Acute bronchitis: symptoms, causes, diagnosis, treatment
The content of the article:
- Types of acute bronchitis
- Causes and risk factors
- Symptoms of acute bronchitis
- Diagnostics of the acute form of bronchitis
- Treatment of acute bronchitis in adults and children
- Prevention
- Video
Acute bronchitis is one of the forms of diffuse inflammation of the bronchi, in which there is a violation of their patency and increased production of bronchial secretions.
Acute bronchitis code according to ICD-10 (International classification of diseases of the 10th revision) - J20.
How to treat acute bronchitis, what medications should be taken, depends on the cause of the development of the pathological process, the symptoms present and the severity of the course of the disease. The decision to recognize the temporary disability of a patient with acute bronchitis is made in accordance with the relevant standards.
The acute form of bronchitis is accompanied by a severe cough due to inflammatory exudate in the bronchi
Types of acute bronchitis
The acute form of bronchitis refers to common pathologies of the respiratory system, can develop independently (primary bronchitis) or be a complication of another pathology (secondary bronchitis).
In the acute form of bronchitis, inflammation in most cases has a diffuse character, much less often a segmental inflammatory process is noted (as a rule, as part of another local inflammatory process).
Depending on the level of damage to the lower respiratory tract, the disease is subdivided into tracheobronchitis, bronchitis, in which mainly medium-sized bronchi are affected, bronchiolitis.
Depending on the nature of the exudate, bronchitis can be catarrhal or (less often) purulent, which is usually observed in the case of a streptococcal and / or viral infection.
Causes and risk factors
Bronchitis can be infectious, non-infectious, or of mixed or unknown origin.
Often, the cause of the development of an acute form of bronchitis is viral diseases (influenza and parainfluenza, acute respiratory viral infections, rubella, measles), less often the disease occurs against the background of a bacterial infection, while the causative agents can be staphylococci, pneumococci, chlamydia.
The causative agents of infection can enter the respiratory tract by air, as well as by hematogenous or lymphogenous routes.
Primary bronchitis of bacterial etiology is recorded quite rarely, usually a bacterial infection is secondary.
The reason for the development of an acute form of bronchitis of non-infectious etiology can be inhalation of dust, smoke, hot dry or cold air, acid vapors, alkalis, ammonia, chlorine, hydrogen sulfide. The disease can also occur with a combination of infectious and physicochemical factors.
Acute allergic bronchitis usually develops when the patient has a genetic predisposition.
Risk factors include hypothermia, industrial hazards, bad habits, chronic infectious diseases of the upper respiratory tract, impaired nasal breathing, malnutrition, stagnation in the pulmonary circulation. The acute form of the disease is more often observed in children and in elderly patients.
Symptoms of acute bronchitis
Symptoms of the acute form of bronchitis depend on the cause and nature of the pathology. The onset of the disease is usually acute, the patient has signs of damage to the upper and lower respiratory tract, intoxication. Acute infectious bronchitis often begins with signs of an acute respiratory viral infection.
Acute bronchitis is characterized by hyperemia and edema of the mucous membrane of the respiratory tract, degeneration of the ciliary epithelium with a decrease in its barrier function, infiltration of the submucosal layer, and an increase in the number of goblet cells. Due to the increased production of mucus in the acute form of bronchitis, obstruction of the small-caliber bronchi and bronchioles is noted. On the inner surface of the bronchi, serous, mucous or mucopurulent exudate is detected. In the acute form of the disease, inflammation of the bronchial mucosa is usually noted, however, in a severe course of the disease, the submucosa and muscle layers may be involved in the inflammatory process.
Clinically, this is manifested by the following symptoms: discharge from the nasal cavity, nasal congestion, sore throat, hoarseness, excessive sweating, muscle pain, shortness of breath, bronchospasm, fever, headache, weakness and fatigue. With a mild form of bronchitis, the temperature may not rise.
One of the main symptoms of the disease is a dry cough, which usually develops at the beginning and lasts throughout the entire period of the disease. The cough can be paroxysmal, barking. During coughing attacks, the patient has a burning sensation behind the breastbone. Due to excessive tension of the pectoral muscles and contraction of the diaphragm, pain in the chest and abdomen is observed during coughing attacks.
Sputum at the onset of the disease is viscous and separated in small quantities; with the progression of the pathological process, it leaves more easily, becoming less viscous. In case of allergic bronchitis, the patient produces light vitreous sputum.
