone wall. After a year of such training, the trainee removed several layers of silk and continued the process for at least 100 days, after which the silk was completely removed.

Training in the iron bull technique at the most basic level began with “scraping out” one’s own abdomen. Every day and nightly this was done, first with the fingers and palms, and then with knives. This was done during both training and rest. After sufficient hardening of the skin, training moved on to blows to the stomach and continued “scraping” of the stomach with a knife. When punching no longer caused pain, we moved on to hammers.

After 40 years of intense training and meditation in Shaolin, monk Xi Hei Ji traveled throughout the country, visiting every monastery in the northern and southern provinces, and not a single person could defeat him. Legend claims that this became possible thanks to his technique. At the very beginning, when Xi Hei Ji began his training, he passed by the same tree every day, on the branch of which he hung a weight. Every day he poked this weight with his finger, after which it swayed.

After several years of similar exercises and constant meditation, he discovered that when he imitated poking his finger into a weight without actually touching it, it began to wobble. After that, he began to repeat this with a burning flame and soon he was able to extinguish the flame. In the end, the monk achieved that he was able to extinguish the fire burning in the lamp... behind the glass (without breaking the glass).

10. Diamond finger

As a young man, Monk Hal-Tank visited Chicago, where he demonstrated his skill: a handstand, supporting his body weight on one index finger. What's even more amazing is that he performed the same trick more than 50 years later, at the age of 90. Until his death in 1989, he was the only person who was able to perform such a diamond finger technique.

Atypical pneumonia is diagnosed quite rarely during the initial examination, since the general symptoms of the disease caused by uncharacteristic pathogens do not differ from ordinary pneumonia. But after some time, when the prescribed therapy does not give the expected result, doctors use additional diagnostic methods, and only then the truth becomes clear. Therefore, with pneumonia, it is so important to know what symptoms the patient should pay attention to and report them to the doctor, so that atypical pneumonia can be recognized at the initial stage.

General characteristics of the disease

The general term - atypical pneumonia - unites infectious and inflammatory diseases of the lungs of varying severity, caused by pathogens such as chlamydia, legionella, mycoplasma and viruses. The course of this inflammatory process is characterized by general malaise, headache and muscle pain, chills, high fever, sweating, shortness of breath and cough.

Diagnosis of the disease is carried out using immunological, x-ray and microbiological studies. As for treatment, depending on the etiology of the disease, antimicrobial or antiviral medications may be prescribed. The main difficulty that specialists face in this process is that to this day no effective drugs have been found against some pathogens.

It is worth noting that the dangerous microorganisms that cause the development of SARS have the ability to multiply and live inside human cells and, unlike simple bacteria, cannot exist in another environment. Depending on the type of microbe that causes it, viral, mycoplasma, chlamydial and legionella pneumonia are distinguished. The risk group consists of people under 40 years of age, but the disease is most often diagnosed in children and adolescents.

The course of atypical pneumonia can be divided into two main stages. The first is similar in symptoms to a common cold, the second is complicated by manifestations of pneumonia.

Main symptoms of atypical pneumonia

It is quite difficult to determine the signs of pneumonia caused by atypical pathogens. After all, the clinical picture of the disease is characterized by an increase in temperature to critical levels (38-40 ˚C), general weakness and increased night sweats. Also, with this illness, the patient may suffer from hoarseness, cough, shortness of breath, headaches - in a word, symptoms inherent in a cold or acute respiratory viral infection. Pain in the lungs and rapid heartbeat complement the general signs of pneumonia in later stages.

Symptoms of the disease in adults

Atypical pneumonia in adults is much more severe than in young patients. In addition, diagnosing the disease in patients over 16 years of age is much more difficult, since its manifestations are very similar to the symptoms of various inflammatory processes of the respiratory tract. And if you consider that many adults do not always consult a doctor with such symptoms and treat themselves, then the disease is often diagnosed in the later stages. By this time, pneumonia, which initially appeared as a left-sided (or right-sided) pneumonia, can spread to both lungs.

