Acute tracheobronchitis

Acute tracheobronchitis is an inflammatory airway disease that seizes the mucous membrane of the respiratory neck (trachea), as well as the bronchial epithelium.

This respiratory disease has a code for the ICD 10 - J06-J21.

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Causes of acute tracheobronchitis

Specialists associate the pathogenesis of the disease with the penetration of the infection in the respiratory tract: adeno- or rhinovirus, influenza viruses or parainfluenza, coronavirus, respiratory syncytial virus, as well as bacteria: staphylococci, streptococci, Mycoplasma pneumoniae, Moraxella catarrhalis, coccobacterium Bordetella pertussis or Bordetella parapertussis.

First, a viral or microbial infection can affect the nasopharynx, and then go down: this way pathology in the presence of the patient already having ARVI, influenza, and whooping cough is marked as the leading cause of acute tracheobronchitis. Also, the causal relationship of the development of this disease with the overall hypothermia of the body, exposure to the mucous membranes of the airways of tobacco smoke or their irritation with gaseous chemicals is not excluded.

With lymphocytic interstitial inflammation, the ciliated epithelium of the trachea and bronchi swells and thickens, and then loosens, and then desquamation begins (desquamation) - due to damage to the basal membranes of ciliated epitheliocytes.

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Symptoms of acute tracheobronchitis

The first signs of acute tracheobronchitis are a convulsive cough, the attacks of which usually begin during inspiration. In many cases, bouts of uncontrollable coughing are painful at night.

First a cough is dry, a sore throat and a painful sensation in the larynx, hoarseness (or hoarseness) and pain after a cough in the chest. After a few days, a dry cough turns into a productive cough, with the release of serous mucous secretion - phlegm, in which impurities of pus or blood can be present. When listening to breathing hard, with a whistle on exhalation and wheezing.

Also, such symptoms of acute tracheobronchitis as rhinitis, perspiration and sore throat, subfebrile body temperature (in the early days of the disease), shortness of breath, chest pain and in the diaphragm area, general weakness are also possible.

One of the most disturbing 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 respiration and pulse, vomiting during coughing attacks, increased chest volume, cyanosis of the lips and skin, swelling of soft tissues, increased excitement, seizures.

Complications of acute tracheobronchitis in elderly patients and in children under five years of age are expressed in the development of chronic disease, obstructive bronchitis, focal pneumonia, emphysema, chronic obstructive pulmonary disease. The consequences of the disease in young children can lead to chronic problems with breathing (partial obstruction of the bronchi) and even its arrest.

Acute tracheobronchitis in 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 muscles of the peritoneum and the diaphragm are strained, the intense movements of the diaphragm push the uterus into a tonus. After the 32nd week, this can cause premature labor.

Cure for pregnant women is possible only the safest means. These include an alkaline drink (milk with mineral water or soda), inhalations with pine buds, eucalyptus, baking soda and steam boiled potatoes. Of medicinal plants pregnant can be infusion or decoction of the root of the althaea and leaves of the mother-and-stepmother (in the first three months, and infusion of thyme). Neither oregano, nor clover, nor elecampane, nor licorice, nor anise seeds can not be used by pregnant women.

It is contraindicated to use antibiotics in the treatment of pregnant women, and if there is an extreme need for a serious infectious disease, then they should be appointed by an experienced doctor, as these drugs penetrate the placenta, and the study of their effect on the unborn child is not always carried out. Even in macrolides, which are considered to be the most harmless antibiotics, in many cases the instructions state that the drug should be used during pregnancy and lactation "only in the absence of an adequate alternative medicine."

Practically in the same ways as in pregnant women, acute tracheobronchitis is treated in a nursing mother.

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Diagnosis of acute tracheobronchitis

Diagnosis is carried out using auscultation - listening to the phonendoscope present when breathing sounds. And with the help of a laryngoscope, the throat is examined.

Analyzes are also required for acute tracheobronchitis, in particular, a general clinical analysis of the blood. And to determine the type of infection and possible detection in the sera of cocci, antigens, eosinophils, mycoplasma, a biochemical blood test is performed. For the same purpose, the sputum composition (bacussis on pathogenic microflora) is investigated.

However, it is absolutely possible to confirm the bacterial origin of the pathological conditions of the respiratory tract with only the serum analysis on the level of procalcitonin.

The instrumental and instrumental diagnosis of the disease implies:

• X-ray of chest organs, allowing to determine structural changes in tissues;
• X-ray of bronchi with contrasting substance (bronchography);
• spirometry (definition of the functional load of respiratory organs);
• Ultrasound of the trachea, bronchi and lungs.

Since the list of pathologies of respiratory organs with similar symptoms is very extensive, differential diagnosis 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 should be distinguished from many other bacterial and viral infections of the upper respiratory tract; In addition, children should take an analysis of feces - to exclude helminthic invasion and cystic fibrosis (in which there is also a strong paroxysmal cough).

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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 attach to 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 in the course of diagnosis the level of procalcitonin in serum was determined.

