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"etiology": "<p> </p>\r\n<p>Возбудитель заболевания - гемофильная палочка или палочка Афанасьева-Пфейффера - является составляющей нормальной микрофлоры верхних дыхательных путей. Это грамотрицательная неподвижная палочковидная бактерия. </p>\r\n<p>Источником, распространяющим инфекцию, обычно является человек с манифестным или стертым течением болезни, бактерионоситель. Распространяется инфекция воздушно-капельным путем, но возможен механизм передачи через зараженные игрушки, постельное белье или предметы домашнего обихода. </p>\r\n<p>Для заболевания характерна определенная сезонность, случаи заражения часты в период зимы и весны.</p>",
"pathogenesis": "<p><strong></strong></p>\r\n<p>Различают четыре стадии развития патологического процесса пневмонии: </p>\r\n<p>Первая стадия длится на протяжении первых трех суток и характеризуется значительным наполнением кровью сосудов и достаточно сильной экссудацией (пропотевание жидкости из сосудов в ткани). В экссудативной жидкости при микробиологическом исследовании определяется большое число пневмококков. </p>\r\n<p>Вторая стадия именуется «красным опеченением» и проявляется следующими признаками: альвеолы полностью заполнены экссудатом, фибрином и эритроцитами. Пораженный участок паренхимы легкого становится полностью безвоздушным и по внешнему виду становится похож на печень (красного цвета). </p>\r\n<p>Третья стадия называется «серозным опеченением» и характеризуется тем, что в альвеолах становится уже больше лейкоцитов, чем эритроцитов, и вследствие этого паренхима меняет свой цвет. Такое патологическое состояние возникает уже по окончанию первой недели болезни. </p>\r\n<p>На четвертой стадии возникают процессы разрешения воспаления, исчезает жидкость, а паренхима принимает свой нормальный цвет. </p>",
"diagnostics": "<p>Заподозрить болезнь можно исходя из жалоб больного и данных объективного обследования пациента (тупой перкуторный звук над легкими, влажные крепитирующие (хрустящие) хрипы при выслушивании). </p>\r\n<p>Обязательными диагностическими методами являются: </p>\r\n<ul>\r\n<li>Рентгенографическое исследование органов грудной клетки. </li>\r\n<li>Микроскопия мокроты (изучение мазков мокроты под микроскопом для установления возбудителя болезни). </li>\r\n<li>Посев биоматериала на питательные среды и определение чувствительности к антибиотикам выделенного микроорганизма. </li>\r\n<li>Общий и биохимический анализ крови и мочи </li>\r\n<li>Исследование оксигенации крови (определение уровня насыщенности крови кислородом). </li>\r\n<li>Серологическая диагностика (определение антител к возбудителю) - латекс-агглютинация и реакция преципитации. </li>\r\n</ul>",
"treatment": "<p>На период лихорадки назначается постельный режим, рекомендуется полноценная, сбалансированная диета, употребление достаточного количества жидкости. </p>\r\n<p>Этиотропная (направленная на возбудителя) терапия заключается в применении антибактериальных препаратов, обладающих наибольшей активностью в отношении возбудителя. Прежде всего, это цефалоспорины третьего-четвертого поколения, карбапенемы, ампициллин, аминогликозиды. </p>\r\n<p>Патогенетический подход к лечению пневмонии основан на проведении дезинтоксикационной терапии, использовании бронхолитиков (препаратов, расширяющих бронхи), противовоспалительных и мочегонных средств. </p>\r\n<p>Симптоматическая терапия подразумевает прием жаропонижающих, противокашлевых, отхаркивающих препаратов, проведение отвлекающей и местной терапии (ингаляции, орошение зева антисептическими растворами). </p>\r\n<p>В фазе разрешения к медикаментозному лечению добавляются реабилитационные мероприятия: дыхательная гимнастика, физиотерапия, массаж грудной клетки, витаминотерапия. </p>",
"prevention": "<p>Специфическая профилактика - вакцинация против Hib </p>\r\n<p>К методам неспецифической профилактики относятся следующие методы: </p>\r\n<ul>\r\n<li>Избегать переохлаждений, контакта с инфекционными больными </li>\r\n<li>Придерживаться правил личной гигиены </li>\r\n<li>Правильно и сбалансированно питаться </li>\r\n<li>Отказаться от вредных привычек </li>\r\n<li>Своевременно лечить сопутствующие болезни. </li>\r\n</ul>",
