Recurrent bronchitis in children

Recurrent bronchitis is a bronchitis with no obstruction, the episodes of which are repeated 2-3 times within 1-2 years against the background of acute respiratory viral infections. Episodes of bronchitis are characterized by the duration of clinical manifestations (2 weeks or more).

[1], [2], [3], [4], [5], [6]

Causes and pathogenesis of recurrent bronchitis

The provoking factor in the development of the first episode of recurrent bronchitis is ARVI (mainly influenza virus or parainfluenza type 1), which are characterized by prolonged viremia and persistence of the virus in the child's body. When the bronchitis relapses, a bacterial infection (pneumococcus, hemophilic rod) and mycoplasma joins.

The main pathogenesis is (violation of ventilation and drainage function of the bronchi!

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Predisposing factors to recurrent bronchitis

• family predisposition to bronchopulmonary diseases;
• adverse prenatal and postnatal background (toxicosis of pregnant women, fetal asphyxia, birth trauma);
• constitutional features of the child (lymphohypoplastic and exudative diathesis);
• acquired immunodeficiency;
• chronic foci of infection in the ENT organs (chronic tonsillitis, sinusitis);
• a number of socio-hygienic reasons: passive smoking, air pollution, unfavorable living conditions;
• climatic and geographical features: high humidity, significant fluctuations in air temperature, atmospheric pressure.

Frequent relapses of bronchitis are associated with allergic heredity, genetically due to insufficiency of the response to infection, "local" inferiority of the bronchopulmonary system (damage to phagocytosis, violation of tracheobronchial clearance), carriage of the pathological gene and deficiency of alpha1 antitrypsin, dysgamma immunoglobulinemia, group deficit of antiviral antibodies, IgG deficiency and SlgA, interferon.

Symptoms of recurrent bronchitis

After another acute respiratory viral infection, for a few weeks, a dry cough, then a wet one, persists for a day or more in the morning. Over the lungs, percussion is determined by a clear sound with a slight shortening in the interblade area. Against the background of severe breathing, various sonorities of the rales are heard and during the period of the severity of the process moist large and medium bubbles, variable in sound and localization. Under the influence of therapy, there is an improvement in the process in the lungs, and then again there are clinical signs of bronchial lesions, especially under the influence of another viral infection or cooling.

Recurrent bronchitis in a number of patients can be a clinical manifestation of cystic fibrosis, malformations of the lungs, ciliary dyskinesia syndrome. If suspected of these diseases, examination in the pulmonology department is necessary.

Symptoms of recurrent bronchitis

Treatment of recurrent bronchitis

In an acute period of relapse appoint a bed rest for 5-7 days. The child must provide access to fresh air (frequent ventilation). A full-fledged diet, taking into account the age of the patient with the maximum content of vitamins, hypoallergenic. For liquefying sputum, a sufficient introduction of liquid is recommended - cranberry and cowberry fruit drinks, fruit and vegetable juices, tea with lemon, mineral waters.

Antibiotics are prescribed for a virus-bacterial infection and exacerbation of a chronic foci of infection for 5-7 days. Oral antibiotics are used: amoxicillin, augmentin, azithromycin, clarithromycin, cefuroxime.

With relapsing bronchitis, therapy aimed at restoring the drainage function of the bronchi is of particular importance. For this purpose, inhalations of 10% acetylcysteine solution, 2% sodium hydrogen carbonate solution, as well as mucolytics and mucolytics (bromhexine, ambroxol, bronchosan) in combination with postural drainage are used. The frequency of the procedure 2-3 times a day, the first is better to spend the morning immediately after awakening the patient.

Treatment of recurrent bronchitis