Asthmatic bronchitis
The content of the article:
- Causes and risk factors
- Forms of the disease
- Asthmatic bronchitis symptoms
- Features of the course of asthmatic bronchitis in children
- Diagnostics
- Asthmatic bronchitis treatment
- Possible complications and consequences
- Forecast
- Prevention
Asthmatic bronchitis is an inflammatory disease of an infectious and / or allergic etiology, in which the pathological process usually occurs in the mucous membrane of large and medium bronchi. Most often, asthmatic bronchitis is diagnosed in children of preschool and primary school age, especially if there is a history of allergic diseases (allergic rhinitis, allergic diathesis, atopic dermatitis, etc.).
Pathogenesis of asthmatic bronchitis
Causes and risk factors
The reason for the development of asthmatic bronchitis is an increased sensitivity to allergens that enter the body by aerobronchogenic route or through the gastrointestinal tract.
Infectious agents in asthmatic bronchitis can be bacteria, viruses, microscopic fungi. Most often, with asthmatic bronchitis of an infectious origin, pathogenic staphylococcus is found in patients. Asthmatic bronchitis often develops against the background of diseases such as acute respiratory viral infections, measles, whooping cough, laryngitis, tracheitis, bronchitis, pneumonia, GERD (gastroesophageal reflux disease).
Most often, asthmatic bronchitis of infectious etiology is caused by pathogenic staphylococcus
Non-infectious allergens include certain foods, house dust, hair and skin particles of pets, fluff, and pollen. The reason for the development of asthmatic bronchitis in children may be vaccinations and medications that have caused an allergic reaction. An important factor in the development of asthmatic bronchitis is a hereditary factor - often the disease has a family history.
Forms of the disease
Asthmatic bronchitis is divided into acute and chronic.
In addition, the following forms of asthmatic bronchitis are distinguished:
- atopic (swelling of the mucous membrane of the walls of the bronchi, narrowing of the segmental bronchi, abundant mucous secretion in the lumen of the bronchi);
- infectious-allergic (changes in the bronchi are typical for bronchitis of infectious etiology - edema of the bronchial mucosa, hyperemia, mucopurulent contents in the lumen of the bronchi).
Asthmatic bronchitis symptoms
Asthmatic bronchitis is characterized by a wavy course with periods of remission, followed by exacerbations. Depending on the allergic factor that caused the disease, exacerbations of asthmatic bronchitis can occur in the spring-summer or autumn-winter season. The acute period in asthmatic bronchitis can last from several hours to a month.
During the period of exacerbation, symptoms of asthmatic bronchitis are attacks of coughing, which can be triggered by physical exertion, laughter, crying, etc. Before a coughing attack, patients sometimes note malaise, sore throat, nasal congestion, nasal discharge. A coughing fit is accompanied by shortness of breath, wheezing exhalation, difficulty exhaling (expiratory dyspnea). At the end of the attack, sputum leaves and the patient's condition improves. A cough in asthmatic bronchitis can change from dry to wet throughout the day.
With an exacerbation of asthmatic bronchitis, the patient suffers from coughing fits
The chest is not enlarged. Dry or wet rales are noted, which are often heard not only during auscultation, but even at a distance. Body temperature can rise to subfebrile numbers, but more often it is within the normal range. Due to the fact that the pathological process proceeds in the bronchi of medium and large caliber, and small bronchi are not affected by it, there are no pronounced attacks of bronchospasm (choking) - this distinguishes asthmatic bronchitis from asthma.
In the case of a non-infectious etiology of the disease, coughing attacks stop with the elimination of the allergic factor.
Features of the course of asthmatic bronchitis in children
Asthmatic bronchitis in children is often accompanied by the appearance of itchy rashes, characteristic of allergies, on the skin. In addition, neurological symptoms are often added: indifference, lethargy, or, on the contrary, irritability, moodiness, as well as increased sweating.
