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Symptoms of acute obstructive bronchitis
Last reviewed: 23.04.2024
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Signs of shortness of breath may appear on the 1-2th day of SARS and during viral infection. Breathing becomes noisy, with an extended exhalation and whistling rattles heard from a distance. In infants, despite the lengthening of the exhalation, shortness of breath appears with the contraction of the pliant areas of the chest, which indicates that they also find it difficult to inhale. Characterized by paroxysmal, obsessive cough.
Auscultation
With percussion over the lungs tympanitis, hard breathing is heard, multiple wheezing over the entire surface of the chest, wheezing can be heard from a distance. The timbre of wheezing, heard during auscultation, depends on the level of lesion of the bronchi: the smaller bronchi are involved in the process, the higher the timbre of wheezing. When accumulating in the bronchi of the liquid secretion, wet rales occur, unlike rales in acute pneumonia, they are devoid of sonority, constant localization and disappear after coughing, they are not constant throughout the day. In contrast to bronchiolitis in acute obstructive bronchitis, there is no “abundance” of moist rales and respiratory failure is not typical. Wet rales in acute obstructive bronchitis are especially often heard in children with a tendency to allergic reactions, with burdened heredity due to allergies.
[Anamnesis
In the history of the child should be considered the presence of any manifestations of allergy in the past (food, drug, ephemeral rash of unknown origin) and eosinophilia in the hemogram. In allergic etiology of acute obstructive bronchitis, the auscultatory pattern in the lungs changes several times a day. Following the abundance of moist rales in a short period, their absence can occur. The effect of antihistamine and bronchodilator drugs is noted. In some children with heredity burdened by 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 relapsing course of obstructive bronchitis: allergization, exposure to passive smoking, contact with patients with SARS. According to research data, an interrelation in the development of bronchial obstruction in acute bronchitis is revealed, not only with allergic reactivity, but also with persistence on the mucous membrane of the bronchi of a certain type of microorganism: hemophilus bacillus, bronchiamella, Staphylococcus aureus. In acute obstructive bronchitis in these children, there is a longer intoxication, a temperature reaction, longer rales are heard in the lungs (9-10 days) compared with acute simple bronchitis (6-7 days).
With repeated bouts of coughing and wheezing associated with bacterial infections, the child should be examined for the timely detection of cystic fibrosis or an immunodeficiency state.