Sharp trakheobronkhit - the acute respiratory disease proceeding with inflammatory damage of a mucous membrane of a trachea and bronchial tubes. Are characteristic of a sharp trakheobronkhit a severe cough (unproductive in the beginning, then with allocation of a mucopurulent phlegm), the burning pain behind a breast, subfebrilitt, the general weakness. Diagnostics includes fizikalny inspection, a X-ray analysis of lungs, a research of clinical blood test and a phlegm. Treatment of a sharp trakheobronkhit is carried out by means of pharmacotherapy (expectorant, protivokashlevy means), thermal procedures (mustard plasters, cans), alkaline inhalations.
Sharp trakheobronkhit – the infectious and inflammatory process occupying the lower departments of airways (a trachea and a bronchial tree) and which is allowed within three weeks. Annually 5% of adult population have a disease; the peak of to the doctor falls on the autumn and winter period - time of epidemic outbreaks of a SARS. Sharp trakheobronkhit quite often it is combined with damages of the top airways: rhinitis, pharyngitis, laryngitis. In pulmonology distinguish sharp (duration up to 3 weeks), long (up to 1 month) and chronic (up to 3rd and more months) trakheobronkhit. The current of a sharp trakheobronkhit can be uncomplicated and complicated – the last option meets at immunokomprometirovanny persons more often (with the HIV status, receiving chemotherapy), patients with HNZL, heart failure.
Reasons of a sharp trakheobronkhit
To 90% of all cases of a sharp trakheobronkhit it is caused by a seasonal respiratory viral infection. Defeat of nizlezhashchy departments of airways is most often initiated by flu viruses, adenoviruses, coronaviruses, enteroviruses, rhinoviruses, metapneumoviruses; at children - the RS-virus and a virus of paraflu III of type. The majority of respiratory viruses cause damage of an epithelium of the lower airways, activation of mediators of an inflammation and malfunction of the mukotsiliarny device of bronchial tubes.
Less than 10% of cases of a sharp trakheobronkhit, according to epidemiological researches, are associated with Chlamydophila pneumoniae and Mycoplasma pneumoniae. It is proved that bacteria of whooping cough and parawhooping cough (B. pertussis and B. Parapertussis) can cause sharp trakheobronkhit at immunizirovanny adults. At the patients who underwent a trakheostomiya or an endotrakhealny intubation, perhaps bacterial inflammation of a trachea and bronchial tubes caused by an intrahospital infection (S. pneumoniae, H.influenzae, St.aureus, Moraxella catarrhalis).
In certain cases sharp trakheobronkhit can have the allergic or toksiko-chemical nature. As noninfectious factors of an inflammation atmospheric pollyutant, tobacco smoke, heavy metals, dust, hair of animals, etc. can act. Is promoted the raised susceptibility to prichinno significant agents by chronic diseases, a post-infectious adynamy, hypovitaminoses, overcoolings, stressful situations; children have an ekssudativny diathesis, a hypotrophy, rickets, bad leaving.
Symptoms of a sharp trakheobronkhit
Usually sharp trakheobronkhit is preceded by ORZ signs: a general malaise, fever, an ache in all body, a headache, rhinitis, pharyngitis. Unpleasant feelings in a nasopharynx quickly go down, covering a trachea and large bronchial tubes.
The leading symptom of a sharp trakheobronkhit – the severe, pristupoobrazny cough which is especially expressed at night. In the beginning cough dry, unproductive, followed by the burning feelings in a throat and pain behind a breast. The deep breath causes morbidity, provokes the next paroxysm of cough owing to what breath becomes superficial, speeded up. At children of early age fits of coughing can be followed by vomiting, cyanosis of a nasolabial triangle, excitement.
In several days the stage of a "dry" catarrhal inflammation is replaced by a "damp" inflammation. There is productive cough with allocation mucous (sometimes a mucopurulent phlegm). As it is facilitated otkhozhdeny phlegms, cough ceases to bring painful feelings, the general state improves. Under usual conditions (a sufficient immunoreactivity of an organism, timely and adequate treatment) sharp trakheobronkhit it is allowed within one-two weeks.
During the periods of epidemics of seasonal flu the special form of a disease meets – sharp hemorrhagic trakheobronkhit which has heavy, sometimes a fatal current. Such form of a trakheobronkhit quite often is complicated by hemorrhagic pneumonia, throat hypostasis with threat of asphyxia.
Diagnostics of a sharp trakheobronkhit
Medical and diagnostic events at a sharp trakheobronkhit are usually held on an outpatient basis by the pediatrician, the therapist or the pulmonologist. At the expressed allergic component consultation of the allergist-immunologist is shown. Hospitalization are subject persons with a heavy current of a sharp trakheobronkhit (for example, a hemorrhagic form), and also with the burdened all-somatic background.
At auskultativny inspection rigid breath with dry (further - damp average and melkopuzyrchaty) rattles is listened. The X-ray analysis of lungs matters, mainly, for an exception of an acute pneumonia. Within an exception of a bacterial infection the phlegm research (the general analysis, bacteriological crops) and peripheral blood (clinical blood test, SRB, a pro-calcitonin) is made. For confirmation or denial of the allergic nature of a sharp trakheobronkhit skin allergic tests are carried out.
Differential diagnostics of a sharp trakheobronkhit is performed with a wide range of diseases: laryngitis, bronchial asthma, HOBL, aspergillomycosis of lungs, respiratory mycoplasmosis, eozinofilny bronchitis, tumors of a trachea and bronchial tubes, pneumonia, tuberculosis, whooping cough, foreign matters of airways.
Treatment of a sharp trakheobronkhit
Effective therapy of a sharp trakheobronkhit assumes a combination of non-drug and medicamentous methods of influence. Treat the first of them: elimination of the factors irritating airways, sufficient moistening of air indoors, warm alkaline drink in the absence of the increased temperature - thermal procedures (banks, mustard plasters, foot bathtubs). Alkaline inhalations possess good anti-inflammatory and expectorant action.
Medicamentous therapy of a sharp trakheobronkhit consists of performing antiviral therapy, reception of immunomodulators, antihistaminic medicines, mukolitichesky and expectorant means (Ambroxol, AZZ, ). At a severe cough short-term purpose of protivokashlevy medicines is shown (, ). Antibiotic treatment can be justified only in case of high risk of development of heavy complications against the background of komorbidny states.
Preventive measures include seasonal vaccination against flu, increase in level of protective forces of an organism, avoiding of overcoolings and contact with sick ORZ. In most cases sharp trakheobronkhit comes to an end with an absolute recovery without consequences. The complicated forms and synchronization of an inflammation occur at persons with the burdened premorbidny background.