home Audience 4 Bronchitis in children. Symptoms of bronchitis in a child. Treatment of bronchitis. Obstructive and simple chronic bronchitis. Correct diagnosis and effective treatment of the disease

Bronchitis in children. Symptoms of bronchitis in a child. Treatment of bronchitis. Obstructive and simple chronic bronchitis. Correct diagnosis and effective treatment of the disease

Bronchitis- this is inflammation of the bronchi of various etiologies. There are several forms of bronchitis: acute simple bronchitis, acute obstructive bronchitis, bronchiolitis, recurrent bronchitis, Chronical bronchitis, chronic bronchiolitis.

The main criteria for diagnosing bronchitis are: cough, presence of diffuse dry and variable wet rales; X-ray shows the absence of focal and infiltrative changes in lung tissue, at the same time, there may be a bilateral increase in the pulmonary pattern and expansion of the roots of the lungs. Let's take a closer look at the causes, symptoms and treatment of acute simple bronchitis in children.

Acute simple bronchitis in children

Acute simple bronchitis in children is, as a rule, one of the manifestations of ARVI.

Etiology

Not all ARVI pathogens can lead to the development of bronchitis in children. In children early age The following viruses lead to the occurrence of bronchitis against the background of ARVI: RS virus, parainfluenza virus, cytomegalovirus, rhinoviruses, influenza viruses.

In preschoolers - influenza viruses, adenoviruses, mycoplasma, measles virus.

Also, the causative agents of bronchitis can be bacteria, most often pneumococci, Haemophilus influenzae, staphylococci, streptococci.

On the other hand, it should be noted that most often the development of bronchitis is associated not with mediocre infection by one or another microorganism, but with the activation and reproduction of its own opportunistic flora as a result of a violation of mucociliary clearance (the protective mechanism of the respiratory tract) during ARVI.

We should not forget about predisposing factors:

Cooling;
Contaminated air;
Passive smoking;
The presence of foci of infection in the upper respiratory tract and oropharynx.

Clinical manifestations of acute simple bronchitis in children

Symptoms of bronchitis largely depend on the etiology. If this is bronchitis against the background of an acute respiratory viral infection, then the child experiences an increase in body temperature, headaches, runny nose, symptoms of pharyngitis (coughing, sore throat), laryngitis ( hoarse voice), tracheitis (soreness behind the sternum, dry painful cough), conjunctivitis.

The main symptom of bronchitis is cough. At first, the cough is dry, then, on days 4-8 of illness, it becomes softer and more moist.

When listening with a stethoscope, wheezing is heard. At first, the wheezing may be dry, then moist and medium-bubbly when inhaling. Characteristic hard breathing. Wheezing during bronchitis is usually scattered, symmetrical, and decreases after coughing.

On a radiograph with simple bronchitis, one can detect a symmetrical increase in the pulmonary pattern in the hilar and inferomedial zones.

In most children, by the end of the first week of illness, the cough becomes wet and rare, and the body temperature returns to normal.

If the cough continues for more than 3 weeks, this may indicate mycoplasma, adenovirus and respiratory syncytial infections.

IN general analysis In this form of blood, leukocytopenia is detected (a decrease in the number of leukocytes, which indicates the viral nature of the disease), or moderate leukocytosis, accelerated ESR.

Differential diagnosis is carried out with pneumonia, which is characterized by a persistent increase in body temperature, the presence respiratory failure and focal lesions of lung tissue.

Treatment of acute simple bronchitis

Mode- bed rest for the entire febrile period and for 3 days after its end. Then they switch to a gentle mode (room).

Diet- milky-vegetable, mechanically and thermally gentle. Avoid salty, extractive and highly allergenic foods. Drinking plenty of fluids is recommended, especially during febrile periods.

Specific therapy for ARVI- antiviral drugs are effective if treatment is started in the first 2 days of illness. Interferon, gripferon, Kagocel, Arbidol and others are used.