Based on the nature of the manifestations, there are 3 main forms of the disease. The first is characterized by a violent and acute onset, which is accompanied by critically high body temperature, toxicosis, and in some cases the patient may exhibit symptoms of central nervous system irritation. After 3-4 days of fever, catarrhal symptoms appear, such as an irritable cough (usually unproductive) and a sore throat. Already at this stage of the development of the disease, the inflammatory process is clearly visible on the x-ray. In the areas of lung tissue affected by the pathogen, changes in the form of a light mesh are visible.

The second form of the disease is characterized by the manifestation of acute catarrhal symptoms from the very beginning of the development of the disease. Patients complain of painful inflammation of the throat mucosa and general malaise against the background of a moderately elevated stable temperature (37.2 - 37.7 o C). Sometimes signs of pneumonia at the initial stage can appear in the form of follicular or catarrhal tonsillitis and tracheobronchitis.

The clinical picture of a severe form of the disease is characterized by a predominance of cardiovascular failure. Initially, a person experiences shortness of breath, but the breathing rhythm is not dramatically disrupted. This process occurs gradually and may take several days. If the correct diagnosis is not made in time, deep breaths appear against the background of shallow breathing, and the lung tissue, in turn, is affected. At this stage, the disease takes on the character of a lobar inflammatory process.

Quite often, atypical pneumonia manifests itself as a disorder of the gastrointestinal tract with severe symptoms of toxicosis.

Symptoms of the disease in children

Unlike adults, in children the manifestations of the disease may have a slightly different character. Thus, most often the onset of the disease is characterized by an increase in temperature to 38 ° C, and in this state antipyretic drugs are not very effective. Signs of intoxication in the form of sweating, weakness and decreased appetite can be very pronounced during this period. As for coughing, it begins much later, and is preceded by inflammation of the mucous membranes of the pharynx and throat. Therefore, a child can often be diagnosed with pharyngitis or tonsillitis and only after additional examination can pneumonia be diagnosed.

Another characteristic symptom of atypical inflammation is rapid, shallow breathing. In addition, in a child with pneumonia, the skin in the area of the affected lung is pulled into the space between the ribs. Not only the doctor, but also the parents can notice such a manifestation of the disease. It is also worth paying attention to the fact that the baby does not lie on his side with a diseased lung, as this causes him discomfort and is sometimes accompanied by pain. Diarrhea, vomiting and nosebleeds can aggravate the patient's condition in later stages of pathology.

Pneumonia caused by atypical pathogens in newborns causes the development of emphysema, which is why it is so important to recognize the disease in time and begin effective treatment.

In general, the disease affects not only the child’s health, but also his behavior - the patient becomes capricious, irritable, lethargic and tearful. And the manifestations of specific symptoms largely depend on the form and type of the causative agent of the disease.

Mycoplasma pneumonia: symptoms, diagnosis and treatment

Mycoplasma pneumonia of the lungs is characterized by the highest degree of morbidity with the possible development of epidemic foci in closed communities. In terms of primary symptoms, the disease is very similar to ARVI. The patient's body temperature rises, aching pain in muscles and joints appears, a runny nose, while he complains of weakness and chills. The disease is characterized by shortness of breath and chest pain, and in some cases, skin rash, nosebleeds and blood in the sputum. Mycoplasma atypical pneumonia in newborns can only manifest itself as fever and shortness of breath.

The disease is diagnosed using laboratory tests and instrumental research methods. An X-ray of the patient reveals medium and low-intensity areas of infiltration of the lung tissue in the form of blurred spots and shadows, as well as an increase in the bronchial and vascular pattern. The type of pathogen is determined by sputum analysis, as well as by a smear from the patient’s nose and throat.

If, based on the results of the study, mycoplasma atypical pneumonia is diagnosed, treatment is selected taking into account the form of the disease and the individual characteristics of the patient - age and allergic predisposition. Timely therapy, including symptomatic remedies and specific drugs, leads to a rapid improvement in the patient’s condition. Complete cure occurs in 7-12 days.

Legionella pneumonia

This pneumonia is more often diagnosed in adults, since the source of the causative agent of the disease is air conditioning systems and devices. The disease is most often detected in office workers and grocery store employees during the hot season. The causative agent is the Legionella bacterium, which was first identified in 1976.

