Tracheitis — an inflammatory disease of a trachea, is more often than infectious character. Tracheitis is followed by pristupoobrazny cough of dry character or with allocation of a dense mucous or mucopurulent phlegm, and also pain behind a breast in time and after cough. Diagnosis of tracheitis includes clinical blood test, a laringotrakheoskopiya, a bacteriological research of a phlegm and dabs from a pharynx, a X-ray analysis of lungs, consultation of the phthisiatrician, allergist, pulmonologist. Treatment is carried out by etiotropny medicines (antibacterial, antiviral, antiallergenic), mucolytics, expectorant or protivokashlevy means, methods of physiotherapeutic influence.
As the independent disease tracheitis meets rather seldom. The combined damage of airways with development of laryngotracheitis or a trakheobronkhit is in most cases observed. Besides, tracheitis is often preceded or accompanied by rhinitis and pharyngitis. Tracheitis of the allergic nature usually develops together with allergic conjunctivitis and allergic rhinitis.
Causes of tracheitis
Tracheitis of infectious genesis arises at hit in an organism being in the inhaled air of viruses or bacteria. As the majority of causative agents of infections of airways are unstable in the external environment, infection can occur only at direct contact with the patient. Development of tracheitis against the background of flu, paraflu, a rubella, measles, scarlet fever, chicken pox is possible. Pneumococci, staphylococcus, an influenza stick, streptococci can cause bacterial tracheitis. However most often bacterial tracheitis arises at activation of pathogenic properties of the opportunistic flora which is in airways.
Treat the factors promoting development of tracheitis: dust content of the inhaled air, tobacco smoke, adverse climatic conditions: too hot or cold, damp or dry air. Normal the inhaled air passes in the beginning through a nose where it is warmed and moistened. In a cavity of a nose settle large particles of dust which then are removed from an organism under the influence of eyelashes of an epithelium mucous or in the course of sneezing. Violation of this mechanism happens at the diseases leading to difficulty of nasal breath: rhinitis, sinusitis, atresia Joán, adenoides, tumor or foreign matter of a nose, curvature of a nasal partition. As a result the inhaled air comes to a throat and a trachea at once and can cause their overcooling or irritation provoking development of tracheitis.
The weakened condition of a macroorganism that can be observed at existence of the chronic infectious centers (tonsillitis, a periodontal disease, antritis, chronic otitis, adenoides), immunodeficiency (HIV infection, consequences beam or chemotherapy), chronic infections (tuberculosis, syphilis) and somatic diseases (chronic hepatitis, cirrhosis, stomach ulcer of a stomach, IBS, heart failure, rheumatism, a chronic renal failure, diabetes) favors to developing of infectious tracheitis.
Tracheitis of allergic genesis represents the allergic reaction developing in response to inhalation of various allergens: house, production or library dust, pollen of plants, microparticles of wool of the animal, chemical compounds which are contained in air of production rooms of the chemical, pharmaceutical and perfumery industry. Allergic tracheitis can arise against the background of infectious, being result at the same time of allergic reaction to microbic anti-genes. In such cases tracheitis carries the name infectious and allergic.
Classification of tracheitis
In clinical otolaryngology allocate infectious, allergic and infectious and allergic tracheitis. In turn infectious tracheitis is divided into bacterial, virus and bacterial and virus (mixed).
By character of a current tracheitis is classified on sharp and chronic. Sharp tracheitis arises suddenly and has small duration (on average 2 weeks). Upon its transition to a chronic form periodic aggravations which alternate with the remission periods are observed. Chronic tracheitis leads to morphological changes of a mucous trachea which can have hypertrophic or atrophic character.
The main symptom of tracheitis is cough. At the beginning of the emergence it has dry character, then allocation of a dense mucous phlegm is observed. For tracheitis typically pristupoobrazny developing of painful cough after a deep breath, during shout, crying or laughter. The fit of coughing is followed by pain behind a breast and comes to an end with office of a small amount of a phlegm. Pain behind a breast can remain some time after cough. In several days from the beginning of tracheitis the quantity of a phlegm increases, its consistence becomes more liquid. At bacterial or virus and bacterial tracheitis the phlegm often gains purulent character.
At the beginning of a disease of tracheitis there can be a rise in body temperature to febrilny figures, however is more often observed subfebrilitt. Slight increase of temperature by the evening is characteristic, the feeling of fatigue by the end of day is noted. Symptoms of intoxication are not expressed. But the exhausting persistent cough brings to the patient considerable discomfort, provoking emergence of irritability, headaches and frustration of a dream.
At existence of the pharyngitis accompanying tracheitis or laryngitis patients show complaints to burning, irritation, dryness, tickling and other unpleasant feelings in a throat. Increase in cervical lymph nodes because of development in them jet lymphadenitis is possible. Percussion and an auskultation of lungs at patients with tracheitis can not reveal any pathological deviations. The diffusion dry rattles which are listened usually in the field of bifurcation of a trachea are in some cases observed.
