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Acute tracheobronchitis
Last reviewed: 05.07.2025
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Acute tracheobronchitis is an inflammatory disease of the respiratory tract that affects the mucous membrane of the windpipe (trachea), as well as the bronchial epithelium.
This respiratory disease has the ICD 10 code J06-J21.
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Causes of acute tracheobronchitis
Experts associate the pathogenesis of the disease with the penetration of an infection into the respiratory tract: adeno- or rhinovirus, influenza or parainfluenza viruses, coronavirus, respiratory syncytial virus, as well as bacteria: staphylococci, streptococci, Mycoplasma pneumoniae, Moraxella catarrhalis, coccobacteria Bordetella pertussis or Bordetella parapertussis.
First, a viral or microbial infection can affect the nasopharynx, and then go down: this path of spreading the pathology in the presence of acute respiratory viral infections, flu, and whooping cough is noted as the leading cause of acute tracheobronchitis. Also, a causal relationship between the development of this disease and general hypothermia of the body, exposure of the mucous membranes of the respiratory tract to tobacco smoke or their irritation by gaseous chemicals is not excluded.
With lymphocytic interstitial inflammation, the ciliated epithelium of the trachea and bronchi swells and thickens, and then loosens, after which its desquamation (sloughing off) begins due to damage to the basal membranes of the ciliated epithelial cells.
Symptoms of acute tracheobronchitis
The first signs of acute tracheobronchitis are a spasmodic cough, the attacks of which most often begin during inhalation. In many cases, attacks of uncontrollable coughing torment at night.
At first, the cough is dry, tearing the throat and causing painful sensations in the larynx, hoarseness (or hoarseness) and pain after coughing in the chest area. After a few days, the dry cough becomes productive with the release of serous mucous secretion - sputum, which may contain admixtures of pus or blood. When listening, breathing is harsh, with a whistle on exhalation and wheezing.
Also possible symptoms of acute tracheobronchitis include rhinitis, sore throat, low-grade fever (in the first days of illness), shortness of breath, pain in the chest and diaphragm area, and general weakness.
One of the most alarming aspects of this disease is the long-term nature of the inflammatory process: according to statistics, the average duration of cough in adults with this diagnosis is 18 days. Acute tracheobronchitis in young children has many identical symptoms, and in infants and toddlers up to 1.5-2.5 years old, the clinical picture is supplemented by: increased respiratory rate and pulse, vomiting during coughing fits, increased chest volume, cyanosis of the lips and skin, swelling of soft tissues, increased agitation, seizures.
Complications of acute tracheobronchitis in elderly patients and children under five years of age are expressed in the development of a chronic form of the disease, obstructive bronchitis, focal pneumonia, pulmonary emphysema, chronic obstructive pulmonary disease. The consequences of the disease in young children can lead to chronic breathing problems (partial bronchial obstruction) and even its cessation.
Acute tracheobronchitis during pregnancy
It should be borne in mind that acute tracheobronchitis during pregnancy can lead to the most negative consequences, especially in the last trimester. During a strong cough, the abdominal muscles and diaphragm tense up, intense movements of the diaphragm push the uterus, bringing it into tone. After the 32nd week, this can cause premature labor.
Treatment of cough in pregnant women is possible only with the safest means. These include alkaline drinks (milk with mineral water or soda), inhalations with pine buds, eucalyptus, baking soda and steam from boiled potatoes with the skin. Of the medicinal plants, pregnant women can use an infusion or decoction of marshmallow root and coltsfoot leaves (in the first three months, also an infusion of thyme). Pregnant women should not use oregano, sweet clover or elecampane, licorice or anise seeds.
Antibiotics are contraindicated in the treatment of pregnant women, and if there is an extreme need - a severe infectious lesion, then they should be prescribed by an experienced doctor, since these drugs penetrate the placenta, and their effect on the unborn child is not always studied. Even macrolides, which are considered the most harmless antibiotics, in many cases the instructions indicate that the drug should be used during pregnancy and breastfeeding "only in the absence of an adequate alternative drug."