"clinical_picture": "<p>Пневмония может быть очаговой или крупозной (с поражением доли легкого или нескольких долей), часто осложняется плевритом (воспаление плевры – оболочки легкого) – до 70% случаев у детей. </p>\r\n<p>У пациента высокая температура, слабость, вялость, кашель сначала сухой или малопродуктивный, а затем становится влажным (мокрота гнойная с желтоватым оттенком). Нередко нарушения дыхательной экскурсии, что проявляется одышкой. Течение пневмонии затяжное, трудно поддается лечению, может быть волнообразным. </p>",
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{
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"code": "J13",
"name": "Пневмония, вызванная Streptococcus pneumoniae",
"icd_name": "Пневмония, вызванная Streptococcus pneumoniae",
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"slug": "j13_pnevmoniya_vyzvannaya_streptococcus_pneumoniae",
"lead": "Нарушение здоровья, относящееся к группе грипп и пневмония",
"description": " Пневмония, вызванная Streptococcus pneumoniae – это острое воспаление ткани легких, которое вызвано инфекционным агентом - стрептококком пневмонии или пневмококком. Может протекать как отдельное заболевание или, как осложнение другой патологии. ",
"etiology": "<p>Возбудитель пневмококковой пневмонии, Streptococcus pneumoniae, является представителем нормальной микрофлоры верхних дыхательных путей человека. </p>\r\n<p>Пневмококк относится к грамположительным диплококкам. Бактерия окружена полисахаридной капсулой, которая служит фактором, определяющим вирулентность и патогенность пневмококка, его способность формировать антибиотикорезистентность. </p>\r\n<p>Заражение может происходить несколькими путями: </p>\r\n<ul>\r\n<li>воздушно-капельным - при вдыхании распыленных в воздухе частиц слизи, содержащих возбудителя </li>\r\n<li>аспирационным – при попадании секрета носоглотки в нижние дыхательные пути </li>\r\n<li>гематогенным – из внелегочных очагов пневмококковой инфекции.</li>\r\n</ul>",
"pathogenesis": "<p>Различают четыре стадии развития патологического процесса пневмонии: </p>\r\n<p>Первая стадия длится на протяжении первых трех суток и характеризуется значительным наполнением кровью сосудов и достаточно сильной экссудацией (пропотевание жидкости из сосудов в ткани). В экссудативной жидкости при микробиологическом исследовании определяется большое число пневмококков. </p>\r\n<p>Вторая стадия именуется «красным опеченением» и проявляется следующими признаками: альвеолы полностью заполнены экссудатом, фибрином и эритроцитами. Пораженный участок паренхимы легкого становится полностью безвоздушным и по внешнему виду становится похож на печень (красного цвета). </p>\r\n<p>Третья стадия называется «серозным опеченением» и характеризуется тем, что в альвеолах становится уже больше лейкоцитов, чем эритроцитов, и вследствие этого паренхима меняет свой цвет. Такое патологическое состояние возникает уже по окончанию первой недели болезни. </p>\r\n<p>На четвертой стадии возникают процессы разрешения воспаления, исчезает жидкость, а паренхима принимает свой нормальный цвет. </p>\r\n<p> </p>",
"diagnostics": "<p>Заподозрить болезнь можно исходя из жалоб больного и данных объективного обследования пациента (тупой перкуторный звук над легкими, влажные крепитирующие (хрустящие) хрипы при выслушивании). </p>\r\n<p>Обязательными диагностическими методами являются: </p>\r\n<ul>\r\n<li>Рентгенографическое исследование органов грудной клетки. </li>\r\n<li>Микроскопия мокроты (изучение мазков мокроты под микроскопом для установления возбудителя болезни). </li>\r\n<li>Посев биоматериала на питательные среды и определение чувствительности к антибиотикам выделенного микроорганизма. </li>\r\n<li>Общий и биохимический анализ крови и мочи </li>\r\n<li>Исследование оксигенации крови (определение уровня насыщенности крови кислородом). </li>\r\n</ul>",