At patients with chronic tracheitis cough has constant character. Strengthening of cough is observed at night and after a dream, during the day cough can be practically absent. At a hypertrophic form of chronic tracheitis cough is followed by allocation of a phlegm, at atrophic — the dry pristupoobrazny cough caused by irritation of a mucous trachea the crusts which accumulated on it is noted. An exacerbation of chronic tracheitis are characterized by strengthening of cough, numerous attacks of the exhausting cough occurring during the day, subfebrilitety.
At allergic tracheitis unpleasant feelings behind a breast and in a throat are sharply expressed. Cough pristupoobrazny persistent and painful, is followed by intensive pain behind a breast. At height of a fit of coughing at children vomiting can be observed. At percussion and an auskultation of lungs pathological changes often are absent. As a rule, allergic tracheitis is accompanied by symptoms of allergic rhinitis, allergic is possible keratit also conjunctivitis.
At tracheitis of an infectious etiology distribution of inflammatory process on airways gives to emergence of bronchopulmonary complications below: bronchitis and pneumonia. It is more often observed also bronchial pneumonia trakheobronkhit. Involvement in infectious process of a bronchial tree is demonstrated by more high temperature of a body, strengthening of cough, emergence in lungs of rigid breath, diffusion dry and damp large and srednepuzyrchaty rattles. At development of pneumonia deterioration in the general condition of the patient with tracheitis and aggravation of symptoms of intoxication is noted, emergence of pains in a thorax is possible during cough and breath. In lungs perkutorno can local obtusion of a sound is defined, during an auskultation the weakened breath, a krepitation, damp melkopuzyrchaty rattles is listened.
Continuous inflammatory process and morphological changes mucous at chronic tracheitis can become the reason of emergence of endotrakhealny new growths of both good-quality, and malignant character. Under long influence of allergens allergic tracheitis can be complicated by development of allergic bronchitis and its transition to the bronchial asthma which is followed by short wind with the complicated exhalation and attacks of suffocation.
Diagnosis of tracheitis
As a rule, patients with tracheitis address the therapist. However consultation of the otolaryngologist is necessary for specification of the diagnosis and the nature of inflammatory changes (especially at chronic tracheitis). To the patient also appoint clinical blood test, a laringotrakheoskopiya, capture of dabs from a pharynx and a nose with their the subsequent bacteriological a research, phlegms and its analysis to the CUBE.
Existence in the anamnesis of the patient of instructions on allergic diseases (, eczema, atopic dermatitis, allergic dermatitis) speaks about the possible allergic nature of tracheitis. Clinical blood test allows to define the nature of tracheitis. At tracheitis of infectious genesis in the general blood test inflammatory changes are noted (, acceleration of SOE), at allergic tracheitis inflammatory reaction of blood is expressed slightly, the increased quantity of eosinophils is noted. Consultation of the allergist and conducting allergologichesky tests is necessary for a final exception or confirmation of allergic tracheitis.
Laringotrakheoskopiya at sharp tracheitis reveals hyperaemia and puffiness of a mucous trachea, in certain cases (for example, at flu) petekhialny hemorrhages. The picture of hypertrophic chronic tracheitis includes tsianotichny coloring mucous and its considerable thickening because of which the border between separate rings of a trachea is not visualized. The atrophic form of chronic tracheitis is characterized by light pink coloring, dryness and thinning mucous, existence on walls of a trachea of plentiful crusts.
At suspicion of tuberculosis of the patient direct to the phthisiatrician, at development of bronchopulmonary complications — to the pulmonologist. Carry in addition out a rinoskopiya, a faringoskopiya, a X-ray analysis of easy and okolonosovy bosoms. Tracheitis needs to be differentiated from bronchitis, whooping cough, a false croup, diphtheria, tuberculosis, lung cancer, a foreign matter of a throat and a trachea.
Treatment of tracheitis
First of all etiotropny therapy of tracheitis is carried out. At bacterial tracheitis antibiotics (amoxicillin, , ) are applied, at virus — antiviral means (, , interferon medicines), at allergic — antiallergic medicines (, , ). Expectorant means (a root , coltsfoot, ) and mucolytics are applied (, Bromhexine). At painful dry cough purpose of protivokashlevy medicines is possible. Immunokorregiruyushchy therapy is in addition shown to patients with chronic tracheitis.
Well proved at tracheitis inhalation therapy (alkaline and oil inhalations), introduction to airways of medicinal solutions by means of a neybulayzer, a spelioterapiya. From physiotherapeutic means UVCh and an electrophoresis on area of a trachea, massage and reflexotherapy is applied.