As a physiotherapeutic effect on the bronchi - to expand their lumens and better airflow to the tissues of the lungs - procedures are needed that promote blood flow and activation of intracellular metabolism: mustard and cans, and hot foot baths (if body temperature is normal). Doctors recommend taking such medications with acute tracheobronchitis (oppress cough reflex with a strong dry cough):

• Libexin (Prenoxidiazine, Tibexin, Toparten): adults - 0.1 g (one tablet) three times a day; with a severe form of the disease - two pills; dosage for children depends on the 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 - 15 ml three times a day (before eating); children 6-12 years old - 10 ml each; 3-6 years - 5 ml each. Sinekod drops: adults and children after three years - 25 drops four times a day; children 1-3 years - 15 drops, newborns from 2 to 12 months - 10 drops 4 times a day.

At a thick sputum for its liquefaction and the best departure are appointed or nominated:

• syrup Ambroxol (Ambrobe, Lazolvan) children over five years of age are given 5 ml three times a day (after meals); 2-5 years - 2.5 ml and in the same dosage to children under the age of two. Adults can take Ambroxol tablets (Bronhopron, Mukozan) - 30 mg (one piece) two or three times a day;
• Acetylcysteine (ATSTS) is used by adults and children after 12 years - 100-200 mg three times a day;
• Muciltin tablets - 1-2 pills three times a day;
• Tablets Terpinhydrate - three times a day, one pill.

To prevent edema of the mucous trachea and bronchi in acute tracheobronchitis, doctors recommend antihistamines, for example, Suprastin tablets (0.025 grams): adults - twice a day (during meals); to kids - on the fourth part of a tablet, after 6 years - on a half of a tablet 2 times a day. Preparation Erespal adults should take the pill 2-3 times a day (before meals), and children should be given syrup - 4 mg per kilogram of body weight (once a day).

With the bacterial etiology of this pathology, the administration of antibiotics such as Amoxicillin (Augmentin, Amoxiclav) can be prescribed for adults and children after 12 years of age - one tablet twice a day; Azithromycin - 0.5 g once a day; and the 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. Also it is necessary to make warm-moist inhalations with soda or any alkaline mineral water, with decoction of herbs of medicinal sage, eucalyptus leaves, with essential oils of juniper, cypress, pine or thyme (thyme). Heat and moisture contribute to the preservation of moisture in the mucous membranes of the trachea and bronchi and help fight cough.

Alternative treatment of acute tracheobronchitis

Applied external alternative treatment includes hot (+ 38-40 ° C) footbaths with mustard powder, compresses with black radish juice on the top of the chest, grinding the breast with melted goat fat, warming the breast boiled in a uniform with hot potatoes.

Inside should use honey with lemon (with warm tea); rubbed with sugar Kalin (tablespoon for 150-200 ml of boiled water, twice a day); for the night - warm milk with mineral alkaline water (1: 1) or put a quarter of a teaspoon of baking soda into 200 ml of milk.

You can prepare such an alternative remedy for a strong dry cough: within 10 minutes boil in water a whole lemon, 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), as well as overnight.

Another recipe is for children. A tablespoon of honey, two tablespoons of anise seeds and salt (a quarter of a teaspoonful), pour 200 ml of water, bring to a boil, strain and cool. It is recommended that the baby be given a teaspoon every two hours.

Treatment with herbs of acute tracheobronchitis is carried out using leaves of mother-and-stepmother, plantain of large, oregano, blackberry flowers, sweet clover, three-color violet. When dry cough helps infusion of thyme (tablespoon into a glass of boiling water, insist 30 minutes, take 50 ml several times a day). Expands the bronchi decoction of licorice root, tri-colored violets, pine buds. When viscous sputum is used, the root of the wasteland, cyanosis or elecampane.

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Homeopathy with acute tracheobronchitis

Given that homeopathy presupposes a sufficiently long-term use of drugs, their administration, especially in severe forms of the disease, may be ineffective. However, the arsenal of homeopathic remedies for coughing is extensive: Arnica (arnica mountainous), Aconitum (wrestler), Apis (honey bee), Argentum nitricum (silver nitrate), Belladonna, Bryonia, White Dulcamara, Echinacea (echinacea angustifolia), Cephaelis ipecacuanha (ipecacuana), Pulsatilla (meadow or sleep-grass slide), Kalii bichromicum (potassium bichromate).

Some medicinal plants on the basis of which these expectorants are made are also used in phytotherapy. For example, mountain arnica growing in the Carpathians is used in the treatment of nocturnal enuresis, colitis and flatulence. A poisonous perestupene white (bryony or adam root) helps with rheumatism and radiculitis.

The complex homeopathic preparation Broncho-Gran (Ukrainian production) facilitates coughing, promotes sputum and reduces inflammation of the respiratory tract.

Mucosa compositum restores damaged mucous membranes; Umcalor is designed to reduce productive cough.

Prevention of acute tracheobronchitis

Tempering, full nutrition with enough vitamins, minerals and minerals maintains immunity, and a high level of body defenses is, in fact, the prevention of this respiratory disease. And it is necessary to conduct timely adequate treatment of all diseases of the upper respiratory tract - from influenza and acute respiratory infections to tonsillitis and pharyngitis.

The prognosis of acute tracheobronchitis - complete recovery without complications - will be positive with timely and correct diagnosis of the disease and appropriate therapy.