Bronchitis in children

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

ICD-10 code

J20.0-J20.9.

Unspecified bronchitis, both acute and chronic, has the code J40. In children under 15 years of age, it can be considered acute in nature, then it should be classified under the heading J20. Recurrent bronchitis and recurrent obstructive bronchitis are included in ICD-10 under the 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 are at risk 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 morbidity is observed in children aged 1 to 3 years). The incidence of acute bronchitis is 75-250 cases per 1000 children per year.

The incidence of bronchitis is seasonal: people get sick more often in the cold season. Obstructive forms of bronchitis are more often observed in spring and autumn, i.e. during the peak periods of PC and parainfluenza infection. Mycoplasma bronchitis - at the end of summer and in autumn, adenovirus - every 3-5 years.

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Causes of bronchitis in children

Acute bronchitis often develops against the background of acute respiratory viral infections. Inflammation of the bronchial mucosa is more often observed with RS viral, parainfluenza, adenovirus, rhinovirus infection and flu.

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

What causes bronchitis in children?

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Symptoms of bronchitis in children

Acute bronchitis (simple) develops in the first days of ARVI (1-3 days of illness). The main general symptoms of a viral infection are characteristic (subfebrile temperature, moderate toxicosis, etc.), clinical signs of obstruction are absent. The features of the course of bronchitis depend on the etiology: with most respiratory viral infections, the condition normalizes starting from the 2nd day, with adenovirus infection, high temperatures persist for up to 5-8 days.

Acute obstructive bronchitis is accompanied by bronchial obstruction syndrome, more often in young children on the 2nd-3rd day of ARVI, in case of a repeated episode - from the first day of ARVI and develops gradually. Acute obstructive bronchitis occurs against the background of RS viral and parainfluenza type 3 infection, in 20% of cases - with ARVI of other viral etiology. In older children, the obstructive nature of bronchitis is noted with mycoplasma and chlamydial etiology.

Symptoms of bronchitis in children

Classification of bronchitis

In the overwhelming majority of children with bronchitis, obstructive syndrome is observed (50-80%), in connection with which acute obstructive and recurrent obstructive bronchitis were included in the classification of bronchopulmonary diseases of children in 1995.

The following classification of bronchitis is distinguished:

• Acute bronchitis (simple): bronchitis that occurs without signs of bronchial obstruction.
• Acute obstructive bronchitis, bronchiolitis: acute bronchitis occurring with bronchial obstruction syndrome. Obstructive bronchitis is characterized by wheezing, bronchiolitis - respiratory failure and fine-bubble moist rales in the lungs.
• Acute obliterating bronchiolitis: bronchitis with obliteration of the bronchioles and alveoli, has a viral or immunopathological nature, severe course.
• Recurrent bronchitis: bronchitis without obstructive symptoms, episodes lasting 2 weeks or more with a frequency of 2-3 times a year for 1-2 years against the background of acute respiratory viral infections.
• Recurrent obstructive bronchitis: obstructive bronchitis with recurrent episodes of broncho-obstruction against the background of acute respiratory viral infections in young children. The attacks are not paroxysmal in nature and are not associated with the effects of non-infectious allergens.
• Chronic bronchitis: chronic inflammatory lesion of the bronchi, occurring with repeated exacerbations.

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Diagnosis of bronchitis in children

The diagnosis of bronchitis is established based on its clinical picture (for example, the presence of obstructive syndrome) and in the absence of signs of damage to the lung tissue (no infiltrative or focal shadows on the radiograph). Bronchitis is often combined with pneumonia, in which case it is included in the diagnosis with a significant addition to the clinical picture of the disease. Unlike pneumonia, bronchitis in ARVI is always diffuse in nature and usually affects the bronchi of both lungs evenly. If local bronchitis changes predominate in any part of the lung, the following definitions are used: basal bronchitis, unilateral bronchitis, bronchitis of the afferent bronchus, etc.

Diagnosis of bronchitis in children

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Treatment of bronchitis in children

The proposed treatment protocols for acute bronchitis include necessary and sufficient prescriptions.

Simple acute viral bronchitis: treatment at home.

Drink plenty of warm fluids (100 ml/kg per day), massage the chest, and drainage if the cough is wet.

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

Treatment of bronchitis in children