Bronchitis in children is a diffuse inflammatory disease of the bronchi, in which the mucous membrane or the entire thickness of the bronchial wall is affected. The disease can occur in isolation or develop against the background of other pathological processes. Bronchitis in children is one of the most common diseases of the respiratory tract, bronchopulmonary pathology in children develops more often, and can also have a more severe course than in adult patients. Obstructive bronchitis is recorded in about 20% of children in the first years of life.

Pathogenesis of bronchitis.

Causes of bronchitis in children and risk factors Acute bronchitis in children often develops against the background of acute respiratory disease of viral etiology (infectious agents are often adenoviruses, parainfluenza viruses, human respiratory syncytial virus, as well as influenza viruses, measles, rhinoviruses, etc.. ), which can later be joined by a bacterial infection. In addition, the causes of bronchitis in children can be allergic reactions (more often due to individual allergic reactions to dust, food, pollen, animal hair, etc.. ) or toxic injury from inhalation of gas, smoke or polluted air in case of living in ecologically unfavorable regions.

Risk factors for the development of acute bronchitis in children include:.

hereditary predisposition (hereditary tendency to allergic reactions, congenital disorders of the respiratory system);

stagnant processes in the pulmonary circulation;

foci of chronic infection in the oral cavity and / or in the nasal cavity (caries, adenoiditis, etc.).

unfavorable weather factors (cold, windy, damp weather, sharp temperature drops);

secondhand smoke (especially if one or both parents smoke, i.e.. constant environment of the child);

decreased immunity.

Obstructive bronchitis in children is sometimes caused by mold, which lives on the walls of rooms with high levels of humidity.

Bronchitis in children can develop due to allergies to dust, pollen, food It can be difficult to assess the role of bacteria in the development of the disease due to the fact that many representatives of the bacterial flora that are found in bronchitis in children are part of the normal microflora of the respiratory tract (opportunistic. Risk factors for the development of obstructive bronchitis in children may be a lack of oxygen during intrauterine development, prematurity, birth trauma, infections at an early age..

Against the background of bronchitis, children can develop: bronchopneumonia, chronic obstructive pulmonary disease, pulmonary emphysema, bronchiectasis, pulmonary hypertension, bronchial asthma.

The recurrent form of bronchitis in children can be caused by helminthic invasions, immunodeficiency states, as well as anatomical and physiological features of the respiratory tract and immune reactivity in children. In addition, risk factors for the development of a recurrent form of the disease in children include smoking women during pregnancy, alcoholic embryopetopathy, aspiration syndrome in newborns, artificial ventilation..

The factors predisposing to the onset of chronic bronchitis in children are:.

genetic predisposition;

respiratory tract malformations;

the presence in the family of a patient with a chronic form of bronchopulmonary disease;

ingress of foreign bodies into the respiratory tract.

Forms of the disease Depending on the severity of the course of bronchitis are mild, moderate and severe.

Depending on the change in the function of external respiration, a simple (non-obstructive) and obstructive form of bronchitis is distinguished in children..

Depending on the duration and characteristics of the course:.

acute - duration 1.5-2 weeks;

recurrent - occurs 3 or more times a year, is typical for preschoolers, tends to turn into chronic bronchitis with age;

chronic - symptoms of the disease persist for several months.

Depending on the origin, acute bronchitis can be:.

infectious;

non-infectious;

mixed;

unspecified.

Depending on the mechanism of development - primary and secondary acute bronchitis.

By the nature of the exudate, bronchitis in children is divided into catarrhal, purulent, catarrhal-purulent, atrophic.

Symptoms of bronchitis in children The clinical picture of bronchitis in children depends on the form of the disease, as well as on the presence of complications. The main symptom of any form is cough.. The nature of the sputum varies depending on the form of the disease. With bronchitis of viral etiology, the sputum is transparent, sometimes with a yellowish tinge, with bacterial sputum it can take on a purulent character.