Antipyretics- with fever.

Antitussives are divided into cough suppressants and expectorants.

Antitussives indicated for obsessive painful cough. It should be remembered that these remedies should be used with caution, since coughing is defensive reaction the body, and with a large amount of sputum, the absence of a cough can lead to obstruction (blockage) of the bronchi and the accumulation of additional bacterial flora.

Cough suppressants include:

Non-narcotic drugs central action- Bluehorn, Glauvent. They have antitussive and antispasmodic effects;
Drugs peripheral action- Libexin. They have an effect by reducing the sensitivity of cough receptors.
Narcotic drugs of central action - they reduce the excitability of the cough center, but at the same time depress breathing and have hypnotic effect, and also inhibit reflexes. They are not used in pediatric practice.

Expectorants

Mucoprotectors- improve regeneration (restoration) of the mucous membrane of the respiratory tract.

Mucolytics- thins mucus and stimulates its elimination.

They are widely used to treat cough in children. medicinal plants:

Marshmallow root - drug Mucalitin;
Plantain leaf;
Coltsfoot leaf:
Thermopsis grass;
Anise fruit;
Thyme extract - drug Pertussin (also contains thyme extract, potassium bromide).

The following recipe is very effective in treating cough:

At the onset of bronchitis, an infusion of marshmallow root is prescribed (3 grams per 100 ml of water with the addition of 1 gram of sodium benzoate, 3 ml of ammonia-anise drops and 1.5 grams of potassium iodide). Dosages - children up to school age- 1 teaspoon; children of primary school age - 1 dessert spoon; children over 12 years old: 1 tablespoon 6-8 times a day.

Effective comprehensive herbal preparation is Bronchicum. This drug enhances the secretion of the bronchial glands, reduces the viscosity of sputum and swelling of the bronchial mucosa.

Derivatives of the plant alkaloid vasocine(Bromhexine, Mucosolvan) and their metabolite Ambroxol (Ambrohexal) - have a pronounced mucolytic effect. Available in the most different forms- syrup, powders, tablets and others.

The drug is well suited for the treatment of bronchitis with cough and difficult to separate sputum. Bronchosan(contains bromhexine and essential oils fennel, anise, peppermint, menthol, eucalyptus). The drug has mucolytic, antispasmodic and antimicrobial effects.

Gaining increasing popularity in cough treatment acetylcysteine(ACC) is a drug that thins sputum and promotes its removal. The drug is approved from 2 years of age.

Other methods of treating cough in children

Inhalations;
The use of moisturizing aerosols is especially effective with the addition of sodium bicarbonate, sodium benzonate, eucalyptus;
Warm milk with butter and honey, warm milk half with Borjomi;
Mustard wraps chest, mustard socks; When placing mustard plasters and jars, children should be very careful, as there is a high risk of burns.
Rubbing with warming ointment ();
Honey applications;
Vibration massage.

Antibacterial therapy in acute simple bronchitis, in most cases, not indicated. Antibiotics are prescribed if a bacterial infection is suspected.

Physiotherapeutic treatment for bronchitis

In a clinic setting, physiotherapy is usually not prescribed.

In the hospital - in acute period it is possible to prescribe UHF therapy, microwave therapy, and local ultraviolet irradiation. After subsiding acute process use diadynamic and sinusoidal modulated currents, electrophoresis, and ultraviolet radiation.

In most cases, recovery occurs within 2-3 weeks from the onset of the disease. If bronchitis lasts more than 3 weeks, it is said to be protracted. In these cases, a more thorough examination of the child is necessary to find out the cause of prolonged bronchitis.

General information

Bronchitis in children is an inflammation of the mucous membrane of the bronchial tree of various etiologies. For every 1000 children, there are 100-200 cases of bronchitis annually. Acute bronchitis accounts for 50% of all respiratory tract lesions in young children. The disease develops especially often in children in the first 3 years of life; is most severe in infants. Due to the variety of causally significant factors, bronchitis in children is the subject of study in pediatrics, pediatric pulmonology and allergology-immunology.