Acute tracheobronchitis in nursing mothers is treated in almost the same ways as in pregnant women.
Diagnosis of acute tracheobronchitis
Diagnosis is made using auscultation – listening to sounds present during breathing with a phonendoscope. And with the help of a laryngoscope, the windpipe is examined.
Also, tests are needed for acute tracheobronchitis, in particular, a general clinical blood test. And to determine the type of infection and possible detection of cocci, antigens, eosinophils, mycoplasma in the serum, a biochemical blood test is carried out. For the same purpose, the composition of sputum is examined (bacterial culture for pathogenic microflora).
However, only a blood serum test for procalcitonin levels can absolutely accurately confirm the bacterial origin of pathological conditions of the respiratory tract.
Hardware and instrumental diagnostics of the disease involves:
- chest X-ray, which allows to determine structural changes in tissues;
- X-ray of the bronchi with a contrast agent (bronchography);
- spirometry (determination of the functional load of the respiratory organs);
- Ultrasound of the trachea, bronchi and lungs.
Since the list of respiratory diseases with similar symptoms is quite extensive, differential diagnostics of acute tracheobronchitis is necessary to distinguish it from influenza, to exclude laryngitis, whooping cough, pneumonia, eosinophilic bronchitis, bronchial asthma, respiratory mycoplasmosis, obstructive pulmonary disease, etc.
Acute tracheobronchitis in children must be distinguished from many other bacterial and viral infections of the upper respiratory tract; in addition, children should have a stool test to rule out helminthic infestation and cystic fibrosis (which also causes severe paroxysmal coughing).
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Treatment of acute tracheobronchitis
In more than 80% of cases, the cause of the disease is a viral infection, so treatment of acute tracheobronchitis with antimicrobial drugs is carried out either in the case of a combined infection (when bacteria join the virus and pus appears in the sputum), or when the pathogen is identified from the very beginning of the disease. And this is possible if the level of procalcitonin in the blood serum was determined during the diagnosis.
As a physiotherapeutic effect on the bronchi - to expand their lumens and improve the passage of air to the lung tissues - procedures are needed that promote blood flow and activate intracellular metabolism: mustard plasters and cups, as well as hot foot baths (if the body temperature is normal). Doctors recommend taking the following medications for acute tracheobronchitis (they suppress the cough reflex with a strong dry cough):
- Libexin (Prenoxdiazine, Tibexin, Toparten): adults - 0.1 g (one tablet) three times a day; in severe forms of the disease - two pills; the dosage for children depends on age (from 0.025 to 0.05 g three times a day;
- Sinekod (Butamirate) in the form of syrup: adults and children over 12 years old - 15 ml three times a day (before meals); children 6-12 years old - 10 ml; 3-6 years - 5 ml. Sinekod drops: adults and children over three years old - 25 drops four times a day; children 1-3 years old - 15 drops, newborns from 2 to 12 months - 10 drops 4 times a day.
For thick sputum, the following is prescribed to thin it and improve its discharge:
- Ambroxol syrup (Ambrobene, Lazolvan) is given to children over five years old, 5 ml three times a day (after meals); 2-5 years old - 2.5 ml and the same dosage to children under two years old. Adults can take Ambroxol tablets (Bronchopront, Mukosan) - 30 mg (one piece) two or three times a day;
- Acetylcysteine (ACC) is used by adults and children over 12 years of age – 100-200 mg three times a day;
- Mucaltin tablets - 1-2 pills three times a day;
- Terpinhydrate tablets - one pill three times a day.
To prevent swelling of the mucous membranes of the trachea and bronchi in acute tracheobronchitis, doctors recommend antihistamines, such as Suprastin tablets (0.025 g): adults - one pill twice a day (during meals); children - a quarter of a tablet, after 6 years - half a tablet 2 times a day. Adults should take Erespal one pill 2-3 times a day (before meals), and children are better given syrup - 4 mg per kilogram of body weight (once a day).
