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Acute bronchitis — bronchitis, as a rule, proceeding till 1 month.
The disease arises in a winter season more often. Treat risk factors of development of an acute bronchitis:
• disturbance of nasal breath;
• the centers of persistent infection in a nasopharynx;
• advanced or children's age;
• smoking (including passive);
• reflux esophagitis;
• environmental pollution.
Classification of an acute bronchitis
Depending on an etiological factor allocate the acute bronchitis of an infectious origin and an acute bronchitis caused by influence of physical and chemical factors.
Etiology and pathogeny of a disease
Most often the acute bronchitis has a virus etiology. Main activators:
· an influenza virus And yes In;
• parainfluenza virus;
• respiratory and syncytial virus.
Bacterial acute bronchitis causes:
• Mycoplasma pneumoniae;
• Chlamydia pneumoniae;
• Bordetella pertusis;
• Streptococcus pneumoniae;
• Haemophilus influenzae;
• Staphylococcus aureus.
The last three activators cause an acute bronchitis seldom (occur mainly at newborn, elderly persons, patients with a tracheostoma and with reduced immunity).
Besides, steam inhalation of ammonia can become the reason of development of an acute bronchitis, chlorine, dioxides are gray.
Influence of infectious or toxic agents causes hypostasis of a mucous membrane of a tracheobronchial tree, increase of products of slime, disturbance of mukotsiliarny clearance. In turn the expressed inflammatory hypostasis of a mucous membrane of bronchial tubes leads to disturbance of their passability.
Clinical signs and symptoms of an illness
The clinical picture of an acute bronchitis is characterized by the acute beginning, existence of the symptoms caused by damage of the upper and lower airways and symptoms of intoxication of various degree of manifestation characteristic of viral infections.
The symptoms caused by damage of airways:
• the main symptom — the cough with department of a small amount of a mucous phlegm gaining hoarse, painful character from some patients;
• the nose congestion, a rhinorrhea and disturbance of nasal breath, a hyperemia of a mucous membrane of a nasopharynx are quite often observed;
• at simultaneous damage of a throat and throat (usually at the infection caused by a parainfluenza virus) the voice osiplost is possible;
• at auscultation vesicular breath with the extended exhalation, the diffusion dry whistling and buzzing rattles is listened;
• in hard cases an asthma disturbs.
• fervescence to subfebrile figures;
For the acute bronchitis caused by M. pneumoniae
symptoms of pharyngitis, conjunctivitis, muscle pain and fervescence are characteristic cough with a mucous phlegm. The disease can proceed till 4 — 6 weeks.
At the acute bronchitis caused by C. pneumoniae symptoms of pharyngitis and laryngitis come to light.
the acute bronchitis caused by Bordetella pertusis (at whooping cough), is characterized by attacks of unproductive cough (can arise benign at vaccinated persons).
Complications. At children till 5 flyings, elderly persons and patients with reduced immunity development of a bronchiolitis and pneumonia is possible.
The acute bronchiolitis results from transition of inflammatory process from bronchial tubes to bronchioles. It is characterized by painful cough with the scanty mucous phlegm expressed by an asthma, fervescence to 38,5 — 39,0 °C.
The diagnosis and the recommended clinical trials
The diagnosis of an acute bronchitis is made on the basis of clinical manifestations. Its existence should be assumed at the patients with sharply arisen cough who did not have earlier bronchopulmonary diseases.
Confirmation of the diagnosis by means of laboratory and tool methods of research usually is not required, however use is possible:
• polimerazny chain reaction (for identification of M. pneumoniae and C. pneumoniae);
• serological tests (for the purpose of detection of M. pneumoniae; seroconversion of specific antibodies in pair blood sera is observed);
• X-ray analysis of lungs. At an acute bronchitis of change on roentgenograms are absent. Are characteristic of a bronchiolitis: focal atelectases, increase of transparency of pulmonary fields, flattening of a diaphragm, expansion of retrosternal space in the perednezadny direction, peribronchial infiltrates.
Differential diagnosis needs to be carried out with:
• exacerbation of chronic bronchitis;
• miliary tuberculosis.