Viral bronchitis: symptoms, signs, treatment
The content of the article:
- Causes and risk factors
- Bacterial or viral bronchitis: how to distinguish
- Symptoms of viral bronchitis
- Diagnostics
- How to treat viral bronchitis
- Complications
- Forecast
- Prevention
- Age features
- Video
Viral bronchitis is an acute inflammation of the trachea, bronchi and bronchioles caused by viruses and lasting no more than one month. Depending on the level of airway damage, they are divided into several groups:
- tracheobronchitis;
- bronchitis, with a predominant lesion of the medium-sized bronchi;
- bronchiolitis.
By the nature of the exudate, bronchitis of viral etiology are catarrhal or mucous. When a streptococcal infection is attached, a purulent form of the disease may develop.
Bronchitis due to viral infection begins as acute respiratory infections
Causes and risk factors
The most common causes of the disease are:
- influenza viruses;
- adenoviruses;
- parainfluenza viruses;
- rhinoviruses;
- Coxsackie virus;
- rubella virus;
- measles virus;
- respiratory syncytial viruses.
Factors that increase the risk of developing the disease include:
- children or old age;
- hypertrophy of the palatine and / or nasopharyngeal tonsil;
- chronic sinusitis;
- chronic obstructive pulmonary disease (COPD);
- immunodeficiency states;
- allergic diseases;
- alcohol abuse;
- smoking, including passive smoking;
- air pollutants (chemical agents, dust);
- reflux esophagitis.
Viruses, getting on the mucous membrane of the bronchi, cause its inflammation, which is accompanied by:
- hyperemia and edema of the mucous membrane;
- hypertrophy of the mucous glands;
- infiltration of the submucosal layer;
- violation of the ciliary function of the cells of the ciliary epithelium;
- an increase in the number of goblet cells.
Edema of the mucous membrane and submucosal layer in combination with increased production of serous or mucous exudate cause a violation of bronchial conduction, the appearance of cough.
Bacterial or viral bronchitis: how to distinguish
Viruses are the causative agents of acute bronchitis in 90% of cases. Much less often, the disease develops as a result of infection of the body with bacteria or fungi. Treatment for viral and bacterial bronchitis differs, so it is important to know the differences between these forms of the disease.
You can distinguish between viral and bacterial bronchitis by the symptoms described in the table.
| Sign | Viral bronchitis | Bacterial bronchitis |
| Frequency of occurrence | Often | Seldom |
| Incubation period | From several hours to 5 days | 2-10 days |
| Constant presence of the pathogen in the body | Adenoviruses only | Typical for many bacteria (streptococcus, pneumococcus, Haemophilus influenzae) |
| Prodromal period | Usually pronounced, lasts up to 24 hours | Practically invisible |
| Onset of the disease | The disease begins acutely, with a rapidly increasing body temperature and growing signs of intoxication | The disease develops gradually. The body temperature almost never rises above 38 ° C. In most cases, bacterial bronchitis develops as a complication of viral, this is the so-called second wave of infection |
| Lesion of mucous membranes (rhinitis, pharyngitis, conjunctivitis) | It is noted in most cases | Not typical |
| Treatment features | During the prodrome, the use of antiviral drugs is very effective. | Antibiotic treatment |
Symptoms of viral bronchitis
Features of the clinical manifestations of bronchitis in adults and children are determined by the nature, severity and prevalence of the inflammatory process, the level of bronchial damage (large, medium, small).
The onset of the disease is preceded by signs of ARVI:
- runny nose and nasal congestion;
- sore throat;
- hoarseness of voice;
- conjunctivitis;
- increased body temperature, often with chills;
- rapid fatigue, general weakness;
- headache;
- pain in muscles and joints.
If acute bronchitis is caused by measles or rubella viruses, then it is accompanied by the appearance of a characteristic rash on the skin.
From the very beginning of acute bronchitis of viral etiology, the patient has a paroxysmal, resonant and rough cough. It is dry and unproductive at first. Due to the spastic contraction of the diaphragm during coughing and overexertion of the pectoral muscles, pain occurs in the lower chest and abdominal wall. After a while, a viscous and scanty sputum appears. Gradually, its character changes, and it becomes less viscous and separates much more easily.