"treatment": "<p>На период лихорадки назначается постельный режим, рекомендуется полноценная, сбалансированная диета, употребление достаточного количества жидкости. </p>\r\n<p>Этиотропная (направленная на возбудителя) терапия заключается в применении антибактериальных препаратов, обладающих наибольшей активностью в отношении S.pneumoniae. Прежде всего, это ингибиторозащищенные пенициллины, цефалоспорины второго-третьего поколения, макролиды, карбапенемы. Для воздействия на устойчивые штаммы пневмококка применяется ванкомицин. </p>\r\n<p>Патогенетический подход к лечению пневмококковой пневмонии основан на проведении дезинтоксикационной терапии, использовании бронхолитиков (препаратов, расширяющих бронхи), противовоспалительных и мочегонных средств. </p>\r\n<p>Симптоматическая терапия подразумевает прием жаропонижающих, противокашлевых, отхаркивающих препаратов, проведение отвлекающей и местной терапии (ингаляции, орошение зева антисептическими растворами). </p>\r\n<p>В фазе разрешения к медикаментозному лечению добавляются реабилитационные мероприятия: дыхательная гимнастика, физиотерапия, массаж грудной клетки, витаминотерапия. </p>",
"prevention": "<p>Специфическая профилактика - вакцинация пневмококковой вакциной. </p>\r\n<p>К методам неспецифической профилактики относятся следующие методы: </p>\r\n<ul>\r\n<li>Избегать переохлаждений, контакта с инфекционными больными </li>\r\n<li>Придерживаться правил личной гигиены </li>\r\n<li>Правильно и сбалансированно питаться </li>\r\n<li>Отказаться от вредных привычек </li>\r\n<li>Своевременно лечить сопутствующие болезни. </li>\r\n</ul>",
"clinical_picture": "<p>Воспаление легких, обусловленное пневмококковой инфекцией, обычно протекает в одном из двух вариантов: в виде крупозной (долевой) или очаговой пневмонии. </p>\r\n<p>Долевая пневмония начинается остро, с внезапного подъема температуры до 38-40°С, потрясающего озноба, лихорадочного румянца на щеках. Значительно выражены признаки интоксикации: слабость, головная боль, боли в мышцах, потеря аппетита. Появляются одышка и тахикардия. Больные отмечают боль в груди на стороне поражения при дыхании и кашле. Сухой, болезненный вначале, кашель вскоре становится влажным, с отделением коричневатой («ржавой») мокроты. Течение крупозной пневмококковой пневмонии тяжелое. Часто встречаются осложнения в виде острой дыхательной недостаточности, плеврита, абсцесса легкого, эмпиемы плевры. </p>\r\n<p>Началу очаговой пневмококковой пневмонии, как правило, предшествует эпизод ОРВИ. Сохраняется общая слабость, высокая утомляемость, сильная потливость. Симптоматика в целом аналогична крупозной пневмонии, но выражена слабее. Лихорадка менее высока и продолжительна, кашель умеренный и не столь болезненный. Течение очаговой пневмонии обычно среднетяжелое, осложнения возникают сравнительно редко. </p>",
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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},
{
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},
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{
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"slug": "oftalmologiya",
"lead": "Область медицины, включающая в себя лечение 851 заболевания. В 696 клиниках России оказывается помощь по этому направлению медицины.",
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{
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"disease_count": null,
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"slug": "fizioterapiya",
"lead": "Область медицины, включающая в себя лечение 743 заболеваний. В 1561 клинике России оказывается помощь по этому направлению медицины.",
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{
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"disease_count": null,
"name": "пульмонология",
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"branch_medicine_code": "037",
"slug": "pulmonologiya",
"lead": "Область медицины, включающая в себя лечение 145 заболеваний. В 181 клинике России оказывается помощь по этому направлению медицины.",
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},
{
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"disease_count": null,
"name": "лечебная физкультура и спортивная медицина",
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"slug": "gematologiya",
"lead": "Область медицины, включающая в себя лечение 984 заболеваний. В 69 клиниках России оказывается помощь по этому направлению медицины.",
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"slug": "j16_pnevmoniya_vyzvannaya_drugimi_infekcionnymi_vozbuditelyami_ne_klassificirovannaya_v_drugih_rubrikah",
