Covid-19
coronavirus infection
diarrhea
The tense epidemiological situation around the world does not lose its relevance. Covid-19 is a viral disease that affects not only the respiratory system, but can also cause complications in the digestive tract. Any virus is prone to mutations, which lead to the emergence of new forms of the disease. Intestinal coronavirus is no less dangerous to health and life than the pulmonary form of this disease, so this condition should not be ignored.
Condition Characteristics
From the moment the virus enters the body until the clinical symptoms of enteric coronavirus appear, 2 to 5 days pass. This condition does not occur in an asymptomatic form. Unlike the respiratory form, after a person has had an intestinal form of coronavirus, their body develops unstable immunity. The clinical picture of this condition is largely reminiscent of gastroenteritis.
In patients with chronic diseases of the gastrointestinal tract, the clinical symptoms of intestinal coronavirus are more pronounced.
Causes
Diarrhea due to coronavirus infection can be either primary or secondary. The primary variant of the disease develops from the direct effect of the virus on the body. When the virus is transmitted by the fecal-oral route, in the intestinal lumen the pathogenic microorganism attaches to the epithelial cells of the organ mucosa and provokes the development of the inflammatory process.
The secondary variant of the intestinal form of coronavirus is a complication that occurs after complex treatment of Covid-19. In 90% of cases, complex therapy for this infectious disease includes taking antibiotics, as this helps prevent the addition of a secondary bacterial infection. Antibiotics, in turn, have a detrimental effect not only on pathogens, but also on beneficial intestinal microflora. A person is faced with a phenomenon called dysbiosis.
Diagnostics
If you complain of foul-smelling sputum, an examination by a pulmonologist is indicated. During a physical examination, a specialist assesses the nature and frequency of breathing, performs percussion and auscultation of the lungs to make a preliminary diagnosis. If destructive processes in the lungs are suspected, consultation with a surgeon is required. The diagnosis plan for diseases manifested by sputum with an unpleasant odor includes the following methods:
- X-ray imaging.
X-ray examination of the OGK is recommended in 2 projections, which shows rounded shadows with a horizontal level of liquid, areas of infiltration or decay, and the contours of space-occupying formations. To clarify the diagnosis, MSCT is prescribed, which allows detailed visualization of pathological changes. - Bronchoscopy.
When examining the bronchi with an endoscope, signs of diffuse purulent endobronchitis are mainly detected. If the foul-smelling sputum is caused by an oncological process, during bronchoscopy the doctor sees a disintegrating tumor that is blocking the bronchus. During the study, biopsies are taken from suspicious areas. - Sputum analysis.
When the biomaterial settles, a division into 3 layers is found (purulent, mucous and foamy). Upon visual examination, you can see particles of pulmonary parenchyma, foreign bodies, and pathogenic fungi. A culture of foul-smelling sputum is performed to isolate the infectious pathogen and perform an antibiotic sensitivity test. - Additional laboratory tests
. Changes specific to inflammation are detected in the hemogram: increased ESR, neutrophilic leukocytosis. A biochemical blood test reveals dysproteinemia and an increase in acute phase parameters. To assess respiratory failure, blood gases are analyzed.
If symptoms of pleurisy are detected, a therapeutic and diagnostic puncture of the pleural cavity and collection of exudate for bacteriological examination are necessary. For patients with chronic bronchopulmonary diseases, ECG and echocardiography are performed to study the functioning of the heart, since such pathologies are often combined with hemodynamic disorders. In difficult cases, they resort to angiopulmonography and diagnostic thoracoscopy.
Lung abscess - cause of foul-smelling sputum
Clinical symptoms
In 50% of patients diagnosed with Covid-19, intestinal symptoms of coronavirus infection initially appear. Respiratory symptoms such as shortness of breath, dry cough, sore throat, and fever may develop later. The most likely symptoms of intestinal coronavirus include:
- partial or complete loss of appetite;
- bowel disorders in the form of diarrhea;
- nausea and vomiting;
- cutting pain in the abdomen.
