Bronchitis in children

Bronchitis is an inflammatory process in the bronchi of various etiologies (infectious, allergic, chemical, physical, etc.). The term "bronchitis" covers the lesions of bronchi of any caliber: small bronchioles - bronchiolitis, trachea - tracheitis or tracheobronchitis.

ICD-10 code

J20.0-J20.9.

Bronchitis, unspecified. Both acute and chronic, has code J40. Children younger than 15 years can be considered as acute in nature, then it should be referred to the rubric J20. Recurrent bronchitis and recurrent obstructive bronchitis are introduced in ICD-10 under code J40.0-J43.0.

Read also: Acute bronchitis

Epidemiology of bronchitis

Bronchitis continues to occupy one of the first places in the structure of bronchopulmonary diseases in pediatrics. It is known that children, who often suffer from acute infectious respiratory diseases, constitute a risk group for the development of acute bronchitis, the formation of recurrent bronchitis, including obstructive forms, and chronic pulmonary pathology. The most common form of complications of ARVI is bronchitis. Especially in young children (the age peak of the incidence is noted in children 1 year - 3 years). The incidence of acute bronchitis is 75-250 cases per 1000 children per year.

The incidence of bronchitis is seasonal in nature: they are more often ill during the cold season. Obstructive forms of bronchitis are more often noted in the spring and autumn, i.e. During periods of peak PC and parainfluenza infection. Mycoplasma bronchitis - in late summer and autumn, adenoviral - every 3-5 years.

[1], [2], [3], [4], [5]

Causes of bronchitis in children

Acute bronchitis often develops against the background of ARVI. Inflammation of the bronchial mucosa is observed more often with PC viral, parainfluenza. Adenovirus, rhinovirus infection and influenza.

In recent years, there has been an increase in the number of bronchitis caused by atypical pathogens - mycoplasma pneumonia and chlamydia (Chlamidia trachomatis, Chlamidia pneumonia) infections (7-30%).

What causes bronchitis in children?

[6], [7], [8], [9], [10], [11], [12], [13], [14]

Symptoms of bronchitis in children

Acute bronchitis (simple) develops in the early days of acute respiratory viral infection (1-3 days of the disease). The main general symptoms of a viral infection (low-grade fever, moderate toxicosis, etc.) are typical, and there are no clinical signs of obstruction. Features of the course of bronchitis depend on the etiology: with the majority of respiratory-viral infections, the condition is normalized starting from 2 days, with adenovirus infection - high temperature figures persist up to 5-8 days.

Acute obstructive bronchitis is accompanied by a syndrome of bronchial obstruction, more often in young children on the 2-3rd day of acute respiratory viral infection, with a second episode - from the first day of acute respiratory infections and develops gradually. Acute obstructive bronchitis occurs against the background of PC viral and parainfluenzal type 3 infections, in 20% of cases - with ARVI of another viral etiology. In older children, the obstructive nature of bronchitis is noted with mycoplasmal and chlamydial etiology.

Symptoms of bronchitis in children

Classification of bronchitis

In the prevailing majority of children with bronchitis, obstructive syndrome (50-80%) is observed, and in 1995, acute obstructive and relapsing obstructive bronchitis was included in the classification of bronchopulmonary diseases of children.

There are the following classification of bronchitis:

• Acute bronchitis (simple): bronchitis, which proceeds without signs of bronchial obstruction.
• Acute obstructive bronchitis, bronchiolitis: acute bronchitis, which occurs with a syndrome of bronchial obstruction. Obstructive wheezing is characteristic of obstructive bronchitis, respiratory failure and small bubble moist wheezing in the lungs for bronchiolitis.
• Acute obliterating bronchiolitis: bronchitis with obliteration of bronchioles and alveoli, has a viral or immunopathological nature, severe course.
• Recurrent bronchitis: bronchitis without obstruction, episodes occurring for 2 weeks or more with a frequency of 2-3 times a year for 1-2 years against the background of acute respiratory infections.
• Recurrent obstructive bronchitis: obstructive bronchitis with recurring episodes of bronchial obstruction against the background of acute respiratory viral infection in young children. Attacks are not of a paroxysmal nature and are not associated with exposure to non-infectious allergens.
• Chronic bronchitis: a chronic inflammatory lesion of the bronchi, proceeding with repeated exacerbations.

[15], [16], [17], [18], [19], [20], [21], [22]

Diagnosis of bronchitis in children

Diagnosis of bronchitis is established on the basis of his clinical picture (for example, the presence of obstructive syndrome) and in the absence of signs of pulmonary tissue damage (there are no infiltrative or focal shadows on the roentgenogram). Often, bronchitis is combined with pneumonia, in which case it is diagnosed with a significant addition to the clinical picture of the disease. Unlike pneumonia, bronchitis in ARVI always has a diffuse character and usually evenly affects the bronchi of both lungs. With the prevalence of local bronchial changes in any part of the lung, the appropriate definitions are used: basal bronchitis, unilateral bronchitis, bronchitis of the leading bronchus, and others.

Diagnosis of bronchitis in children

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Treatment of bronchitis in children

The proposed protocols for the treatment of acute bronchitis include necessary and sufficient purposes.

Simple acute viral bronchitis: treatment at home.

A plentiful warm drink (100 ml / kg per day), chest massage, with a wet cough - drainage.

Antibiotic therapy is indicated only if the elevated temperature is maintained for more than 3 days (amoxicillin, macrolides, etc.).

Treatment of bronchitis in children