With the development of an acute form of bronchitis against the background of childhood infections, its symptoms are combined with signs of the underlying disease.
In the case of the development of bronchitis against the background of inhalation of toxic substances, laryngospasm develops, there is a feeling of lack of air, tightness in the chest.
With the transition of the inflammatory process from the bronchi to the bronchioles (bronchiolitis), the process is more difficult, has a protracted course. The patient's condition deteriorates sharply, there is a fever, shortness of breath, a painful cough, pallor and / or cyanosis of the skin is observed, blood pressure may decrease and the pulse becomes more frequent.
The disease can be accompanied by asthmatic bronchitis, respiratory and heart failure (more often in elderly patients). With frequent relapses, the disease becomes chronic, such patients have a high risk of developing bronchial asthma, chronic obstructive pulmonary disease, pulmonary emphysema.
Diagnostics of the acute form of bronchitis
Before starting treatment for bronchitis, the patient is referred for examination. To make a diagnosis, the data obtained from the study of the medical history, collection of complaints and anamnesis, physical examination, laboratory and instrumental studies are used. A general and biochemical blood test, an immunological blood test, a general urine test, sputum culture for microflora (with determination of sensitivity to antibacterial drugs, if necessary), a study of respiratory functions, bronchoscopy, X-ray examination of the lungs, if necessary - electrocardiography, echocardiography, etc.
During auscultation of the chest, hard breathing, dry wheezing are noted. With the accumulation of secretions in the bronchi, the patient may hear moist fine-bubbling rales, which disappear after coughing up sputum.
In a blood test for this form of bronchitis, an increase in the erythrocyte sedimentation rate, neutrophilic leukocytosis, an increase in the number of eosinophils (with allergic bronchitis) are revealed.
Differential diagnosis is carried out with bronchopneumonia, miliary tuberculosis.
Treatment of acute bronchitis in adults and children
In case of acute bronchitis, you should not take any medications without consulting your doctor.
In most cases, patients with acute bronchitis do not require hospitalization; treatment is carried out on an outpatient basis. Hospitalization in the department of pulmonology is carried out in case of severe and complicated course of the disease (with the development of pneumonia, the presence of obstructive syndrome).
At elevated body temperature, the patient is shown bed rest, adherence to a diet, and an abundant drinking regime. It is recommended to drink hot tea with honey, lemon, raspberry jam, lime tea, warm alkaline mineral water (in the absence of contraindications).
A patient with bronchitis should stop smoking. The room in which there is a patient with an acute form of bronchitis should be well ventilated and maintain optimal humidity.
With the development of the disease against the background of an acute respiratory viral infection, analgesic, antipyretic drugs (usually a group of non-steroidal anti-inflammatory drugs in a short course), and plenty of drinking are prescribed.
Medication for bronchitis is prescribed and monitored by a doctor
Sulfonamides and antibiotics are indicated when a bacterial infection is attached.
Expectorants, mucolytic drugs, steam alkaline inhalation can be used to dilute sputum.
In the presence of bronchospasm, antispasmodics, antiadrenergic drugs, and in some cases steroid hormones may be prescribed.
For the treatment of acute allergic bronchitis, antihistamines and glucocorticosteroids are used.
Of the folk remedies for treating the disease at home, infusions and decoctions of medicinal herbs (breast collection, tea from dry raspberries, marshmallows, thermopsis) are effective. After suffering acute bronchitis, natural adaptogens (eleutherococcus, echinacea, ginseng) can be used to stimulate recovery processes.
Physiotherapy procedures can be shown after acute inflammation subsides in the stage of convalescence, especially if there is a risk of chronicity of the pathological process. Prescribe ultra-high-frequency therapy, diathermy, inductothermy, ultraviolet irradiation, as well as physiotherapy exercises, vibration massage. For such patients, spa treatment may be recommended.
With timely diagnosis and correctly selected treatment, uncomplicated bronchitis usually lasts 1-3 weeks, functional indicators are restored within a month. Treatment of protracted bronchitis can be 1-1.5 months. With the development of purulent bronchitis, bronchiolitis, the prognosis worsens.
Prevention
In order to prevent the development of an acute form of bronchitis, it is recommended to avoid industrial hazards, abandon bad habits, timely treatment of diseases that can lead to a pathological process, increased immunity, proper nutrition. According to clinical guidelines, compliance with the rules of personal hygiene is of no small importance (especially frequent hand washing and minimization of contact of hands with eyes and nose), since many infectious agents are transmitted by household contact.
Video
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
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