Additionally, the clinical picture of the intestinal form of coronavirus can be supplemented by headache, dizziness, fever, general weakness, increased sweating and muscle pain.
The duration of the so-called acute phase of an infectious lesion of the gastrointestinal tract is individual. On average, this period ranges from 4 to 10 days. Compared to the respiratory form of coronavirus, the intestinal form of the disease is more severe and its symptoms are more pronounced.
Stool disorders due to intestinal coronavirus in humans persist for 2-5 days. Vomiting may persist for 2-4 days.
Causes of foul-smelling sputum
Lung abscess
In the acute course of the pathology, large quantities of purulent sputum with a foul odor are expectorated.
The unpleasant odor is caused by the breakdown of protein compounds as a result of prolonged stagnation of exudate in the abscess cavity. Sputum begins to be coughed up suddenly, “mouth full”, its amount reaches 1 liter. The stench when an abscess breaks into the bronchus is so strong that it can be felt several meters from the patient. With chronic pulmonary abscess, there is periodic coughing up of fetid pus and mucus in small quantities. During an exacerbation, the volume of foul-smelling sputum increases to 300-500 ml per day. Febrile fever, weakness, and chills occur. Patients complain of pain in one half of the chest, shortness of breath on exertion, and night sweats.
Lung gangrene
With extensive destruction of lung tissue, dirty gray putrid sputum appears. It has a pungent odor and coughs up large volumes - 500-1000 ml per day. If the blood vessels are damaged, the expectorated secretion contains blood impurities. Pulmonary gangrene is characterized by the release of foul-smelling sputum in a mouthful after a coughing attack. Symptoms include dull chest pain, hectic fever, and disturbances of consciousness.
Aspiration pneumonia
The disease, as a rule, proceeds hidden. Initially, when you cough, a scanty amount of mucus mixed with pus is released, which smells unpleasant. As aspiration pneumonia progresses, the amount of discharge increases. The sputum gradually acquires a putrid character, its smell becomes even more fetid and pungent. Hemoptysis often begins, and when large vessels are destroyed, pulmonary hemorrhage occurs. Patients experience chest pain, febrile fever, and chills.
Foul-smelling sputum
Friedlander's pneumonia
For this type of pneumonia, the appearance of brown, foul-smelling sputum with scarlet blood streaks is pathognomonic. Gradually, the amount of pus in the discharge increases. With Friedlander pneumonia, the sputum acquires a characteristic smell of burnt meat, which distinguishes the pathology from other types of lung damage. Patients are exhausted by a painful paroxysmal cough, difficulty breathing, and interruptions in the functioning of the heart.
Bronchiectasis
If the disease is complicated by infection with anaerobic flora, typical purulent sputum is replaced by putrefactive sputum, and the stench becomes more noticeable. Patients after a cough paroxysm cough up large amounts of grayish-green pus. Foul-smelling sputum is secreted intensely in the morning after waking up. The clinical picture of bronchiectasis is complemented by shortness of breath and pain in the chest area.
Empyema of the pleura
Foul-smelling sputum is expectorated when the inflammatory process is complicated by a bronchial fistula. In this case, the purulent exudate accumulated in the pleural cavity is drained through the respiratory tract when coughing. Expectorated sputum has a foul odor and is dirty green in color. When coughing, patients experience severe pain in the affected part of the chest. With pleural empyema, a forced position is typical: half-sitting with emphasis on the arms placed behind the body.
Lung cancer
When a malignant tumor disintegrates, a painful cough occurs with expectoration of foul-smelling brown, dirty green or gray sputum. The discharge has a heterogeneous structure, sometimes reddish particles of destroyed lung tissue are visible in it. Symptoms are more typical for peripheral lung cancer, while with a central location of the tumor, bleeding often occurs and atelectasis of the affected lobe or segment develops.