As a rule, Legionella atypical pneumonia symptoms manifest themselves very clearly and rapidly, even at the initial stage. The patient's body temperature rises to 39-40°C, an unproductive cough and chills appear. And after 20-25 hours, the symptoms are supplemented by shortness of breath and purulent mucous sputum, and in some cases, hemoptysis. A little later, vomiting, diarrhea and acute muscle pain join the atypical pulmonary manifestations. If in this condition the patient is not prescribed appropriate therapy, renal and respiratory failure may develop. The risk of death with such diseases is very high, so if the first symptoms appear, you should not postpone a visit to the doctor.

Diagnosis and treatment of Legionnaires' disease

Already from the second day of illness, the doctor, when ascultating the respiratory tract, will be able to determine the predominance of moist rales in the lungs. An x-ray helps to establish the full clinical picture of the disease, as with typical pneumonia. These images clearly show lesions of the lung tissue with a tendency to merge and pleurisy. To determine the type of pathogen, the patient must undergo cultures of sputum from pleural effusion or taken during bronchoscopy.

With properly prescribed treatment, legionnaires' pneumonia in adults recedes on the fifth or sixth day. But improvements are not typical for all symptoms of the disease. For example, it is considered normal for a patient to continue to have a fever for another 10-14 days after starting medication. It will take a month to restore the affected areas of the lungs, but in severe cases of the disease, not all focal areas return to their original state, which often provokes the development of pneumosclerosis.

A complete cure for an illness is not only a lengthy process, but also a labor-intensive one, since the patient, in addition to therapy, will need to undergo a course of restoring the immune system.

Chlamydial pneumonia

At the initial stage, such atypical pneumonia manifests symptoms rather sluggishly, which makes it difficult to make a correct diagnosis. As with ARVI, the patient complains of malaise, sore throat and difficulty breathing due to a runny nose and swelling of the mucous membranes. In addition, the temperature may rise to 39°C, and after a couple of days shortness of breath and a non-productive irritable cough may appear. Sometimes chlamydial atypical pneumonia in children is complicated by lymphadenopathy, obstructive bronchitis and bronchial asthma.

The diagnosis is made through a comprehensive examination of the patient. On auscultation, dry and moist rales are heard in the lungs for 10 days, which are also characteristic of a normal inflammatory process. The x-ray shows interstitial or small focal infiltration on the right and left lungs. The most informative method for diagnosing this disease is considered to be an analysis to detect immunoglobulins against pathogens, in this case, chlamydia.

Therapy is based on the use of specific antibiotics for 10-14 days. A shorter course of treatment may cause the disease to become chronic and cause relapses.

SARS, or viral pneumonia

Pneumonia caused by coronaviruses is considered the most dangerous and complex type of disease. There are many reasons for this, but the main one is that the pathogen has been known only since 2002 and has not yet been fully studied.

The disease was first reported in China and caused an epidemic that claimed more than 800 lives. At that time, about 8 thousand people were attacked by SARS, but a third of them were unable to fully recover their health after pneumonia. Only one case was registered in Russia, and the patient was saved after long-term hospital treatment.

This type of pulmonary pneumonia is characterized by nonspecific symptoms of viral intoxication. Headaches/muscle pains, as well as chills, fever and sweating appear for 3-5 days. After this, shortness of breath, dry cough and progressive hypoxia join them. In cases of a favorable outcome, symptoms regress within a week. And in severe cases of the disease, the patient requires immediate hospitalization, as the risk of developing distress syndrome, acute respiratory failure and toxic shock increases.

As for diagnostics, there is currently no specific method for detecting SARS. On auscultation, weakened breathing, dullness of percussion sound, crepitus, and moist fine bubbling rales are noted. Changes in lung tissue are visible on x-rays in the form of tissue infiltrates, most often on the periphery of the lungs. The results of the patient's blood test indicate a decrease in platelet and leukocyte counts against the background of increased values of liver enzymes.

Since the pathogen was identified only recently, there is no specific data on how to treat pneumonia. And given the fact that the virus is subject to constant mutation, the search for a universal drug becomes several times more complicated.

Recommended drug therapy is based on broad-spectrum antimicrobials and antivirals, such as Ribavirin. To prevent the development of inflammation, corticosteroids, as well as symptomatic agents, are often added to specific therapy. Treatment is carried out only in a hospital setting, since patients may need oxygen therapy, mechanical ventilation, and infusion therapy.