Asthmatic bronchitis in children is often accompanied by other allergic processes, such as allergic diathesis, atopic dermatitis, seasonal allergic rhinoconjunctivitis, etc.
In children, asthmatic bronchitis is often accompanied by allergic skin rashes
Diagnostics
Diagnosis of asthmatic bronchitis includes the collection of complaints and anamnesis, physical and instrumental examination, scarification allergological tests, as well as a number of laboratory tests.
When percussion over the lungs, a boxed tone of sound is noted. During auscultation, hard breathing, dry wheezing, as well as small and large bubbling wet rales are determined.
A blood test reveals an increase in the number of eosinophils, an increased content of histamine, IgA, IgE, and a decrease in the titer of complement.
Sputum culture reveals the infectious agent of asthmatic bronchitis
In order to detect an infectious agent in asthmatic bronchitis, a bacteriological culture of sputum is carried out to determine the sensitivity of the pathogen to antibiotics (antibioticogram). A bacteriological study of bronchial washings may also be prescribed.
According to the results of radiography of the lungs, the strengthening of the pulmonary pattern in the basal zones, the thickening of the pulmonary pattern in the medial regions and rarefaction in the lateral regions are determined.
When conducting an endoscopic examination, depending on the presence or absence of an infectious-inflammatory process, signs of catarrhal or catarrhal-purulent endobronchitis or practically unchanged mucous membrane of the bronchial walls can be determined.
Assessment of the degree of bronchial obstruction is carried out by examining the functions of external respiration:
- gas analytical study of external respiration;
- measurement of peak expiratory flow rate (peak flowmetry);
- measurement of volumetric and speed indicators of respiration (spirometry);
- study of the mechanics of external respiration (plethysmography, pneumotachography).
Asthmatic bronchitis treatment
The treatment regimen for asthmatic bronchitis is selected depending on the form of the disease, as well as the individual characteristics of the patient.
First of all, it is necessary to eliminate the effect of the allergen that caused the development of the disease. It is effective to carry out long-term specific hyposensitization of the identified allergen, especially in cases where it is impossible to stop the patient's contact with the causative allergen. The therapeutic dose of the allergen is gradually increased until the maximum level tolerated by the patient is reached. After that, treatment is carried out with maintenance dosages for two years or longer. Specific hyposensitization prevents the transformation of asthmatic bronchitis into bronchial asthma.
Patients with asthmatic bronchitis are prescribed bronchodilator and antispasmodic drugs, mucolytics, antihistamines, and vitamin complexes. When confirming the infectious process, anti-infectious drugs are used, the choice of which is carried out depending on the type of pathogen.
The complex treatment includes nebulizer (inhalation) therapy, alkaline inhalations are effective, as well as inhalations using sodium chloride thermal mineral water.
After the acute symptoms subside, physiotherapy is prescribed: general and local chest massage, percussion massage, hydrotherapy, electrophoresis, UFO therapy, acupuncture, electroacupuncture.
Nebulizer therapy is part of the treatment for asthmatic bronchitis
Patients are shown a hypoallergenic diet and adherence to a water regime (drinking plenty of fluids).
In severe cases, the patient may require hospitalization.
Dispensary observation is indicated for patients with asthmatic bronchitis. During the period of remission, the patients are advised to take a spa recovery.
Possible complications and consequences
With frequent relapses, asthmatic bronchitis is able to transform into bronchial asthma. This transformation is observed in about 30% of cases.
Forecast
With timely diagnosis and properly selected treatment, the prognosis is favorable.
Prevention
In order to prevent the development of asthmatic bronchitis, as well as to prevent relapses, it is recommended:
- elimination of the allergic factor from the patient's environment;
- carrying out specific and non-specific hyposensitization;
- elimination of chronic foci of infection in the body;
- carrying out a set of exercises for physiotherapy exercises;
- hardening;
- balanced diet;
- rejection of bad habits.
Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