Causes of bronchitis in children

In most cases, bronchitis in a child develops following previous viral diseases- influenza, parainfluenza, rhinovirus, adenovirus, respiratory syncytial infection. Somewhat less frequently, bronchitis in children is caused by bacterial pathogens (streptococcus, pneumococcus, Haemophilus influenzae, Moraxella, Pseudomonas and Escherichia coli, Klebsiella), fungi of the genus Aspergillus and Candida, intracellular infection (chlamydia, mycoplasma, cytomegalovirus). Bronchitis in children often accompanies measles, diphtheria, and whooping cough.

Bronchitis of allergic etiology occurs in children sensitized by inhalation allergens entering the bronchial tree with inhaled air: house dust, household chemicals, plant pollen, etc. In some cases, bronchitis in children is associated with irritation of the bronchial mucosa by chemical or physical factors: polluted air, tobacco smoke, gasoline vapors, etc.

There is a predisposition to bronchitis in children with a burdened perinatal background (birth injuries, prematurity, malnutrition, etc.), constitutional anomalies (lymphatic-hypoplastic and exudative-catarrhal diathesis), congenital defects of the respiratory system, frequent respiratory diseases(rhinitis, laryngitis, pharyngitis, tracheitis), impaired nasal breathing (adenoids, deviated nasal septum), chronic purulent infection(sinusitis, chronic tonsillitis).

Epidemiologically highest value have a cold season (mainly autumn-winter), seasonal outbreaks of acute respiratory viral infections and influenza, children staying in children's groups, and unfavorable social and living conditions.

Pathogenesis of bronchitis in children

The specifics of the development of bronchitis in children are inextricably linked with the anatomical and physiological characteristics of the respiratory tract in childhood: abundant blood supply to the mucous membrane, looseness of the submucosal structures. These features contribute to the rapid spread of the exudative-proliferative reaction from the upper respiratory tract into the depths of the respiratory tract.

Viral and bacterial toxins suppress motor activity ciliated epithelium. As a result of infiltration and swelling of the mucous membrane, as well as increased secretion of viscous mucus, the “flickering” of the cilia slows down even more - thereby turning off the main mechanism of self-cleaning of the bronchi. This leads to a sharp decrease drainage function bronchi and difficulty in the outflow of mucus from the lower parts of the respiratory tract. Against this background, conditions are created for further reproduction and spread of infection, obstruction of smaller caliber bronchi with secretions.

Thus, the features of bronchitis in children are the significant extent and depth of damage to the bronchial wall, the severity inflammatory reaction.

Classification of bronchitis in children

Based on their origin, primary and secondary bronchitis in children is distinguished. Primary bronchitis initially begins in the bronchi and affects only the bronchial tree. Secondary bronchitis in children is a continuation or complication of another pathology of the respiratory tract.

The course of bronchitis in children can be acute, chronic and recurrent. Taking into account the extent of inflammation, limited bronchitis (inflammation of the bronchi within one segment or lobe of the lung), widespread bronchitis (inflammation of the bronchi of two or more lobes) and diffuse bronchitis in children ( bilateral inflammation bronchi).

Depending on the nature of the inflammatory reaction, bronchitis in children can be catarrhal, purulent, fibrinous, hemorrhagic, ulcerative, necrotic and mixed. In children, catarrhal, catarrhal-purulent and purulent bronchitis is more common. Special place Among the lesions of the respiratory tract, bronchiolitis in children (including obliterative) is a bilateral inflammation of the terminal parts of the bronchial tree.

According to etiology, viral, bacterial, viral-bacterial, fungal, irritative and allergic bronchitis in children are distinguished. Based on the presence of obstructive components, non-obstructive and obstructive bronchitis in children is distinguished.

