Recurrent bronchitis

Recurrent obstructive bronchitis

Recurrent obstructive bronchitis is a repeated exacerbation of bronchial obstruction that occurs several times in a single season, usually against the background of an existing infection. Simply put, cured acute obstructive bronchitis, can become aggravated once a person falls ill with an ordinary cold. Similar outbreaks of exacerbation that occur several times in a short period of time are usually called relapses.

ICD-10 code J44 Other chronic obstructive pulmonary disease J44.0 Chronic obstructive pulmonary disease with acute respiratory infection lower respiratory tract J44.1 Chronic obstructive pulmonary disease with exacerbation, unspecified J44.8 Other specified chronic obstructive pulmonary disease J44.9 Chronic obstructive pulmonary disease, unspecified J41 Simple and mucopurulent chronic bronchitis

What causes recurrent obstructive bronchitis?

Provocative of relapses of obstructive bronchitis are acute respiratory infections. Most often, such a disease is characteristic of children, and of an early age. In the medical field, recurrent obstructive bronchitis is known as a harbinger of bronchial asthma.

This is explained by the fact that children prone to frequent obstructions of the bronchial tree are most prone to develop further attacks of bronchial asthma.

How does recurrent obstructive bronchitis occur?

As already mentioned above, relapses are called repeated outbreaks of a recent illness. In the case of obstructive bronchitis, relapses may occur within the first two years. The impetus for relapse is the infectious disease of the body, it is SARS.

On the background of the main symptoms of acute respiratory viral infection: insignificant or subfebrile body temperature, reddening of the throat, enlarged tonsils, discharge from the nose, coughing turning into a strong dry cough. General weakness of the body, lack of appetite. Within a few days, the symptoms of SARS decrease, and the cough acquires a wet character, the mucous or mucopurulent sputum escapes.

In the lungs can be heard rough rales, single, dry or wet, small or large bubble, with a changing quantitative and qualitative index before and after coughing.

For relapsing conditions, it is important to observe during the periods of remission, recovery of the organism after the disease. It is worth noting that after the acute phase of recurrent obstructive bronchitis subsides during the remission period, the so-called "increased readiness for cough" is observed. An example is the situation in which a breath of fresh frosty air or other provoking factor causes a strong attack of cough.

How to recognize recurrent obstructive bronchitis?

The most informative methods are the radiographic image of the chest, in which you can clearly see the greatly enlarged pulmonary pattern. The clarity of the pulmonary pattern is more pronounced in the period of exacerbation, but also in the state of remission its increase significantly differs from the norm values.

In the acute period, bronchoscopy is very informative. With its help, the distribution of catarrhal or catarrhal-purulent endobronchitis can be detected in a timely manner.

The bronchography is also indicative in which a contrast medium is introduced into the bronchi and the bronchial tree is observed to follow it. Recurrent obstructive bronchitis gives a picture of a very slow or partial filling of the bronchi, or a visible narrowing of the bronchial lumen, which indicates the presence of bronchospasm.

In clinical and biochemical analyzes of blood and urine, no significant changes in the character of the examined disease are detected.

Differential diagnostics

When making an accurate diagnosis, in young children, a detailed differential diagnosis should be carried out to exclude bronchial asthma. The diagnosis of bronchial asthma will be made if:

• Exacerbation of obstruction more than three times in a row for a calendar year.
• An aggravated allergic anamnesis or the presence of any severe allergic reaction.
• Eosinophilia (presence of eosinophils in peripheral blood).
• Absence of fever in the period of an attack of obstruction.
• Positive allergic indices in the blood.

Who to contact?

Pulmonologist

What is the treatment for recurrent obstructive bronchitis?

The algorithm for the treatment of acute obstructive bronchitis is also used to treat relapses of this disease. Separate, specially developed treatment regimens are relapses - no. To exclude the subsequent repetition of the disease, it is necessary to conduct constant and targeted prevention.

For the treatment period, the necessary rest, nourishment and breathing regime is provided. For the inhaled air, indices are required for the total temperature, it should be within the range of +18 - +20 degrees and humidity not lower than 60%. Warm and moist air promotes the removal of bronchospasm, dilution of sputum and the alleviation of the condition as a whole.

The main task in the treatment of obstructive bronchitis is to remove the bronchial jam. With this task, the drugs of such groups as mucolytics and bronchodilators are successfully cope, consistently applied, according to certain schemes. To small children more often similar preparations are appointed or nominated in the form of inhalations.

Antibiotic therapy is prescribed solely on indications. Can be a period of 3 to 7 days.

A good therapeutic effect is provided by physiotherapy and physiotherapy exercises, massage exercises aimed at improving blood circulation and ventilation of the lungs.