A protracted and severe course of the disease is observed when bronchioles are involved in the pathological process, which is accompanied by the development of a pronounced obstructive syndrome, circulatory and gas exchange disorders. Against the background of bronchiolitis, a sharp deterioration in the patient's condition occurs. He has:
- severe shortness of breath (over 40 respiratory movements per minute);
- pallor of the skin, followed by cyanosis in the future;
- general anxiety and agitation, which, as hypercapnia (increased content of carbon dioxide in the blood) intensifies, are replaced by drowsiness, lethargy;
- excruciating, unproductive cough with scanty mucus;
- lowering blood pressure;
- tachycardia.
Diagnostics
The diagnosis is made based on the symptoms of the disease, the results of instrumental and laboratory studies.
The auscultatory picture is characterized by hard breathing and the presence of diffuse dry wheezing. With the accumulation of secretion in the bronchi, moist rales appear, which usually disappear after coughing up sputum.
A general blood test helps to make a differential diagnosis between viral, bacterial and allergic bronchitis. The parameters typical for each form of the disease are presented in the table.
| General blood test parameter | Viral bronchitis | Bacterial bronchitis | Allergic bronchitis |
| Leukocyte count | Decreased (leukopenia) | Increased (leukocytosis) | Complies with the norm |
| Features of the leukocyte formula | Increased lymphocyte count | There is a shift to the left | Increased number of eosinophils |
| Erythrocyte sedimentation rate (ESR) | Corresponds to the values of the norm or slightly increased | Increased (moderate to significant) | Corresponds to the values of the norm or slightly increased |
If necessary, the patient is prescribed an instrumental examination:
- radiography of the lungs;
- study of the function of external respiration;
- bronchoscopy;
- electrocardiography.
The disease requires differential diagnosis with miliary pulmonary tuberculosis, bronchopneumonia, bronchial foreign body, cystic fibrosis, acute sinusitis, bronchiectasis.
There are a number of signs that distinguish bacterial from viral bronchitis, but only a doctor can make an accurate diagnosis.
How to treat viral bronchitis
In adults and children, the treatment of viral bronchitis in most cases is carried out on an outpatient basis. The indications for hospitalization are:
- infancy or old age;
- the presence of severe concomitant pathology;
- the development of complications (pneumonia, obstructive syndrome).
For the entire febrile period, patients are prescribed bed rest, diet food and abundant warm drinks. No smoking. The room must be regularly ventilated and wet cleaned 2-3 times a day.
Medication therapy includes the following drugs:
- antipyretic (Aspirin, Paracetamol);
- antiviral (Interferon, Remantadin);
- antitussives (Libeksin, Codeine, Codelac) - only at the stage of dry, unproductive cough;
- expectorant and mucolytics (Ambroxol, Mukaltin, thermopsis herb infusion)
- antispasmodics (Euphyllin, Drotaverin);
- immunomodulators and vitamins.
Alkaline inhalation is recommended to dilute sputum and improve its coughing.
Antibiotics for uncomplicated course of the disease are not used. The indications for their appointment are:
- prolonged course of bronchitis;
- pronounced inflammatory response;
- the presence of concomitant COPD;
- the appearance of purulent sputum.
In complex therapy, physiotherapy methods (UHF, diathermy, inductothermy, UFO), as well as vibration massage, respiratory and therapeutic gymnastics, are of no small importance.
Complications
With an untimely started or inadequate treatment, bronchitis can lead to the development of a number of complications:
- bronchiolitis;
- bronchopneumonia;
- acute respiratory failure.
Frequently recurring bronchitis of viral etiology increases the risk of developing asthmatic bronchitis, bronchial asthma, pulmonary emphysema.
Bronchitis is especially difficult in the elderly.
Forecast
The prognosis is favorable in most cases. The disease ends with complete recovery within 2-4 weeks. The prognosis worsens with the development of complications (pneumonia, bronchiolitis).
Prevention
Prevention includes the following measures:
- increasing the general defenses of the body (proper nutrition, adherence to the daily regimen, staying in the fresh air, maintaining an active lifestyle);
- timely vaccination against measles, rubella, influenza;
- to give up smoking;
- ecological improvement of the environment;
- timely and adequate treatment of underlying diseases (reflux esophagitis, sinusitis, bronchial asthma).
Age features
In the elderly, bronchitis caused by a viral infection is very often severe and leads to the development of acute respiratory and cardiovascular failure. Inflammation of the bronchi caused by the influenza virus is especially difficult in this category of patients.
In children with frequent bronchitis, a thorough medical examination is necessary in order to exclude congenital malformations of the respiratory system.
Video
We offer for viewing a video on the topic of the article.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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