Symptoms of bronchitis in children

Development acute bronchitis In most cases, children are preceded by signs viral infection: sore throat, coughing, hoarseness, runny nose, symptoms of conjunctivitis. A cough soon appears: obsessive and dry at the beginning of the disease, by 5-7 days it becomes softer, moist and productive with the separation of mucous or mucopurulent sputum. In case of acute bronchitis, a child experiences an increase in body temperature up to 38-38.5 ° C (lasting from 2-3 to 8-10 days depending on the etiology), sweating, malaise, chest pain when coughing, in young children - shortness of breath. The course of acute bronchitis in children is usually favorable; the disease ends with recovery on average after 10-14 days. In some cases, acute bronchitis in children can be complicated by bronchopneumonia. With recurrent bronchitis in children, exacerbations occur 3-4 times a year.

Obstructive bronchitis in children it usually manifests itself in the 2-3rd year of life. The leading sign of the disease is bronchial obstruction, which is expressed by paroxysmal coughing, noisy wheezing, prolonged exhalation, and distant wheezing. Body temperature may be normal or low-grade. General state children usually remain satisfactory. Tachypnea, shortness of breath, and participation of auxiliary muscles in breathing are less pronounced than with bronchiolitis. Severe obstructive bronchitis in children can lead to respiratory failure and the development of acute cor pulmonale.

Chronical bronchitis in children it is characterized by exacerbations of the inflammatory process 2-3 times a year, occurring sequentially for at least two years in a row. Cough is the most constant sign chronic bronchitis in children: during remission it is dry, during exacerbations it is wet. Sputum is coughed up with difficulty and in small quantities; has mucopurulent or purulent character. There is a low and variable fever. Chronic purulent inflammatory process in the bronchi may be accompanied by the development of deforming bronchitis and bronchiectasis in children.

Diagnosis of bronchitis in children

Primary diagnosis of bronchitis in children is carried out by a pediatrician, clarification - by a pediatric pulmonologist and a pediatric allergist-immunologist. When establishing the form of bronchitis in children, clinical data (nature of cough and sputum, frequency and duration of exacerbations, course characteristics, etc.), auscultatory data, results of laboratory and instrumental studies are taken into account.

The auscultatory picture of bronchitis in children is characterized by scattered dry (wheezing in case of bronchial obstruction) and moist rales of various sizes.

In a general blood test, at the height of the severity of the inflammatory process, neutrophilic leukocytosis, lymphocytosis, and an increase in ESR are detected. For allergic bronchitis Children are characterized by eosinophilia. A blood gas study is indicated for bronchiolitis to determine the degree of hypoxemia. Sputum analysis is of particular importance in the diagnosis of bronchitis in children: microscopic examination, sputum culture, AFB test, PCR analysis. If the child is unable to independently cough up bronchial secretions, bronchoscopy with sputum collection is performed.

X-ray of the lungs with bronchitis in children reveals an increase in the pulmonary pattern, especially in the hilar zones. When performing an FVD, a child may experience moderate obstructive disorders. During the period of exacerbation of chronic bronchitis in children with

Acute bronchitis in a child is a fairly common and dangerous disease. Although bronchial inflammation is different light current and responds well to treatment, pathology becomes the cause serious complications. The disease should be treated immediately, but do it wisely.

But a dry hacking cough can be alleviated with the help of freshly squeezed lingonberry juice and adding sugar or melted natural honey to it.

For acute bronchitis, it is useful for children to drink infusions or decoctions healing herbs. This Linden blossom, leaves of viburnum, coltsfoot, black currant. When making, brew a tablespoon of dry raw materials in a glass of boiling water.

If the child’s temperature does not exceed normal, it is useful to carry out the following procedures:

Oil chest wraps(except for the heart area).
Compress treatment. Better to use boiled potatoes with the addition of 2-3 drops of iodine and vegetable oil. You can use any vegetable oil. It is heated, soaked in cotton fabric and applied to the body. The compress is secured on top with wax paper.
Put your baby to bed with two heating pads on the chest and back. Do not forget to change the water in them promptly and do not allow the heating pads to cool down.
Soar your feet every evening(you can use mustard powder) and put mustard plasters (but not homemade ones). Provided that the child has reached the age of 3 years.

