Bronchitis in children
The content of the article:
- Causes of bronchitis in children and risk factors
- Forms of the disease
- Symptoms of bronchitis in children
- Diagnostics
- Treatment of bronchitis in children
- Possible complications and consequences
- Forecast
- Prevention
Bronchitis in children is a diffuse inflammatory disease of the bronchi, in which the mucous membrane or the entire thickness of the bronchial wall is affected. The disease can occur in isolation or develop against the background of other pathological processes. Bronchitis in children is one of the most common diseases of the respiratory tract, bronchopulmonary pathology in children develops more often, and can also have a more severe course than in adult patients. Obstructive bronchitis is recorded in about 20% of children in the first years of life.
Pathogenesis of bronchitis
Causes of bronchitis in children and risk factors
Acute bronchitis in children often develops against the background of an acute respiratory disease of viral etiology (infectious agents are often adenoviruses, parainfluenza viruses, human respiratory syncytial virus, as well as influenza viruses, measles, rhinoviruses, etc.), to which a bacterial infection can later join. In addition, the causes of bronchitis in children can be allergic reactions (more often due to individual allergic reactions to dust, food, pollen, animal hair, etc.) or toxic damage when breathing gas, smoke or polluted air in the case of living in environmentally unfriendly regions.
Risk factors for the development of acute bronchitis in children include:
- hereditary predisposition (hereditary tendency to allergic reactions, congenital disorders of the respiratory system);
- stagnant processes in the pulmonary circulation;
- foci of chronic infection in the oral cavity and / or in the nasal cavity (caries, adenoiditis, etc.);
- unfavorable weather factors (cold, windy, damp weather, a sharp temperature drop);
- passive smoking (especially if one or both parents smoke, that is, the child's constant environment);
- decreased immunity.
Obstructive bronchitis in children is sometimes caused by mold, which lives on the walls of rooms with high levels of humidity.
Bronchitis in children can develop due to allergies to dust, pollen, food
It may be difficult to assess the role of bacteria in the development of the disease due to the fact that many representatives of the bacterial flora that are found in bronchitis in children are part of the normal microflora of the respiratory tract (opportunistic microflora). Risk factors for the development of obstructive bronchitis in children can be a lack of oxygen during intrauterine development, prematurity, birth trauma, infections at an early age.
The recurrent form of bronchitis in children can be caused by helminthic invasions, immunodeficiency states, as well as the anatomical and physiological features of the respiratory tract and immune reactivity in children. In addition, risk factors for the development of a recurrent form of the disease in children include female smoking during pregnancy, alcoholic embryopetopathy, aspiration syndrome in newborns, and artificial ventilation.
The factors predisposing to the onset of chronic bronchitis in children are:
- genetic predisposition;
- respiratory tract malformations;
- the presence in the family of a patient with a chronic form of bronchopulmonary disease;
- ingress of foreign bodies into the respiratory tract.
Forms of the disease
Depending on the severity of the course, bronchitis are mild, moderate and severe.
Depending on the change in the function of external respiration, a simple (non-obstructive) and obstructive form of bronchitis in children is distinguished.
Depending on the duration and characteristics of the course:
- acute - duration 1.5–2 weeks;
- recurrent - occurs 3 or more times a year, typical for preschoolers, tends to turn into chronic bronchitis with age;
- chronic - symptoms of the disease persist for several months.
Depending on the origin, acute bronchitis can be:
- infectious;
- non-infectious;
- mixed;
- unspecified.
Depending on the mechanism of development - primary and secondary acute bronchitis.
By the nature of the exudate, bronchitis in children is divided into catarrhal, purulent, catarrhal-purulent, atrophic.
Symptoms of bronchitis in children
The clinical picture of bronchitis in children depends on the form of the disease, as well as on the presence of complications. The main symptom of any form is cough. The nature of the sputum varies depending on the form of the disease. With bronchitis of viral etiology, the sputum is transparent, sometimes with a yellowish tinge, with bacterial sputum it can take on a purulent character.
