Patient's question:
My child was born via cesarean section, and now they are 21 days old. They occasionally spit up saliva. Is this pneumonia? What are the other symptoms of pneumonia? What should we do?Doctor's answer:
I. History of foreign body aspiration, such as meconium, large amounts of amniotic fluid, vaginal (secretions), milk, vomit, etc.II. Antenatal infection history
(1) Premature rupture of membranes lasting more than 12 hours, especially more than 24 hours;
(2) Mother with TORCH infection;
(3) Aspiration of contaminated vaginal (secretions) during delivery.
III. Postnatal infection history
IV. Exposure to cold.
Clinical and radiographic findings
(1) Shallow and rapid breathing;
(2) Cyanosis;
(3) Triad of retractions (subcostal, intercostal, and submammary retractions);
(4) Lung auscultation may be normal or may reveal fine crackles at the end of deep inspiration. Fine crackles are more easily heard if the condition is severe;
(5) Chest X-ray may show small patchy shadows in the lung fields.
Key points of treatment
(1) Keeping warm;
(2) Nasal cannula or mask oxygen therapy;
(3) Correction of acidosis;
(4) Attention to fluid and nutritional supplementation;
(5) Antibiotics: Initially, penicillin combined with ampicillin or gentamicin combined with ampicillin may be used. Cephalosporins can also be selected. If Staphylococcus aureus infection is suspected, new-generation penicillins (e.g., oxacillin, nafcillin, or dicloxacillin), erythromycin, and cephalosporins may be used.
(6) Symptomatic treatment
1. If tension pneumothorax or pyopneumothorax occurs, emergency intubation and drainage should be performed immediately;
2. If persistent fetal circulation (PFC) occurs, benazepril may be considered. If hypotension is also present, dopamine may be added.
Consult a doctor for diagnosis and treatment.