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Acute bronchitis in children
Medical expert of the article
Last reviewed: 04.07.2025
Acute bronchitis (simple) - bronchitis that occurs without signs of bronchial obstruction. This is an inflammatory disease of the bronchi with increased bronchial secretion, the main symptoms of which include cough, dry and moist rales of various sizes, radiologically - the absence of infiltrative or focal changes in the lung tissue; bilateral enhancement of the pulmonary pattern and roots of the lungs may be observed.
[ What causes acute bronchitis in children?
In young children, acute bronchitis is usually a manifestation or complication of ARVI. Acute bronchitis is more common with parainfluenza, adenovirus, and respiratory syncytial infections.
Factors that contribute to the development of bronchitis:
- endogenous-constitutional (lymphatic constitution, allergy);
- changes in immunological status - decrease in IgA, IgG;
- age-related anatomical and physiological characteristics of the respiratory organs in children - imperfection of protective barriers, tendency to exudation, imperfection of functions;
- concomitant diseases (malnutrition, rickets, anemia, polyhypovitaminosis);
- exogenous influences - cooling, airborne allergens, atmospheric fluctuations, parental smoking, air pollution (mechanical or chemical irritation of the mucous membrane by dust of mineral or plant origin, gases).
Acute bronchitis in children is most often caused by viruses (parainfluenza types I and II, PC viruses, adenoviruses, influenza viruses, cytomegalovirus). Activation and movement of autoflora from the nasopharynx is possible under the influence of physicochemical factors, hypothermia. In most cases, viral-bacterial associations are confirmed in the etiology of acute simple bronchitis, in which viruses that have tropism for the epithelium of the respiratory tract damage it, reduce the barrier properties of the bronchial wall and create conditions for the development of a bacterial inflammatory process. Most often, we are talking not about invasive, but intralaminar reproduction of opportunistic bacterial autoflora.
Symptoms of acute bronchitis in children
Acute bronchitis in children usually begins gradually. Against the background of the distinctive features of ARVI, inherent in a particular respiratory virus, there is an increase in coughing, especially at night. The cough is initially dry, rough, sometimes intrusive, without secretions or with a difficult to separate lump of mucous sputum after repeated coughing shocks. Body temperature in the first days depends on the nature and course of ARVI, then with the clinic of uncomplicated bronchitis - normal or subfebrile. Young children may have such nonspecific symptoms of acute bronchitis as: lethargy, moodiness, sleep and appetite disturbances. With simple bronchitis, signs of bronchial obstruction and respiratory failure are not noted.
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Acute bronchitis in children usually lasts 2-3 weeks.
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How is acute bronchitis diagnosed in children?
Differential diagnostics of acute bronchitis in children is carried out with pneumonia, bronchopulmonary diseases, exacerbations of which can occur with the clinical picture of acute bronchitis (cystic fibrosis, bronchiectasis, etc.). If pneumonia is suspected (asymmetry of physical data, pronounced signs of intoxication), chest X-ray is mandatory.
In the presence of clear clinical and anamnestic data indicating acute bronchitis, radiographic examination is not necessary.
An X-ray examination becomes mandatory if there is a suspicion of a local or predominantly unilateral nature of the lesion during examination of the bronchopulmonary system, especially when combined with fever for more than three days, severe signs of intoxication, leukocytosis, neutrophilia and increased ESR.
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Treatment of acute bronchitis in children
Treatment of acute bronchitis (simple) should be comprehensive, taking into account the reactivity of the sick child's body, the characteristics of the nature of the course and period of it. With this form of bronchitis, home regime is preferable. Hospitalization is possible only in case of severe concomitant pathology or severe course of a viral infection. The regime in the acute period is bed rest for several days. It is necessary to provide the freshest air possible (frequent blood ventilation). The diet should include the most vitaminized food, include easily digestible products with a physiological, age-appropriate content of proteins, fats and carbohydrates, with complete proteins and unsaturated fatty acids. To thin phlegm, it is recommended to drink plenty of fluids - milk with sodium bicarbonate, Borjomi, tea with milk, cranberry and lingonberry fruit drinks, linden tea.
Treatment of acute bronchitis in children
Acute bronchitis in children in most cases does not require the use of antibiotics. However, in young children, there are a number of indications for their use: suspected bacterial flora (symptoms of intoxication, purulent sputum, signs of bacterial infection according to general blood test); children with an unfavorable premorbid background (severe rickets, dystrophy, secondary and primary immunodeficiencies; severe anemia); children with severe congenital lung or heart defects. In such cases, oral antibiotics are used: amoxicillin, azithromycin, augmentin, clarithromycin, midecamycin suspension, cefuroxime, ceftriansone. The course is 5-7 days.
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