Drug treatment of atypical pneumonia

Left- or right-sided pneumonia caused by chlamydia regresses when taking tetracyclines and macrolides. Regardless of which etiotropic drug is prescribed, the duration of the course cannot be less than 10-14 days. If after seven days of taking Azithromycin, Tetracycline or Erythromycin, no positive dynamics are observed, doctors resort to the use of fluoroquinolones, such as Ofloxacin, Sparfloxacin and Doxycycline.

As a rule, clinical improvements in Legionella pneumonia are observed on days 5-6 of taking antibiotics Rifampicin, Ciprofloxacin or Erythromycin.

If the causes of pneumonia, such as coronaviruses, are identified, several antimicrobial medications from the group of tetracyclines, fluoroquinolones, cephalosporins and ß-lactams are comprehensively included in the treatment regimen. Ribavirin is almost always used as an antiviral agent. For complete recovery, individual treatment is supplemented with infusion therapy and oxygen therapy.

Atypical pneumonia is a group of diseases of the human respiratory system related to pneumonia. A special feature of this group of diseases are pathogens that are characterized as “atypical”. Atypical pneumonia is a primary pathology and has no connection with other diseases of the respiratory system.

Causative agents of atypical pneumonia

To make a correct diagnosis, the attending physician must determine the cause and causative agent of the infectious inflammatory process, otherwise treatment of the pathology may be delayed or unsuccessful.

Bacterial pathogens of atypical pneumonia include:

mycoplasma (Mycoplasma pneumoniae);
chlamydia (Chlamydia pneumoniae, Chlamydia psittaci);
legionella (Legionella pneumophila);
Coxiella burnetii;
tularemia (Francisella tularensis).

Important! Determination of pathogenic microorganisms occurs by culture or laboratory tests, which makes it possible to create a vaccine for prevention and narrow-spectrum drugs to combat infection.

Viral pathogens of SARS include:

human respiratory syncytial virus (RSV);
influenza A and B viruses;
parainfluenza virus;
adenovirus;
cytomegalovirus;
severe acute respiratory syndrome virus (SARS);
measles virus

Infectious infection begins against a background of low immunity after contact with a pathogen. As a rule, the spread of bacterial and viral infections of the respiratory system occurs through airborne droplets.

Causes and risk factors

The main cause of the disease is infection with pathogenic organisms of various natures. However, not in all cases, infection entering the human body leads to the progression of the disease.

Risk factors that increase the likelihood of developing the disease if infected include:

Diseases that affect the reduction of immune defense (HIV, AIDS).
Premature birth.
The presence of chronic diseases of the respiratory system.
The presence of chronic diseases of the cardiovascular system.
Undergoing chemotherapy.
Use of immunosuppressive drugs.
The appearance of malignant neoplasms.
Diabetes.
Kidney and liver diseases.
Infectious diseases of the respiratory system that have become chronic.

Risk factors reduce the body's defenses, making it more vulnerable to the pathogens of SARS and other diseases.

Symptoms

The course of atypical pneumonia is conventionally divided into several stages:

The incubation period is the stage counted from the moment of infection with a pathogenic infection until the appearance of the initial symptoms of the disease (maximum duration - 10 days).
The prodromal period is the stage of manifestation of nonspecific signs of the disease, the occurrence of which resembles the onset of many respiratory diseases (maximum duration - 3 days).
The height is a period of active infection and the manifestation of specific signs of an infectious disease. Progress of the inflammatory process in the lungs.
Convalescence is the normalization of the general condition and a decrease in the manifestation of pathological signs.

The severity of the symptoms of the disease, as well as the duration of the pathogenic process, refers to individual indicators that depend on the state of the human body at the time of infection and the presence of associated risk factors.

General symptoms of atypical pneumonia

Common signs of atypical pneumonia that appear in all types of the disease include:

chills;
coughing attacks;
headache;
fever;
pain in the muscles;
decreased appetite;
dyspnea;
rapid breathing;
fast fatiguability;
weakness.

It is worth noting that the strength of the manifested ailments and their combination depend on the general condition of the patient at the time of infection.

Features of chlamydial pneumonia

The chlamydial form of atypical pneumonia is provoked by several strains of chlamydia, which can also provoke the development of bronchitis or rhinitis.

