Symptoms of recurrent bronchitis

After another acute respiratory viral infection, a dry cough persists for several weeks, then a wet cough during the day or more in the morning. A clear sound with a slight shortening in the interscapular region is determined by percussion over the lungs. Against the background of harsh breathing, wheezing of varying sonority is heard and, during the acute phase of the process, wet large- and medium-bubble rales, variable in sound and localization. Under the influence of therapy, an improvement in the process in the lungs is observed, and then clinical signs of bronchial damage appear again, especially under the influence of another viral infection or cold. The duration of exacerbations in recurrent bronchitis varies from 2-3 weeks to 3 months. During an exacerbation, an increase in body temperature to subfebrile is noted for several days, and sometimes weeks. During remission, a moderate cough persists, especially in the morning, with the release of scanty mucous or mucopurulent sputum, the child's condition is quite satisfactory; In the lungs at the beginning of remission, harsh breathing during auscultation remains, catarrhal changes disappear. Radiologically, some increase in the vascular pattern in the root zones remains.

Children with recurrent bronchitis often have foci of infection in the nasopharynx and paranasal sinuses (adenoiditis, sinusitis, tonsillitis), which requires consultations with ENT specialists at least 2-3 times a year and sanitation of foci of infection. In case of persistent recurrent bronchitis with long-term respiratory syndrome, with persistent physical changes in the lungs, having the same localization, bronchoscopy is indicated.

The experience of the Research Institute of Pulmonology shows that in 84% of cases in children with recurrent bronchitis, inflammatory changes in the bronchial tree are non-purulent in nature and are represented endoscopically by catarrhal or hypertrophic endobronchitis. Endoscopic signs of the inflammatory process are the presence of hyperemia, edema, thickening of the mucous membrane, and excess secretion in the lumens of the bronchi. In 12% of patients during the exacerbation period, catarrhal-purulent endobronchitis is observed, and in 3% - purulent endobronchitis. In isolated patients, atrophic changes in the bronchial walls are detected. In the period of remission, bronchoscopic signs of bronchitis are weakly expressed, but in most patients they persist, indicating a tendency of the disease to a latent course. X-ray examination notes an increase in the pulmonary pattern and expansion of the roots of the lungs.

There are no significant changes in the blood at the time of exacerbation of recurrent bronchitis.

Recurrent bronchitis in some patients may be a clinical manifestation of cystic fibrosis, pulmonary malformations, and ciliary dyskinesia syndrome. If these diseases are suspected, examination in the pulmonology department is necessary.

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