Acute bronchitis is dangerous due to its complications. In order to prevent the development of dangerous situations, preventive measures must also be taken during treatment.

Prevention of acute bronchitis in children

If the disease has visited a child at least once, there is a high probability of its recurrence. To prevent returns dangerous situation, arm yourself with the following tips:

Stick to a good daily routine.
Take daily walks, but in good weather.
Vaccinate your child promptly in anticipation of an impending flu epidemic.
Balance children's diet nutrition, including a lot of fruits and vegetables in the menu.
Introduce your child to the basics of hardening, pave the way to the pool or sports sections.
Spare the child the sight smoking parents. Passive smoking is a common cause of acute bronchitis.

Acute bronchitis in children under one year of age - how are infants treated?

In an infant, acute bronchitis becomes a consequence of an incompletely cured acute respiratory infection or influenza. How to treat pathology in infancy? After all, the baby’s immunity is still weak, and most medications contraindicated. The first thing parents should do is contact a pediatrician and carefully follow all his recommendations.

Often used to treat disease in infants as complementary therapy use massage. Parents can do it, but subject to the following rules:

Before the session, the baby should be given medicine prescribed by the doctor.
Give the child a warm drink. This will increase the effectiveness of the procedure and promote the removal of sputum.
The best time for a massage is day or morning. If you massage your baby in the evening, he will cough at night and have trouble resting.
To prevent overload of the gastrointestinal tract, conduct sessions 2 before meals or an hour after.
The duration of the procedure should not exceed half an hour. It is better to massage 2-3 times a week.

First, warm up the baby's body with baby oil and begin stroking the chest. Movements should be soft with a gradual increase. After the chest, go to upper area backs. After stroking, proceed to intense rubbing.

Important! When massaging, avoid the area of the heart, hypochondrium and kidneys. Movements should be smooth and not cause pain to the baby.

In addition to medicines and home massage When treating acute bronchitis in infants, drinking plenty of fluids is important. Let your baby drink more often warm water, children's teas or juices. Make sure there is good humidity in the house. The famous pediatrician Komarovsky also advises this.

Tips for treating acute bronchitis in children from Dr. Komarovsky

The main advice that Dr. Komarovsky gives when treating acute bronchitis in children, the mucus produced by the bronchi should not be allowed to dry out. To do this, maintain the correct microclimate in the nursery: air humidity within 50-60% at a temperature of +18-22⁰ C.

Advice! This can be achieved by regular good ventilation, using air humidifiers, or simply hanging wet sheets on radiators.

If your doctor suggests adding antibiotics to your treatment, ask about the advisability of using aggressive agents. According to Komarovsky, in 99% of cases, acute bronchitis is the result of a viral infection, and only 1% of the disease actually requires antibiotics.

Treatment of acute bronchitis in children should include traditional methods: drinking plenty of warm fluids, taking antipyretics for fever and bed rest. But as soon as the child’s condition returns to normal, get him out of bed and go for daily walks.

If cases of inflammation recur, think about what leads to relapses of the disease. Do the parents smoke, does the child have allergies, what is the air like in your area. With long-term residence in areas with unfavorable ecology, it develops.

The most important thing is to prevent recurrence of the disease (very dangerous) and not to engage in self-treatment. After all, a successful recovery depends on timely therapy, which can only be prescribed by an experienced pediatrician.

Useful video

From the video below you will learn some more tips on treating acute bronchitis from Dr. Komarovsky:

Bronchitis(lat. inflammation) is a disease respiratory system, in which the bronchi are involved in the inflammatory process. A common cause of bronchitis is an infection, such as a viral or bacterial infection, requiring antiviral treatment. Chronic bronchitis as a result long acting non-infectious irritants.