The main symptom of acute bronchitis in children is a low chest cough, which usually appears against the background of symptoms of acute respiratory illness. There is an increase in body temperature, weakness, nasal congestion. At the beginning of the disease, the cough is dry, aggravated at night, sputum is difficult to separate and practically does not leave. Frequent attacks of coughing cause pain in the muscles of the chest and abdomen. The child's psycho-emotional state is deteriorating, he is capricious, refuses to eat. A few days after the onset of the disease, the patient begins to sputum. In the case of swallowing sputum with bronchitis in young children, gagging may occur. Shortness of breath may indicate the development of obstructive syndrome,with an uncomplicated course of acute bronchitis in children, shortness of breath is not observed. The general condition returns to normal, as a rule, after a few days; the cough can continue for several more weeks. Maintaining a high body temperature for a long time, longer than 3-5 days, may indicate the addition of a secondary infection (bacterial) and the development of complications.
Low chest cough, fever, weakness are the main symptoms of bronchitis in children
The first episode of obstructive bronchitis often occurs in a child 2–3 years of age. For the onset of the disease, signs of an acute respiratory viral infection are characteristic, against which it usually develops. In addition to the general signs of the acute form of the disease, patients with obstructive bronchitis have dry wheezing and wheezing. The clinical picture of this form of the disease resembles the manifestations of bronchial asthma. Signs of bronchial obstruction can occur both on the first day of illness, and several days after the onset of obstructive bronchitis. In patients, there is an increase in the frequency of respiratory movements, expiratory (difficulty exhaling) or mixed dyspnea, during breathing, the auxiliary muscles are involved, the anteroposterior chest size increases. A cough in the obstructive form of the disease is unproductive, a painful paroxysmal cough may occur that does not bring relief. The phlegm is difficult to pass, even with a wet cough. There is pallor of the skin or a cyanotic skin tone around the mouth (perioral cyanosis). Signs of bronchial obstruction usually last from several days to one week, then gradually disappear.
The obstructive form of bronchitis in children is characterized by a wave-like course with periods of exacerbation and remission. During relapses, patients have bouts of coughing, coughing is provoked by physical exertion, laughter, crying. A coughing fit may be preceded by a sore throat, serous-mucous discharge from the nose, and malaise. The attack may be accompanied by difficulty breathing, shortness of breath, noisy wheezing exhalation. At the end of the attack, as a rule, sputum discharge and an improvement in the patient's general condition are observed. Body temperature during exacerbations is usually within normal limits, it can rise to subfebrile numbers (not higher than 38 ° C). The duration of an exacerbation in obstructive bronchitis in children ranges from several hours to several weeks. In some cases, with this form of the disease, children experience increased sweating,irritability, lethargy. A protracted course of obstructive bronchitis in children is typical for patients with background pathologies such as rickets, anemia, psychophysiological exhaustion, chronic diseases of the upper respiratory tract, a burdened allergic history.
The recurrent form of bronchitis in children is characterized by annual exacerbations (3-4 exacerbations per year), which last about 2-4 weeks. Relapses are characterized by a milder course than for primary acute bronchitis. Usually, relapses begin with symptoms of an acute respiratory viral infection, later patients develop viscous mucous membranes or mucopurulent sputum. The clinical picture of recurrent bronchitis in children is similar to that in the acute form of the disease, however, the cough in this form of the disease usually bothers the patient much longer (up to two months). The cough is more pronounced in the morning, and may worsen with physical and emotional stress. During the period of remission, clinical manifestations are absent.
Chronic bronchitis in children develops gradually. The onset of the disease is characterized by the appearance of a cough in the morning. In this case, a large amount of mucous sputum is separated from the child. With the progression of the disease, cough can also occur during the day and night, shortness of breath develops, weakness and fatigue are observed. The cough is worse in damp and cold weather. The amount of sputum gradually increases, it can acquire a mucopurulent or purulent character. Body temperature is usually within normal limits, it may slightly increase. Patients have dry wheezing and hard breathing.