Symptoms of chlamydial infection include:

Runny nose.
Persistent dry cough.
Sore throat.
Wheezing.
Redness of the throat.
Dyspnea.
Prolonged increase in body temperature to 38-39 degrees.
Muscle and joint pain.
Increased size of lymph nodes in the neck.

This type of disease occurs in 10% of cases of childhood pneumonia. The disease manifests itself as bilateral inflammation, however, chlamydial infection is one of the least severe forms of atypical pneumonia.

Features of mycoplasma pneumonia

The disease is caused by the development of the pathogenic organism M.pneumoniae, also called mycoplasma pneumoniae. The form of atypical pneumonia occurs in 20% of cases of pneumonia in children and adolescents and 3% in cases of infection in adults.

Symptoms of the disease include:

Increase in body temperature to 38 degrees.
Fever.
Chills.
General weakness.
Runny nose.
Dryness of the mucous membrane of the upper respiratory tract.
Sore throat.
Dry cough.
Dyspnea.
Headache.
Signs of intoxication.
Pain in muscles and joints.
Nosebleeds.
Polymorphous skin rashes.
Inflammation of the lymph nodes in the neck.
Albuminuria (the appearance of protein in the urine).
Microhematuria (the appearance of blood in the urine, determined with the help of laboratory tests by the presence of red blood cells).
Hepatosplenomegaly (enlarged liver and spleen).
Dystrophy of the muscular tissues of the heart.

The incubation period of the disease reaches 11 days, and epidemics may also occur in children's educational institutions.

Inflammation is bilateral in nature, and the severity of symptoms depends on the extent of infection.

Clinical features of Legionnaires' disease

Legionnaires' disease, or Legionella pneumonia, most often develops in people who are constantly exposed to air-conditioned air. Unlike other forms of SARS, the disease most often occurs in the adult population.

Signs of pathology include:

General weakness.
Decreased appetite.
Headache.
Runny nose.
Cough.
Nausea, vomiting.
Cardiopalmus.
Sore throat (absent at the beginning of the disease).
Diarrhea (occurs early in the disease).
Isolation of sputum interspersed with blood (up to 30% of all cases of the disease).
Discharge of sputum with purulent inclusions.
Increase in body temperature to 40 degrees for 1 or 2 days.

Important! It is believed that smoking, taking immunosuppressants and the presence of chronic renal failure are directly related to the incidence of infection in the adult population. The course of the disease is characterized as severe.

Complications of SARS can lead to death due to respiratory or kidney failure.

Signs of SARS, or viral pneumonia

SARS or severe acute respiratory syndrome is also known as the "purple death". The cause of atypical pneumonia is believed to be the SARS coronavirus. The pathology negatively affects lung tissue, destroying the alveoli.

Statistics indicate that 10% of diagnosed cases were fatal.

Signs of pathology include:

Fever and increased body temperature up to 38 degrees.
Chills.
Heavy sweating.
Headache.
Muscle pain.
Vomiting, diarrhea.
Dry cough.
Dyspnea.
Increasing hypoxia.
Blueness of the nasolabial triangle.
Cardiopalmus.
Deafness of heart sounds.
Reduced blood pressure.
Respiratory distress syndrome (if a symptom develops, the risk of death due to toxic-infectious shock, acute respiratory or heart failure increases).

The disease appears 2-7 days after infection.

Diagnostics

Diagnostics is the most important stage of treatment, since it is thanks to it that it becomes possible to establish an accurate diagnosis and prescribe the necessary medications.

To identify pathology in medical practice, the following methods are used:

analysis of medical history and symptoms;
bacterial culture of sputum and nasopharyngeal swabs;
enzyme immunoassay (ELISA);
complement fixation reaction (CFR);
radioimmunoassay;
immunofluorescence reaction (RIF);
polymerase chain reaction (PCR);
computed tomography (CT);
magnetic resonance imaging (MRI) of the lungs;
bacterial blood culture;
throat swab;
clinical blood test (no leukocytosis is observed);
blood test for the presence of antigens;
X-ray examination in 2 projections;
pulse oximetry;
stetoacoustic examination.
molecular tests.

Bacterial culture of various body fluids makes it possible to identify the causative agent of atypical pneumonia in order to draw up a more effective treatment regimen.