In some cases, with bronchitis, blockage of the bronchi develops due to swelling of the mucous membrane; such bronchitis is called obstructive. Treatment of bronchitis depends on the provoking factor, type of course and form of the disease.

Types of disease

There are 3 types of bronchitis in children:

spicy simple;
acute obstructive;
acute bronchiolitis (occurs in infants and infants, affects small bronchi).

In adults, there are 2 types of the disease:

acute form
chronic form.

Symptoms of acute simple bronchitis in children

The main symptom of acute bronchitis is a cough, which at the beginning of the disease is usually dry and persistent. The cough may be accompanied by a feeling of pressure or pain in the chest. In the second week of illness, the cough becomes mild and productive. Cough and other symptoms may persist for more than 2 weeks. Simple bronchitis is also characterized by harsh breathing and moist wheezing, the amount of which changes with coughing. With deeper bronchitis, you can listen to fine wheezing. The duration of acute bronchitis usually does not exceed two weeks, although in some cases a dry cough lasts longer without being accompanied by a disturbance in the general condition.

Symptoms of obstructive bronchitis

Bronchitis often occurs in preschool children with broncho-obstructive syndrome which is usually called obstructive bronchitis. Obstruction is caused by a combination of several factors, including: an initially narrow lumen of the bronchi, massive swelling of the mucous membrane, which further narrows this lumen, copious discharge viscous and poorly discharged sputum and (in older children) bronchospasm (additional narrowing of the bronchial lumen). As a result, instead of moving freely along a “wide highway,” the air has to “squeeze” through narrow openings. All this is accompanied by wheezing, which can be heard by placing your ear to the baby's chest. Wheezing is the most distinguishing feature namely obstructive bronchitis.

Symptoms of acute bronchiolitis

In most cases, the disease develops in children in the first two to three years of life against the background of an acute respiratory viral infection; the maximum peak incidence occurs at the age of 5-7 months. Every year, 3-4% of young children suffer from acute bronchiolitis. The onset of acute bronchiolitis resembles ARVI: the child becomes restless and refuses to eat; body temperature rises to subfebrile levels, rhinitis develops. After 2-5 days, signs of damage to the lower parts of the respiratory tract appear - obsessive cough, wheezing, expiratory shortness of breath. At the same time, hyperthermia increases to 39°C and above, and moderately pronounced symptoms of pharyngitis and conjunctivitis occur.

Symptoms of acute bronchitis

Infectious bronchitis usually occurs in winter. It begins with symptoms reminiscent of a common cold, primarily fatigue and a sore throat, followed by a cough. At first, the cough is often dry, but later it becomes wet and white, yellow or even greenish sputum is coughed up. In more serious cases, a rise in temperature may occur.

Symptoms of chronic bronchitis

The term “chronic bronchitis,” in contrast to acute bronchitis, is used by doctors to designate a long-term disease that sometimes does not go away for several months. Cough and sputum production may recur annually and last longer each time. Chronic bronchitis often occurs due to prolonged inhalation of various irritants, such as cigarette smoke.

The main difference between the processes in the lungs during acute and chronic bronchitis is that with chronic bronchitis, the bronchial mucosa produces more sputum, which causes a cough, while with infectious bronchitis cough occurs mainly due to inflammation of the respiratory tract. One of the most common reasons Chronic bronchitis is caused by constant smoking.

The meaning of sputum color in bronchitis

The color of sputum released when coughing is important. diagnostic value for a doctor. Thanks to only this sign, the doctor can determine the stage of the disease, its severity, and the cause of its occurrence. Sputum consists of saliva, which is produced in the mouth, cells produced immune system, particles of blood and plasma, dust, pathogenic microorganisms.

