Recurrent obstructive bronchitis in children

Recurrent obstructive bronchitis in children is an obstructive bronchitis, the episodes of which are repeated in young children against the background of ARVI. Unlike bronchial asthma, obstruction is not of a paroxysmal nature and is not associated with exposure to non-infectious allergens. Sometimes repeated episodes of obstruction are associated with chronic aspiration of food. In some children, relapsing obstructive bronchitis is the debut of bronchial asthma (at-risk groups: children with allergy symptoms in a personal and family history, and with 3 or more episodes of obstruction.

[1], [2], [3], [4], [5], [6], [7], [8]

Causes of recurrent obstructive bronchitis in children

In the etiology of recurrent obstructive bronchitis is the role of persistence of respiratory viruses - PC, adenoviruses; in recent years, increased importance in the development of recurrent obstructive bronchitis of mycoplasmal and chlamydial infections.

[9], [10], [11]

Pathogenesis of recurrent obstructive bronchitis

Bronchoobstructive syndrome is largely due to the anatomical and physiological features of the respiratory system in young children: narrow airways, looseness and hydrophilicity of the mucous membrane of the bronchial tree, its propensity for swelling and hypersecretion against the background of the inflammatory process of any nature. In recent years, it has been shown that ARVI can provoke the development of temporary (transient) hyperreactivity of the bronchi during 4-6 weeks from the onset of the disease (the viruses penetrate the submucosal layer of the bronchi and lead to irritation of the nerve endings). Thus, even after reconvalescence of the patient from ARVI for 1 month, he may have signs of bronchial hyperreactivity (GDD) and maintain the risk of recurrence of obstructive bronchitis. Foci of chronic respiratory infection can lead to the formation of more resistant bronchial hyperreactivity. Risk factors predisposing to the emergence of hyperreactivity of the bronchi are: an unfavorable heredity to bronchial obstructive diseases; possible immunological anomalies of general and local nature; diseases of the nervous system; Atopic "mood"; hyperplastic changes in the upper respiratory tract. Consequently, in some patients, relapsing obstructive bronchitis may later transform into bronchial asthma or be its debut. In this sense, it certainly is a factor in the high risk of developing bronchial asthma. Diagnosis of bronchial asthma in such children should be made in the presence of signs of atopy in the anamnesis and with the recurrence of 3 or more episodes of bronchial obstruction.

Symptoms of recurrent obstructive bronchitis in children

Exacerbation of recurrent obstructive bronchitis occurs against the background of acute respiratory viral infection and the clinic corresponds to acute obstructive bronchitis. With chlamydial infection, there may be conjunctivitis, pharyngitis with a pronounced "granularity" on the posterior wall of the pharynx and an increase in lymphatic cervical nodes, a persistent cough against a moderate fever, and then a bronchoobstructive syndrome develops. Mycoplasma infection is characterized by a rise in body temperature to 38-39 C, intoxication (lethargy, may be vomiting), symptoms of vegeto-dystonia (pallor, "marbling" of the skin, sweating); local - weak hyperemia of the throat, dry mucous membranes, poor mucus production in rhinitis and pharyngitis, obstructed nasal breathing, 70% of patients radiographically note changes in the sinuses of the nose, although the clinic of sinusitis is mild. One of the leading symptoms of relapsing obstructive bronchitis with mycoplasmal infection is dry cough, painful, it can cause vomiting and leads to disruption of the baby's sleep. Then develops an obstructive syndrome with all its inherent manifestations. In 50% of cases with mycoplasmal infection, obstructive recurrent bronchitis is resolved slowly, bronchodilators have insufficient effect.

Treatment of recurrent obstructive bronchitis in children

During the period of exacerbation (relapse), the tactic is the same as in acute obstructive bronchitis, during the inter-recurrent period, as with relapsing bronchitis.