"lead": "Нарушение здоровья, относящееся к группе грипп и пневмония",
"description": "Хламидийная пневмония – инфекционно-воспалительный процесс в легких, вызванный облигатными внутриклеточными бактериями рода Chlamydia и Chlamydophila.",
"etiology": "<p>Хламидийную пневмонию вызывают три типа хламидий: Chlamydophila pneumoniae, Сhlamydia trachomatis и Chlamydophila psittaci. </p>\r\n<p>Самым частым возбудителем респираторных хламидиозов служит хламидии пневмонии. Передача этих бактерий от человека к человеку осуществляется преимущественно воздушно-капельным и контактно-бытовым путями. </p>\r\n<p>С хламидией трахоматис связана заболеваемость хламидийной пневмонией среди новорожденных и грудных детей до 6 месяцев. Также с этим типом хламидий ассоциированы пневмонии у иммунокомпрометированных лиц и сотрудников лабораторий. Инфицирование новорожденных Ch. trachomatis происходит в процессе родов от матерей с урогенитальной хламидийной инфекцией. </p>\r\n<p>Хламидия пситаци рассматривается как возбудитель орнитоза, часто протекающего в форме тяжелой интерстициальной пневмонии. Инфицирование этим штаммом происходит воздушно-пылевым или фекально-оральным путем при вдыхании пыли или употреблении пищи, содержащей биологические секреты птиц-переносчиков инфекции (попугаев, канареек, кур, уток, голубей, воробьев и др.). </p>\r\n<p>Все хламидии являются грамотрицательными микроорганизмами, паразитирующими внутри клеток хозяина. В макроорганизме хламидии могут существовать в инфекционной форме (элементарные тельца) и вегетативной форме (ретикулярные тельца). </p>",
"pathogenesis": "<p>Различают четыре стадии развития патологического процесса пневмонии: </p>\r\n<p>Первая стадия длится на протяжении первых трех суток и характеризуется значительным наполнением кровью сосудов и достаточно сильной экссудацией (пропотевание жидкости из сосудов в ткани). В экссудативной жидкости при микробиологическом исследовании определяется большое число пневмококков. </p>\r\n<p>Вторая стадия именуется «красным опеченением» и проявляется следующими признаками: альвеолы полностью заполнены экссудатом, фибрином и эритроцитами. Пораженный участок паренхимы легкого становится полностью безвоздушным и по внешнему виду становится похож на печень (красного цвета). </p>\r\n<p>Третья стадия называется «серозным опеченением» и характеризуется тем, что в альвеолах становится уже больше лейкоцитов, чем эритроцитов, и вследствие этого паренхима меняет свой цвет. Такое патологическое состояние возникает уже по окончанию первой недели болезни. </p>\r\n<p>На четвертой стадии возникают процессы разрешения воспаления, исчезает жидкость, а паренхима принимает свой нормальный цвет. </p>",
"diagnostics": "<p>Рентгенография легких - выявляется очаговая, сегментарная или долевая инфильтрация либо интерстициальные изменения. </p>\r\n<p>Для подтверждения хламидийной пневмонии применяются лабораторные методы. </p>\r\n<p>Наиболее специфичным и чувствительным из них является культуральный метод выделение возбудителя, однако из-за длительности и трудоемкости диагностики на практике обычно ограничиваются серотипированием. </p>\r\n<p>Стандартом выявления хламидийной пневмонии на сегодняшний день служат ИФА и МИФ (реакция микроиммунофлюоресценции). При проведении ИФА на активность хламидийной инфекции укажет повышение титра специфических иммуноглобулинов. </p>\r\n<p>ПЦР-анализ позволяет быстро и безошибочно идентифицирвоать ДНК возбудителя, однако не позволяет отличить персистирующую инфекцию от активной. </p>",
"treatment": "<p>Этиотропная терапия (направленная на возбудителя включает назначение антибактериальных препаратов из группы макролидов, фторхинолонов и тетроциклинов. Препаратами выбора являются макролиды, так как их назначение возможно в грудном возрасте и у беременных женщин. Длительность курса противомикробного лечения хламидийной пневмонии составляет не менее 2–3 недель. </p>\r\n<p>С целью коррекции иммунологических расстройств, а также предупреждения рецидива инфекции, помимо антимикробных средств, назначаются иммуномодуляторы, витамины, пробиотики. В период реконвалесценции большое внимание уделяется физиотерапии, дыхательной гимнастике. </p>",
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