Green sputum.Green color sputum indicates an existing infection chronic. The green color is the result of the decay process of neutrophils that tried to cope with pathogenic agents. If the disease is infectious nature, then the green tint of sputum can also indicate the presence of a large amount of pus in the sputum. If the disease is non-infectious, then there will be more mucus in the sputum than greens.
White sputum. When the color of the sputum is white, the patient’s condition is regarded as the normal course of the disease. However, it is worth paying attention to the amount of sputum discharged and the presence of foam in it. So, with foamy, abundant white sputum, pulmonary edema, tuberculosis or asthma can be suspected.
Yellow sputum. Indicates the presence of white blood cells, namely neutrophils. They always show up in large quantities for allergic, infectious and chronic inflammation. By yellow color bronchial discharge, doctors most often define: asthma, sinusitis, acute stage pneumonia or bronchitis.

When a deviation is detected yellow sputum You should not hesitate to go to the doctor, as her morning analysis allows you to determine the presence of a bacterial infection.

Black (dark gray) sputum. If a patient produces black or dark gray sputum, this most often indicates the presence of dust from smoking tobacco. Also, blackening of sputum may occur when taking certain medications.
Brown sputum. Brown color sputum – serious sign, which requires medical assistance. This mucus color indicates the breakdown of a large number of red blood cells and the release of hemosiderin.
Red sputum (with blood). The presence of blood in the sputum may indicate a serious infection or pulmonary hemorrhage.

Treatment of bronchitis

Treatment of acute bronchitis comes down to prescription bed rest, drink plenty of fluids and distraction procedures. Drug therapy consists of prescribing drugs that relieve cough and promote rapid recovery (expectorants and mucolytics). For a dry cough without discharge, take antitussives combination medications. At high temperatures, antipyretics are prescribed. When pneumonia occurs, antibiotic therapy is administered.

In case of chronic bronchitis, the doctor can give several recommendations. Your doctor will most likely recommend stopping smoking, as this will significantly slow the progression of the disease and reduce shortness of breath. The doctor may prescribe bronchodilators (bronchodilators), which widen the airways and make breathing easier. They are often prescribed as inhalations (using inhalers). At the time of exacerbation, corticosteroids and antibiotics are sometimes prescribed. IN severe cases or when frequent exacerbations Corticosteroid use may be ongoing.

Possible complications

Bronchitis can be complicated by the development of the following conditions:

transition of acute bronchitis to chronic form diseases;
development of pneumonia;
inflammation of the lungs with the possible onset of a septic process;
the occurrence of cardiopulmonary failure;
the appearance of bronchial asthma or obstructive bronchitis. This complication is especially common in people prone to allergic reactions.

Prevention of bronchitis

Primary prevention of the disease comes down to following the following rules:

Refusal bad habits and primarily from smoking and drinking alcohol.
Avoiding activities that involve inhaling harmful fumes of lead, aluminum, and chlorides.
Getting rid of sources of chronic infection.
Avoiding low temperatures.
Strengthening immunity: balanced diet, hardening, adherence to work and rest regime, dosing of physical activity.
Seasonal flu vaccination.
Frequent ventilation of living spaces.
Walks in the open air.

When the first symptoms of the disease occur, you should consult a therapist. He is the one who does everything diagnostic measures and prescribes treatment. It is possible that the therapist will refer the patient to more specialized specialists such as a pulmonologist, an infectious disease specialist, an allergist.

The disease is a lesion of the bronchi that occurs without airway obstruction. Most often it is a manifestation of an acute respiratory viral infection.

Reasons for development

In young children, the most common pathogens diseases are respiratory syncytial, cytomegalovirus, riaovirus and parainfluenza infections. In children of school age - influenza, adenovirus, measles and mycoplasma infections. In more in rare cases The causative agents of the disease may be bacteria (pneumococci, Haemophilus influenzae, staphylococci and streptococci).
Factors predisposing to the development of bronchitis include hypothermia, air pollution and passive smoking.
The development of the disease occurs as a result of the entry of a pathological agent into the respiratory tract. The pathogen multiplies in the epithelial cells of the respiratory tract, as a result of which their functioning is disrupted.