Features of diagnosing types of pneumonia include:

Discrepancy between complaints of physiological ailments and X-ray data in mycoplasma pneumonia.
Ineffectiveness of penicillin and cephalosporin antibiotics for mycoplasma pneumonia.
One third of patients with Legionella pneumonia develop pleural effusion.
In Legionella pneumonia, bacterial culture of biological fluids gives a negative result.

Severe acute respiratory syndrome was identified relatively recently, so specific diagnostic methods and the most effective treatment method are still at the stage of development and testing.

Treatment

Treatment of the inflammatory process begins after identifying the cause and associated symptoms. Accurate diagnosis allows you to prescribe specific drugs for a specific type of pathogen; this method is necessary to reduce the severity of side effects due to the use of broad-spectrum toxic drugs.

It is worth noting that the use of antibiotics and antiviral agents is effective only if the group of the infectious organism is correctly determined, otherwise the treatment may not be effective.

Etiological treatment

To treat mycoplasma infection, the following are used:

macrolides - Azithromycin, Erythromycin;
lincosamines – “Clindamycin”.

The general course of treatment lasts at least a week.

To treat chlamydial infection, the following are used:

tetracyclines;
macrolides;
fluoroquinolones – “Sparfloxacin”, “Ofloxacin”;
"Doxycycline."

The general course of treatment lasts at least 10 days.

The following are used to treat Legionnaires' disease:

"Erythromycin";
"Rifampicin";
"Doxycycline";
"Ciprofloxacin."

The average duration of treatment for Legionella infection is 14 days.

To treat the viral form of the disease – SARS, the following drugs are used:

fluoroquinolones;
ß-lactams;
cephalosporins;
tetracyclines;
"Ribavirin";
corticosteroids.

Also, in the treatment of pathology, blood plasma transfusions are used from patients who have previously been infected with coronavirus.

Attention! Antibiotics have many side effects, which is why, after finishing taking the medication, the patient needs to consult with the attending physician about means for restoring intestinal microflora and antifungal medications.

Symptomatic treatment

In addition to means to destroy the infection, the course of treatment includes the use of:

antipyretic drugs (“Paracetamol”, “Ibuprofen”);
glucocorticosteroids (“Prednisolone”);
means for liquefying and removing sputum (Ambroxol, Acetylcysteine, Bromhexin, Lazolvan);
bronchodilators (Atrovent, Berodual, Eufillin).

Medicines are prescribed by the attending physician based on the identified symptoms of the pathology. In addition to the methods listed above, it is possible to prescribe a specialized diet aimed at increasing fluid intake, as well as reducing the amount of irritating foods.

Possible complications and consequences

Pulmonary complications include:

lung abscess;
development of pleurisy;
pleural empyema;
gangrene of the lung;
acute respiratory failure.

The emergence of complications contributes to prolongation of the treatment period and complication of procedures. Also, in cases of severe complications, surgical intervention may be used to remove irreversibly damaged tissue.

Extrapulmonary complications include:

myocarditis;
infectious-toxic shock;
encephalitis;
meningitis;
acute psychosis;
Iron-deficiency anemia.

The development of extrapulmonary forms of complications is facilitated by the spread of infection to neighboring tissues, as well as the addition of third-party infectious or chronic pathologies.

Forecast

Depending on the treatment measures taken and the timeliness of assistance, the prognosis may be as follows:

Full recovery.
Transition of the disease into a chronic form with the risk of pneumosclerosis.
Death.

To eliminate the risk of negative consequences, it is useful for the patient to seek help from specialists as soon as possible and undergo diagnostics. Carrying out independent treatment with traditional methods also leads to the danger of developing an advanced process and a severe form of pathology.

Prevention

Prevention of SARS is aimed at reducing the risk of infection by pathogenic organisms. To prevent infection you must:

lead a healthy lifestyle;
avoid visiting crowded places during epidemics;
reduce the duration of contact with patients with respiratory diseases or use personal safety equipment (masks);
carry out regular wet cleaning and ventilation of the room while caring for the patient;
disinfect personal hygiene products, clothing, and bed linen of the patient.

Strengthening the body's immune defense with the help of vitamin complexes and completing treatment for various types of respiratory diseases also helps prevent the development of inflammatory processes in the respiratory tract.

