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Acute bronchitis in children
Last reviewed: 23.04.2024
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Acute bronchitis (simple) - bronchitis, taking place without signs of bronchial obstruction. This inflammatory disease of the bronchi with an increase in bronchial secretion, the main symptoms of which include cough, dry and variegated wet rales, radiologically - the absence of infiltrative or focal changes in the lung tissue; can be observed bilateral enhancement of the pulmonary pattern and the roots of the lungs.
[What causes acute bronchitis in children?
In children of early age, acute bronchitis, as a rule, is a manifestation or complication of acute respiratory viral infection. Acute bronchitis is more common in parainfluenza, adenovirus, respiratory syncytial infections.
Factors contributing to the occurrence of bronchitis:
- endogenous-constitutional (lymphatic constitution, allergy);
- changes in the immunological status - a decrease in IgA, IgG;
- age anatomical and physiological features of respiratory organs in children - imperfection of protective barriers, propensity for exudation, imperfection of functions;
- concomitant diseases (hypotrophy, rickets, anemia, polyhypovitaminosis);
- exogenous influences - cooling, air allergens, atmospheric fluctuations, parents' smoking, air pollution (mechanical or chemical irritations of the mucous membrane with dust of mineral or vegetable origin, gases).
Acute bronchitis in children is caused most often by viruses (parainfluenza type I and II, PC viruses, adenoviruses, influenza viruses, cytomegalovirus). It is possible to activate and move from the nasopharynx of the autoflora under the influence of physical and chemical factors, supercooling. In most cases, the etiology of acute simple bronchitis is confirmed by viral-bacterial associations in which viruses that have a tropism to the epithelium of the respiratory tract, damage it, reduce the barrier properties of the bronchial wall and create the conditions for the development of a bacterial inflammatory process. Most often it is not about invasive, but intralaminar reproduction of opportunistic bacterial autoflora.
Symptoms of acute bronchitis in children
Acute bronchitis in children begins, as a rule, gradually. Against the background of the distinctive features of acute respiratory viral infection, which are peculiar to this or that respiratory virus, coughing intensifies, especially at night. Cough initially dry, rough, sometimes obtrusive, without secreted secretion or with a hard to separate lump of mucous sputum after repeated coughing thrusts. The temperature of the body in the early days depends on the nature and course of acute respiratory viral infection, then at the clinic of uncomplicated bronchitis - normal or subfebrile. Young children may have such nonspecific symptoms of acute bronchitis as: lethargy, moods, sleep and appetite disorders. 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 diagnosis of acute bronchitis in children is carried out with pneumonia, bronchopulmonary diseases, exacerbations of which can occur with the clinic of acute bronchitis (cystic fibrosis, bronchiectasis, etc.). If there is a suspicion of pneumonia (asymmetry of physical data, marked signs of intoxication), chest radiographs must be performed.
If there are clear clinical and anamnestic data, which testify in favor of acute bronchitis, X-ray examination is not necessary.
X-ray examination becomes mandatory if there is a suspicion of a local or predominantly one-sided nature of the lesion when examining the bronchopulmonary system, especially when combined with fever for more than three days, marked by intoxication, leukocytosis, neutrophilia and increased ESR.
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Treatment of acute bronchitis in children
Treatment of acute bronchitis (simple) should be complex taking into account the reactivity of the organism of the sick child, the characteristics of the nature of the course and its period. With this form of bronchitis, home treatment is preferred. Hospitalization is possible only with severe concomitant pathology or in severe viral infection. The regime in the acute period for several days is bed rest. It is necessary to provide the most fresh air (frequent tsrovetrivaniya). In the diet should provide the most vitaminized food, include easily assimilated products with physiological, age-appropriate content of proteins, fats and carbohydrates, with full proteins and unsaturated fatty acids. For liquefaction sputum recommend a plentiful drink - milk with sodium hydrocarbonate, borzom, tea with milk, cranberry and cowberry mors, lime tea.
Treatment of acute bronchitis in children
Acute bronchitis in children in most cases does not require the use of antibiotics. However, in infants, a number of indications can be identified for their use; suspicion of joining the bacterial flora (symptoms of intoxication, sputum purulent sputum, signs of bacterial infection according to the general blood test); children with a disadvantaged premorbid background (severe rickets, dystrophy, secondary and primary immunodeficiencies, severe anemia); children with severe congenital malformations of the lungs or heart. In such cases, oral antibiotics are used: amoxicillin, azithromycin, augmentin, clarithromycin, a suspension of midecamycin, cefuroxime, ceftriaansone. Course 5-7 days.