Clinic

The main complaints in acute bronchitis are weakness, malaise, increased body temperature to 37-38 ° C, cough, headache, a feeling of pressure and less often pain in the chest. There are no signs of obstruction in simple acute bronchitis, but parents may complain of wheezing when inhaling during sleep.

Cough comes to the fore in the bronchitis clinic. In the first days of the disease, the cough is dry and somewhat obsessive, but after 4-6 days it becomes moist and productive. The sputum is often mucous in nature, but as the disease progresses it can become purulent (acquire green color). Gradually its volume increases. The duration of the cough ranges from 2 to 6 weeks.

Symptoms of intoxication are mild, body temperature rises to low-grade levels and persists for an average of 2-3 days.

When examining a child, manifestations of conjunctivitis are noted (redness of the mucous membrane of the eyes, injection of blood vessels in the sclera and conjunctiva, lacrimation). Hyperemia and swelling of the anterior and posterior arches, uvula, back wall throats. The soft palate is noted to be grainy.

Frequency breathing movements, as a rule, corresponds to the norm. When auscultating the lungs against the background of hard breathing, scattered dry, less often wet medium-bubble and coarse-bubble rales are heard on inspiration. After coughing, wheezing changes, decreases or even disappears. Wheezing is heard symmetrically, on both sides, throughout all pulmonary fields. The appearance of an asymmetric auscultation pattern is observed with pneumonia. Upon percussion, a clear pulmonary sound is detected. The appearance of respiratory failure is not typical.

When studying the data of a general blood test, inconsistent changes are revealed (normal or slightly reduced leukocyte content, shift leukocyte formula to the left, acceleration of erythrocyte sedimentation rate).

When conducting x-ray examination of the chest organs, an increase in the pulmonary pattern is determined, as a rule, in the hilar and inferomedial segments.

The clinical manifestations of simple acute bronchitis largely depend on the causative agent of the disease.

1. Viral bronchitis is characterized by more pronounced symptoms of intoxication, especially with influenza infection. Duration low-grade fever ranges from one to 10 days. Catarrhal phenomena are pronounced. The frequency of respiratory movements is slightly higher than the age norm.

2. Mycoplasma bronchitis is most often observed in school-age children. The onset of the disease is accompanied by the appearance high temperature. Symptoms of intoxication are mild. Catarrhal symptoms are mild, and sometimes conjunctivitis is detected. Often small bronchi are involved in the pathological process. When auscultating the lungs, scattered fine rales are heard. A feature of the auscultatory picture is the asymmetry of wheezing.

3. Chlamydial bronchitis occurs both in children in the first six months of life and in adolescents. In adolescents, the disease occurs with obstructive syndrome.

4. Descending (stenotic) tracheo-bronchitis is a bacterial complication of croup, accompanied by a violation respiratory functions. The most common causative agents of the disease are hemolytic Staphylococcus aureus, less often coli. Inflammatory changes in the mucous membrane of the trachea and bronchi develop. Inflammation can be purulent, fibrinopurulent and necrotic. Pathological changes quickly spread from the subglottic space and the upper part of the trachea to the bronchi. IN clinical picture signs of stenosis come to the fore. For bacterial pathogen characterized by a prolonged increase in body temperature to febrile levels and a pronounced intoxication syndrome. A general blood test reveals an increase in erythrocyte sedimentation rate, leukocytosis with a neutrophilic shift to the left.

On average, the duration of an uncomplicated disease is 10-14 days, but in some patients cough can last up to 4-6 weeks.

Differential diagnosis

Differential diagnosis of simple acute bronchitis must be carried out with a number of nosological diseases.

1. With pneumonia there are severe symptoms intoxication, asymmetry of physical data, focal symptoms and characteristic radiographic changes.

2. Availability foreign body bronchus may be suspected in case of a long-term illness lasting more than 2 weeks.