Ozena
With fetid atrophic rhinitis, thick, bloody-purulent nasal discharge is formed, but it can flow down the back of the throat, causing a cough with sputum. The patient constantly emits a noticeable putrid odor, which is not associated with a coughing attack or blowing his nose. During ozena, the olfactory receptors are usually damaged, so the patient himself does not feel the stench. Patients are concerned about dryness and painful itching in the nose, and disturbances in nasal breathing.
The danger of intestinal coronavirus
This condition is dangerous not only because an inflammatory reaction develops, but also because during vomiting and diarrhea, the human body loses a large amount of fluid, which can result in dehydration (dehydration). Elderly people with additional chronic diseases are at particular risk. For them, this condition poses a threat not only to health, but also to life.
Diagnostics
By analogy with the respiratory form of coronavirus, diagnosis of the intestinal form of the disease is carried out using a laboratory PCR test. The nature of the patient's complaints is taken into account.
Sputum when coughing
When you cough, your lungs reflexively push mucus out. This phenomenon is familiar to every person who has suffered from respiratory diseases. If the cough is accompanied by sputum production, it is called wet. Sputum can be mucous, purulent and hemorrhagic, with blood.
The nature of the sputum discharged when coughing often indicates the disease that has affected the human pulmonary system. As the pathology progresses, the nature of the expectorated secretion may change.
Treatment
Help before diagnosis
Cough with foul-smelling sputum occurs with severe lesions of the bronchopulmonary system, which cannot be treated at home. If you have such a symptom, you should consult a doctor as soon as possible. If the symptom is accompanied by impaired consciousness, hemoptysis or pulmonary hemorrhage, hectic fever, the patient needs emergency medical attention.
Conservative therapy
Most diseases that cause foul-smelling sputum are caused by bacterial infections. Therefore, etiotropic antimicrobial therapy is selected with the inclusion of drugs in the therapeutic regimen based on the results of the antibiogram. Combinations of 2-3 drugs are recommended, which are administered parenterally or locally (into the pleural cavity). Long-term antibiotic therapy is required - at least 10-14 days.
To improve sputum discharge, inhalations with brocholytics and proteolytic enzymes are used. To remove toxic products from the blood, detoxification methods are indicated: administration of electrolyte solutions in combination with diuretics, plasmapheresis, and the use of desensitizing agents. To improve the rheological properties of blood, anticoagulants and antiplatelet agents are prescribed.
If the patient’s condition is satisfactory and moderate, it is possible to perform percussion or vibration massage of the chest, which enhances the drainage function of the bronchi and stimulates expectoration of foul-smelling sputum. After the acute process subsides, physiotherapy is effective: ultrasound, speleotherapy, magnetic therapy. Patients are given complexes of breathing exercises and exercise therapy.
Classification
The consistency of sputum can be thick, viscous or thin and watery. When settling, in some cases it is divided into 2 or 3 layers. Based on physical properties (color, smell, transparency, other macroscopic characteristics), the following types of sputum are distinguished:
- Serous.
Isolated in acute left ventricular failure accompanied by pulmonary edema. Characterized by the absence of odor, watery consistency, and an abundance of foam. Serous sputum is usually colorless, sometimes has a pinkish tint. - Mucous.
The appearance of mucous discharge indicates the onset of inflammation of the respiratory tract or the attenuation of the activity of an acute pathological process. Sputum is coughed up in small quantities and is colorless, viscous mucus. - Mucopurulent.
Formed in the acute period of many respiratory diseases. This type of secretion is characterized by increased viscosity and the presence of yellow or green impurities. - Purulent.
Appears with severe inflammation, suppurative processes of the respiratory system. The consistency of the purulent secretion is liquid, the color is green or yellow-green, and sometimes there is a putrid odor.
Perhaps there are shocking photos of medical operations hidden here that show blood and guts.
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Purulent sputum