In difficult situations, when repetitions of obstruction occur frequently, treatment can be delayed up to three months or more. The treatment includes preparations used in bronchial asthma in mild form.

Specific individual schemes and doses of drugs are prescribed, depending on the degree of complexity of the form of the disease, the age of the child and the presence of concomitant diseases.

In addition to treatment

Treatment of bronchitis Physiotherapy with bronchitis Obstructive bronchitis: treatment with folk remedies Treatment of obstructive bronchitis at adults Antibiotics at a bronchitis Antibiotics at a bronchitis at adults: when appoint or nominate, names Than to treat? Fagotsef Cebanex

What is the prognosis of recurrent obstructive bronchitis?

A child's body many diseases simply outgrow. Obstructive bronchitis is one of such diseases.

On a follow-up visit, children are present for 2-3 years after the first attack of the disease and are removed from it if there were no relapses during the period of observation. From all this it follows that recurrent obstructive bronchitis has a favorable prognosis for complete cure.

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Why there is a recurrent bronchitis?

Recurrent bronchitis is a re-inflammation of the bronchi.A characteristic feature of the disease is that it is repeated every year, on average, the exacerbation lasts two weeks.Recurrent bronchitis often appears in childhood.

Regarding chronic bronchitis in children, it should be noted that they are always secondary and can occur with various diseases of the bronchial system. Repeated manifestations of bronchitis often occur because of the hereditary predisposition of the child, for example, if parents are concerned about respiratory tract diseases. In addition, the disease often overtakes children who have a blood group of 0 (1), intrauterine malnutrition or rickets. Recurrent bronchitis often develops in preschool children.

The disease can occur after the child has recovered from acute pneumonia, tuberculosis or whooping cough.

The pathogenesis of the disease depends on the general state of the immune system.

The course of recurrent bronchitis in children

As a rule, the child's organism reacts to seasonal changes. Thus, exacerbations of diseases are often observed in autumn or winter, in some cases in the spring. Also, exacerbations occur after contact with a viral patient. Recurrent bronchitis in children can occur as a result of hypothermia and overwork. As for the course of the disease, it should be noted that it is more easily tolerated than in the primary manifestation.

Among the symptoms of recurrent rickets: fever and headache. Runny nose with pus is rare, in some cases, there is a sore throat. With relapsing bronchitis, the child often has a headache, after a few days a cough develops.

In the early days, a dry cough disturbs, while the process is accompanied by soreness. After a while it becomes wet: sputum is separated. In some cases, coughing overtakes during or after sleep. With relapsing bronchitis in a person there are wheezing during breathing. When bronchitis affects the major bronchi, so there can be no wheezing. Determine the amount of sputum in preschool children is very difficult, but the daily sputum in a schoolboy does not exceed 25 ml.

Diagnosis of the disease

To identify relapsing obstructive bronchitis in children, it is necessary to conduct a cytological examination. If the disease lasts more than 10 years, serious damage occurs in the bronchi. Changes in the x-ray character are noted when the recurrent bronchitis is at the stage exacerbation, with the expansion of the roots of the lungs, the nearby bronchi are not clearly seen in the picture.

If a teenager has a relapsing bronchitis for about 10 years, the picture shows a deformation of the roots. If you perform bronchoscopic examinations, the child can detect inflammation in the large bronchi, as well as in the trachea. Inflammatory changes are usually not purulent. When the period of remission comes, the bronchoscopic signs of the disease are not so pronounced - this may indicate a latent course of the disease. Schoolchildren suffering from recurrent bronchitis suffer from acute pneumonia more often than healthy children.

Treatment of the disease

To rid the child of such a problem, it is necessary to take care of the treatment as soon as possible. If in the first year of life the child suffers an acute respiratory infection or pneumonia, it is necessary that the ENT and the radiologist are engaged in treatment. In the event that the bronchitis worsens, the doctor prescribes a strict bed rest, on average for a week.

That the child quickly recovered, it is necessary to create suitable conditions: try to ventilate the room as often as possible, but do not allow the child to supercool. As for antibacterial treatment, it should be noted that its duration should be 8 days. If there are concomitant diseases, they also need to be treated. In the process of treatment, agents that are capable of softening the sputum and providing it with expectoration are used.

In the first week you can use aerosols with soda-salt solutions, then you can use aerosols with chamomile and sage. In some cases, the doctor prescribes drugs that can increase the body's resistance and provide stimulation of cellular immunity. If the disease is manifested in the summer, you can prescribe treatment at a local pulmonary sanatorium. During the period of remission, it is important to strictly observe the regime of the day and monitor diet. It is desirable to do gymnastics, which will strengthen the diaphragm and muscles of the chest. It is recommended to spend enough time in the open air, play outdoor games, if possible, go swimming.