The main symptom of acute bronchitis in children is a low chest cough, which usually occurs against the background of symptoms of acute respiratory illness. There is an increase in body temperature, weakness, nasal congestion. At the onset of the disease, the cough is dry, aggravated at night, sputum is difficult to separate and practically does not leave. Frequent attacks of coughing cause pain in the muscles of the chest and abdomen. The child's psycho-emotional state is deteriorating, he is capricious, refuses to eat. A few days after the onset of the disease, the patient begins to sputum. In the case of swallowing sputum with bronchitis, young children may experience gagging.. The onset of shortness of breath may indicate the development of obstructive syndrome, with an uncomplicated course of acute bronchitis in children, shortness of breath is not observed. The general condition returns to normal, as a rule, after a few days, the cough may continue for several more weeks. Retention of a high body temperature for a long time, longer than 3-5 days, may indicate the addition of a secondary infection (bacterial) and the development of complications.

Low chest cough, fever, weakness are the main symptoms of bronchitis in children The first episode of obstructive bronchitis often occurs in a child at the age of 2-3 years. For the onset of the disease, signs of an acute respiratory viral infection are characteristic, against which it usually develops. In addition to the general signs of the acute form of the disease, patients with obstructive bronchitis have dry wheezing and wheezing.. The clinical picture of this form of the disease resembles the manifestations of bronchial asthma.. Signs of bronchial obstruction can occur both on the first day of illness, and several days after the onset of obstructive bronchitis. In patients, there is an increase in the frequency of respiratory movements, expiratory (difficulty exhaling) or mixed shortness of breath, during the breathing process, the auxiliary muscles are involved, the anteroposterior chest size increases. The cough in the obstructive form of the disease is unproductive, a painful paroxysmal cough may occur that does not bring relief. Sputum comes out with difficulty, even with a wet cough. Pallor or cyanotic skin tone around the mouth (perioral cyanosis). Signs of bronchial obstruction usually last from several days to one week, then gradually disappear.

Obstructive bronchitis in children is characterized by a wavy course with periods of exacerbation and remission. During relapses, patients have coughing fits, coughing is provoked by physical exertion, laughter, crying. A coughing fit may be preceded by a sore throat, serous-mucous discharge from the nose, malaise. The attack may be accompanied by difficulty breathing, shortness of breath, noisy wheezing. At the end of the attack, as a rule, there is sputum discharge and an improvement in the patient's general condition.. Body temperature during exacerbations is usually within normal limits, it can rise to subfebrile numbers (no higher than 38 ° C). The duration of exacerbation in obstructive bronchitis in children ranges from several hours to several weeks. In some cases, with this form of the disease, children have increased sweating, irritability, lethargy. A protracted course of obstructive bronchitis in children is typical for patients with background pathologies such as rickets, anemia, psychophysiological exhaustion, chronic diseases of the upper respiratory tract, aggravated allergic anamnesis.

The recurrent form of bronchitis in children is characterized by annual exacerbations (3-4 exacerbations per year), which last about 2-4 weeks. Relapses are characterized by a milder course than for primary acute bronchitis. Usually relapses begin with symptoms of an acute respiratory viral infection, later patients develop viscous mucosa or mucopurulent sputum. The clinical picture of recurrent bronchitis in children is similar to that in the acute form of the disease, however, coughing with this form of the disease usually bothers the patient much longer (up to two months). The cough is more pronounced in the morning, it can worsen with physical and emotional stress. During the period of remission, clinical manifestations are absent.

Chronic bronchitis in children develops gradually. The onset of the disease is characterized by the appearance of cough in the morning.. In this case, a large amount of mucous sputum is separated from the child.. With the progression of the disease, cough can also occur during the day and at night, shortness of breath develops, weakness and fatigue are observed. Cough worse in damp and cold weather. The amount of sputum gradually increases, it can acquire a mucopurulent or purulent character. Body temperature is usually within normal limits, may rise slightly. Patients have dry wheezing and hard breathing.

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