Atypical pneumonia is a group of infectious and inflammatory lung diseases that are caused by atypical pathogens and have an uncharacteristic clinical picture.

The term “atypical pneumonia” was introduced into medical practice in the late 30s of the 20th century. It was used to name interstitial pneumonias caused by non-coccal bacteria.

In 2002–2003, an epidemic of SARS caused by coronavirus broke out. During the outbreak, 8,437 people became infected with the disease, of whom 813 died, meaning the mortality rate was 10%. Cases of the disease were recorded in more than 30 countries, but most of them were in China, Hong Kong and Vietnam. Pulmonologists called this type of atypical pneumonia “severe acute respiratory syndrome” (SARS), or “acute respiratory syndrome” (SARS).

Each form of atypical pneumonia has its own characteristics depending on the pathogen

Causes and risk factors

The causative agents of atypical pneumonia can be numerous infectious agents:

chlamydia;
mycoplasma;
Epstein–Barr virus;
influenza A and B viruses;
respiratory parainfluenza viruses;
respiratory syncytial virus;
coronavirus;
hantavirus;
Coxiella;
legionella;
causative agents of tularemia, leptospirosis.

These pathogens have different microbiological characteristics, and the infectious processes they cause also differ in epidemiology and pathomorphological picture. However, all of these microorganisms exhibit high resistance to beta-lactam antibiotics (penicillins, cephalosporins, carbapenems and monobactams).

SARS infection occurs through airborne droplets through close contact with a sick person. Young people are more often affected.

Prevention of SARS consists of a healthy lifestyle that allows you to maintain the body's defenses in an active state.

Forms of the disease

Depending on the type of pathogen, the following forms of atypical pneumonia are distinguished:

acute respiratory syndrome;
chlamydial pneumonia;
mycoplasma pneumonia;
Legionnaires' disease;
Q fever.

Stages of the disease

For atypical pneumonia, as, indeed, for most infectious diseases, a certain staged course is characteristic:

Incubation period. It begins from the moment of infection and continues until the first signs of the disease appear. On average it lasts 7-10 days.
Prodromal period, or period of precursors. Lasts 1-3 days. Nonspecific symptoms of the disease occur, characteristic of most respiratory viral infections (headache and muscle pain, sore throat, minor malaise, dry cough).
High period. Characteristic signs of an infectious-inflammatory process in the lungs appear.
The period of convalescence. The activity of the inflammatory process in the lungs subsides, and the condition gradually returns to normal.

Symptoms

The main symptoms of atypical pneumonia at its height:

increase in body temperature to 40-41°C;
intense headache;
severe general weakness;
cough;
dyspnea;
profuse night sweats;
pain in the chest area.

These are common symptoms characteristic of almost all atypical pneumonias. But since they are caused by different microbial agents, each form of the disease has its own characteristics.

Atypical chlamydial pneumonia

The onset of chlamydial pneumonia resembles a banal respiratory viral infection with symptoms of rhinitis and pharyngitis. However, after 2-3 days the patient’s condition quickly deteriorates. There are complaints of muscle pain, aching bones and joints, dry cough, shortness of breath, increased body temperature to 38-39 °C. Enlargement of the cervical lymph nodes often occurs. Chlamydial pneumonia is characterized by a long course and severe allergization of the body.

Atypical mycoplasma pneumonia

Mycoplasma pneumonia is characterized by a sluggish course with a blurred clinical picture. The first symptoms of the disease, as in the case of chlamydial pneumonia, are similar to the signs of ARVI (pain and sore throat, dry cough, weakness). On days 2-3 of the disease, body temperature rises to 37-38 °C.

Occasionally, mycoplasma pneumonia is severe, with severe intoxication syndrome, high fever, and enlarged cervical lymph nodes.

The term “atypical pneumonia” was introduced into medical practice in the late 30s of the 20th century. It was used to name interstitial pneumonias caused by non-coccal bacteria.

A distinctive feature of the mycoplasma form of atypical pneumonia is a non-productive, paroxysmal cough that persists for a long time in patients.

Legionnaires' disease

Its causative agent is a gram-negative aerobic bacterium that lives in air conditioning and water supply systems.

Legionella pneumonia affects mainly older people and is characterized by a severe course, with severe symptoms of intoxication, and a strong non-productive cough. The infectious-inflammatory process affects not only the lung tissue, but also the bronchioles.