In case of bacterial etiology of this pathology, antibiotics such as Amoxicillin (Augmentin, Amoxiclav) may be prescribed - for adults and children over 12 years old - one pill twice a day; Azithromycin - 0.5 g once a day; and for children - Sumamed suspension - 10 mg per kilogram of body weight once a day for three days.
During treatment, you need to double the amount of liquid you drink. You should also do warm-moist inhalations with soda or any alkaline mineral water, with a decoction of sage, eucalyptus leaves, with essential oils of juniper, cypress, pine or thyme. Warmth and moisture help maintain the moisture of the mucous membranes of the trachea and bronchi and help fight cough.
Folk treatment of acute tracheobronchitis
The applied external folk treatment includes hot (+38-40°C) foot baths with mustard powder, compresses with black radish juice on the upper chest, rubbing the chest with melted goat fat, warming the chest with hot potatoes boiled in their skins.
Internally, you should take honey with lemon (with warm tea); viburnum mashed with sugar (a tablespoon per 150-200 ml of boiled water, twice a day); at night - warm milk with alkaline mineral water (1:1) or put a quarter teaspoon of baking soda in 200 ml of milk.
You can prepare this folk remedy for a strong dry cough: boil a whole lemon in water for 10 minutes, cut it and squeeze the juice into a glass, add two tablespoons of glycerin and 150 g of natural honey, mix thoroughly. Take a teaspoon three times a day (before meals), and also at night.
Another recipe is for children. Pour 200 ml of water over a tablespoon of honey, two tablespoons of anise seeds and salt (a quarter of a teaspoon), bring to a boil, strain and cool. It is recommended to give the baby a teaspoon every two hours.
Herbal treatment of acute tracheobronchitis is carried out using coltsfoot leaves, plantain, oregano, black elder flowers, sweet clover, and wild pansy. For dry cough, thyme infusion is good (a tablespoon per glass of boiling water, leave for 30 minutes, take 50 ml several times a day). A decoction of licorice root, wild pansy, and pine buds expands the bronchi. For viscous sputum, use the root of hyssop, blueweed, or elecampane.
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Homeopathy for acute tracheobronchitis
Considering that homeopathy involves a fairly long-term use of drugs, their prescription, especially in severe forms of the disease, may be ineffective. However, the arsenal of homeopathic remedies for cough treatment is extensive: Arnica (mountain arnica), Aconitum (turnip aconite), Apis (honey bee), Argentum nitricum (silver nitrate), Belladonna (deadly nightshade), Bryonia (white bryony), Dulcamara (bittersweet nightshade), Echinacea (narrow-leaved echinacea), Cephaelis ipecacuanha (ipecac), Pulsatilla (meadow pasqueflower or sleep-grass), Kalii bichromicum (potassium dichromate).
Some medicinal plants, on the basis of which these expectorants are made, are also used in phytotherapy. For example, mountain arnica, which grows in the Carpathians, is used to treat nocturnal enuresis, colitis and flatulence. And the poisonous white bryony (Adam's root) helps with rheumatism and radiculitis.
The complex homeopathic preparation Broncho-Gran (Ukrainian production) relieves cough, promotes expectoration and reduces inflammation of the respiratory tract.
Mucosa compositum restores damaged mucous membranes; Umckalor is intended to relieve productive cough.
Prevention of acute tracheobronchitis
Hardening, proper nutrition with sufficient vitamins, microelements and minerals support immunity, and a high level of the body's defenses is, in fact, the prevention of this respiratory disease. And it is necessary to carry out timely adequate treatment of all diseases of the upper respiratory tract - from flu and acute respiratory infections to tonsillitis and pharyngitis.
The prognosis for acute tracheobronchitis – complete recovery without complications – will be positive with timely and correct diagnosis of the disease and appropriate therapy.