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Symptoms of acute obstructive bronchitis
Last reviewed: 06.07.2025
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Signs of difficulty breathing may appear on the 1st or 2nd day of ARVI and during the viral infection. Breathing becomes noisy, with prolonged exhalation and wheezing audible at a distance. In infants, despite the prolongation of exhalation, shortness of breath appears with retraction of the compliant parts of the chest, which indicates that they also have difficulty inhaling. A paroxysmal, obsessive cough is characteristic.
Auscultation
Percussion of the lungs reveals tympanitis, harsh breathing, multiple wheezing sounds over the entire surface of the chest, and wheezing sounds are audible at a distance. The timbre of wheezing sounds heard during auscultation depends on the level of bronchial damage: the smaller the bronchi involved in the process, the higher the timbre of the wheezing sounds. When liquid secretion accumulates in the bronchi, moist rales occur; unlike wheezing sounds in acute pneumonia, they are devoid of sonority, permanent localization, and disappear after coughing; they are inconstant during the day. Unlike bronchiolitis, acute obstructive bronchitis does not have an "abundance" of moist rales and respiratory failure is not characteristic. Moist rales in acute obstructive bronchitis are especially often heard in children with a tendency to allergic reactions, with a burdened heredity for allergies.
[ Anamnesis
The anamnesis should take into account the presence of any manifestations of allergies in the child's past (food, medication, ephemeral rashes of unknown genesis) and eosinophilia in the hemogram. In case of allergic etiology of acute obstructive bronchitis, the auscultatory picture in the lungs changes several times a day. Following the abundance of moist rales, their complete absence may occur in a short period. The effect of antihistamines and bronchodilators is noted. In some children with a hereditary burden of allergies, acute obstructive bronchitis recurs at a later age, sometimes transforming into bronchial asthma.
It is necessary to take into account and prevent the action of risk factors that contribute to the recurrent course of obstructive bronchitis: allergization, exposure to passive smoking, contact with patients with acute respiratory viral infections. According to research data, a relationship has been found in the development of broncho-obstruction in acute bronchitis not only with allergically altered reactivity, but also with the persistence of a certain type of microorganisms on the bronchial mucosa: Haemophilus influenzae, Bronchamel, Staphylococcus aureus. In acute obstructive bronchitis, such children experience longer intoxication, temperature reaction, wheezing in the lungs is heard longer (9-10 days) compared to acute simple bronchitis (6-7 days).
If the child has repeated bouts of coughing and wheezing associated with bacterial infections, it is necessary to examine the child for early detection of cystic fibrosis or an immunodeficiency state.