Acute respiratory syndrome

The most severe form of atypical pneumonia, accompanied by high mortality. It begins with symptoms of influenza infection (headache, fever, weakness, weakness). After a few days, they are joined by tachycardia, dry cough, and shortness of breath.

The further development of the clinical picture is determined by the immune status of the patient’s body. With a good immune response, the patient recovers. If the immune system is weakened, the condition worsens catastrophically, and respiratory distress syndrome develops. Against the background of increasing acute respiratory failure, death is possible.

Severe acute respiratory syndrome (SARS), or acute respiratory syndrome (SARS), is also a type of atypical pneumonia.

Features of the disease in children

Atypical pneumonia in children often occurs with a poorly expressed temperature reaction. However, despite normal or subfebrile temperature, the general condition quickly and severely deteriorates. Appears:

drowsiness;
lethargy and apathy;
decreased or complete lack of appetite;
dyspnea;
increased sweating;
vomit;
diarrhea.

Mycoplasma pneumonia in children is often accompanied by an enlargement of the spleen and liver, and the appearance of a polymorphic rash on the skin.

Children with SARS try to lie on their side on the side of the affected lung because this position reduces chest pain. They often experience disturbances in the depth and frequency of respiratory movements, and periodic short-term apneas (stopping breathing) occur.

In newborns, atypical pneumonia is quickly complicated by the development of emphysema. In this age group, the disease is extremely severe and difficult to treat.

Diagnostics

Atypical pneumonia can be suspected based on the clinical picture of the disease and examination data of the patient. To confirm the diagnosis, an x-ray of the lungs is performed in two projections, which makes it possible to determine the presence of an inflammatory focus. To identify the causative agent of the disease, bacteriological, immunological and microbiological studies are carried out.

It is quite difficult to diagnose atypical pneumonia of viral origin. This is due to the fact that there are currently no test systems for widespread use in clinical practice.

Treatment

Treatment of atypical pneumonia includes etiotropic and symptomatic treatment. Etiotropic therapy is aimed at destroying the causative agent of the disease. For this purpose, antibiotics are prescribed, taking into account the sensitivity of pathogenic microflora to them, for a course of at least 10-14 days. Moreover, antibiotic therapy is also justified for viral atypical pneumonia - for the purpose of preventing (or treating) a secondary bacterial infection. However, the etiotropic treatment in this case will be the use of antiviral drugs.

Symptomatic therapy is aimed at eliminating the symptoms of the disease, for which antipyretic and anti-inflammatory drugs, expectorants, mucolytics, etc. are used.

If there is a significant deterioration in the general condition, or an increase in respiratory failure, the patient is transferred to the intensive care unit, where he is connected to a ventilator.

With a good immune response, the patient recovers. If the immune system is weakened, the course of atypical pneumonia worsens catastrophically, and respiratory distress syndrome develops. Against the background of increasing acute respiratory failure, death is possible.

Possible complications and consequences

Complications of atypical pneumonia can be divided into two large groups: pulmonary and extrapulmonary. Pulmonary complications include:

lung abscess;
pleurisy;
pleural empyema;
gangrene of the lung;
acute respiratory failure.

Extrapulmonary complications:

myocarditis;
infectious-toxic shock;
encephalitis;
meningitis;
acute psychosis;
Iron-deficiency anemia.

Forecast

The prognosis is favorable if the patient has a strong immune status and timely treatment.

In newborns, atypical pneumonia is quickly complicated by the development of emphysema. In this age group, the disease is extremely severe and difficult to treat.

The outcome of atypical pneumonia can be:

complete recovery;
death;
transition of the disease into a chronic form with the formation of pneumosclerosis.

Prevention

Prevention of SARS consists of a healthy lifestyle that allows you to maintain the body's defenses in an active state. It is also recommended to follow the following rules:

during the peak period of seasonal viral diseases, refrain from visiting places with large crowds of people;
when in contact with a sick person, wear a protective mask, regularly wash your hands and treat them with antiseptic liquids;
The room in which the patient is located should be frequently ventilated and regularly wet cleaned with the obligatory use of disinfectants. Disinfect care items and dishes by boiling in a baking soda solution for 15-20 minutes.

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