In children who are not yet 5 years old, recurrent bronchitis appears quite often. They should be under strict dispensary supervision, which should be conducted despite clinical well-being. If the patient is removed from the dispensary, additional tests should be carried out.

If a teenager suffers from a relapsing bronchitis, in the future he can not work on posts related to hypothermia, and in dusty conditions. To ensure the prevention of recurrent bronchitis, it is necessary to treat viral diseases in a timely manner, it is important to completely give up smoking. If the child has recurrent bronchitis, it is necessary to consult a therapist and a pulmonologist.

respiratoria.ru

Recurrent obstructive bronchitis in children

Recurrent obstructive bronchitis in children is an obstructive bronchitis, the episodes of which are repeated in young children against the background of ARVI. Unlike bronchial asthma, obstruction is not of a paroxysmal nature and is not associated with exposure to non-infectious allergens. Sometimes repeated episodes of obstruction are associated with chronic aspiration of food. In some children, relapsing obstructive bronchitis is the debut of bronchial asthma (at-risk groups: children with allergy symptoms in a personal and family history, and with 3 or more episodes of obstruction.

Causes of recurrent obstructive bronchitis in children

In the etiologyrecurrent obstructive bronchitis is played by the role of persistence of respiratory viruses - PC, adenoviruses; in recent years has increased in the development of recurrent obstructive bronchitis of mycoplasmal and chlamydial infections.

Pathogenesis of recurrent obstructive bronchitis

Bronchoobstructive syndrome is largely due to the anatomical and physiological features of the respiratory system in young children: narrowness of airborne ways, looseness and hydrophilicity of the mucous membrane of the bronchial tree, its propensity to swelling and hypersecretion against the background of the inflammatory process of any nature. In recent years, it has been shown that ARVI can provoke the development of temporary (transient) hyperreactivity of the bronchi during 4-6 weeks from the onset of the disease (the viruses penetrate the submucosal layer of the bronchi and lead to irritation of the nerve endings). Thus, even after reconvalescence of the patient from ARVI for 1 month he may have signs of bronchial hyperreactivity (GHR) and the risk of recurrence of obstructive bronchitis. Foci of chronic respiratory infection can lead to the formation of more resistant bronchial hyperreactivity. Risk factors predisposing to the emergence of hyperreactivity of the bronchi are: an unfavorable heredity to bronchial obstructive diseases; possible immunological anomalies of general and local character; diseases of the nervous system; Atopic "mood"; hyperplastic changes in the upper respiratory tract. Consequently, in some patients, relapsing obstructive bronchitis may later be transformed into bronchial asthma or to be its debut, in this sense, it certainly is a factor of high risk of developing bronchial asthma. Diagnosis of bronchial asthma in such children should be made in the presence of signs of atopy in the anamnesis and with the recurrence of 3 or more episodes of bronchial obstruction.

Symptoms of recurrent obstructive bronchitis in children

Exacerbation of recurrent obstructive bronchitis occurs against the background of acute respiratory viral infection and the clinic corresponds to acute obstructive bronchitis. With chlamydial infection, there may be conjunctivitis, pharyngitis with a pronounced "granularity" on the back wall of the pharynx and an increase in lymphatic cervical nodes, a persistent cough against a moderate fever, and then a bronchoobstructive syndrome develops. Mycoplasma infection is characterized by a rise in body temperature to 38-39 C, intoxication (lethargy, may be vomiting), symptoms of vegeto-dystonia (pallor, "marbling" of the skin, sweating); locally - mild hyperemia of the pharynx, dry mucous membranes, poor mucus production in rhinitis and pharyngitis, obstructed nasal breathing, in 70% of patients radiographically noted changes in the sinuses of the nose, although the clinic of sinusitis is poorly expressed. One of the leading symptoms of relapsing obstructive bronchitis with mycoplasmal infection is dry cough, painful, it can cause vomiting and leads to disruption of the baby's sleep. Then develops an obstructive syndrome with all its inherent manifestations. In 50% of cases with mycoplasmal infection, obstructive recurrent bronchitis is resolved slowly, bronchodilators have insufficient effect.

Where does it hurt?

Chest pain

What's bothering you?

Shortness of breath Cough Chypuses in the lungs

What it is necessary to survey?

Bronchi

How to inspect?

X-rays of light

What tests are needed?

General blood analysis

Who to contact?

Pulmonologist Pediatrician

Treatment of recurrent obstructive bronchitis in children

During the period of exacerbation (relapse), the tactic is the same as in acute obstructive bronchitis, during the inter-recurrent period, as with relapsing bronchitis.

In addition to treatment

Physiotherapy for bronchitis Antibiotics for bronchitis Treatment of bronchitis

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