Diagnostics
To diagnose bronchitis in children, the following can be performed:
- collection of complaints and anamnesis;
- objective examination;
- general analysis of blood and urine;
- blood chemistry;
- immunological blood test;
- allergological research;
- bacteriological examination of sputum with an antibioticogram;
- study of the function of external respiration;
- X-ray examination of the lungs;
- tracheobronchoscopy;
- electrocardiography, echocardiography.
To diagnose bronchitis in children, a comprehensive examination is carried out, including X-ray of the lungs
Differential diagnosis is carried out with bronchial asthma, pneumonia, bronchiectasis, tuberculosis.
Treatment of bronchitis in children
When bronchitis occurs in children, first of all, it is necessary to eliminate the unfavorable factors that provoke the development of the pathological process. In the first days of the disease, the patient is shown bed rest.
Drug treatment of bronchitis in children includes the use of antiviral drugs; when the body temperature rises above 38 ° C, antipyretic drugs are prescribed. In case of bronchospasm and in the absence of mucus hypersecretion, antitussives are used. With the beginning of coughing up sputum, they stop taking them. To improve the excretion of sputum, expectorant drugs, mucolytic agents are used.
Antitussives for bronchitis in children improve sputum discharge
Steam and aerosol inhalations of antiseptic and anti-inflammatory drugs are effective.
Patients are shown an abundant drinking regimen, intake of vitamin complexes, immunostimulants, and a diet.
Antibiotics for bronchitis in children are used in the case of a bacterial infection, as well as in the chronic form of the disease (with the separation of purulent sputum and the pathogen detected in it) and a pronounced inflammatory process. Antibacterial drugs are usually used in tablet form, but in some cases, parenteral administration of antibiotics may be required.
In severe bronchitis in children, hospitalization in a pulmonary hospital is indicated. In milder forms of bronchitis in children, treatment is outpatient.
In the case of severe bronchial obstruction, oxygen therapy, cupping massage, hot foot baths are used. Nebulizer therapy is effective.
Treatment of recurrent forms of bronchitis in children during exacerbations is similar to the treatment of acute forms of the disease.
Treatment of chronic bronchitis in children is longer and requires an integrated approach. In some cases, medical bronchoscopy is performed, during which the bronchi are washed with medicinal solutions. In chronic bronchitis of allergic etiology, antihistamines are indicated. The main treatment can be supplemented with physiotherapy methods, vibration massage, physiotherapy exercises, breathing exercises.
Dispensary observation is indicated for patients with chronic bronchitis. In the absence of exacerbations of the disease for two years, the patient is removed from the dispensary.
During periods of remission, children with chronic bronchitis are shown sanatorium treatment.
The effectiveness of treatment in the chronic form of the disease is assessed by the immediate and distant clinical outcomes - by the severity and rate of disappearance of signs of bronchitis in children, as well as by the duration of the period of absence of the disease and the frequency of relapses.
Possible complications and consequences
Against the background of bronchitis, children can develop: bronchopneumonia, chronic obstructive pulmonary disease, pulmonary emphysema, bronchiectasis, pulmonary hypertension, bronchial asthma.
Forecast
With timely diagnosis and adequate treatment, the prognosis is favorable, it worsens with the transition of bronchitis to a chronic form. In about 30% of cases of recurrent obstructive bronchitis in children, the disease transforms into bronchial asthma.
Prevention
In order to prevent the development of bronchitis in children, as well as to prevent recurrence of the disease and its transition to a chronic form, it is recommended:
- timely treatment of bronchopulmonary diseases and infectious processes in the body;
- routine vaccinations;
- hardening of the body;
- increased immunity;
- balanced diet;
- sufficient physical activity;
- improvement of social conditions;
- refusal of surrounding adults from smoking in the presence of a child.
YouTube video related to the article:
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!
