Epidemiology

In the structure of all childhood diseases, the proportion of bronchitis is about 5%;
in the structure of NLD - on average 30% and more;
Morbidity rates have a clear relationship with AVI;
The incidence of bronchitis among children ranges from 15% to 50%,
averaging 75-250 per 1000 children per year;
The prevalence of bronchitis is higher among children living in large industrial cities,
in crowded conditions, in regions with a cold, humid climate
Predisposing factors

 Anatomical and physiological features

 High incidence of AVI
 Features of immunity
 Unfavorable environmental conditions (increased receptor sensitivity)
 The presence of foci of infection in the upper respiratory tract
 Concomitant allergic diseases
 Unfavorable weather factors
 Preferential stay on the back, longer sleep, frequent crying
BRONCHITIS is an inflammatory disease of the bronchi of various etiologies
(infectious, allergic, toxic, physicochemical, etc.),
proceeding without signs of damage to the lung tissue,
the clinical manifestation of which is cough, sputum formation,
and in case of damage to small bronchi - shortness of breath
Classification of bronchitis (symposium of pediatricians-pulmonologists - XI.1995

ACUTE BRONCHITIS (SIMPLE) - J 20

ACUTE OBSTRUCTIVE BRONCHITIS - J 20
ACUTE BRONCHIOLITIS - J 21
ACUTE OBLITERATING BRONCHIOLITIS - J 21
RECURRENT BRONCHITIS - J 40.0 (repeated bronchitis)
RECURRENT OBSTRUCTIVE BRONCHITIS - J 40.0
(Diagnosis used in pediatric practice.
J 40 - bronchitis not specified as acute or chronic, additional subheading
"0")
CHRONIC BRONCHITIS (WITH OBLITERATION) - J 43
CHRONIC BRONCHITIS - simple and mucopurulent - J 41;
unspecified - J 42
(Morphologically proven chronic process)
 etiology

pathogens representatives
viruses Parainfluenza 1 и 3 type RСV Аadenovirus Rhinovirus
Coronavirus Influenza Virus Cytomegalovirus Enterovirus Herpes virus
Measles virus, etc.Mycoplasma pneumoniae – до 20-25% случаев
Mycoplasma hominis
Intracellular Clamydia trachomatis
exciters Clamydophyila pneumoniae – до 7% случаев

Strept. рneumoniae
Haemoph. Influenzae
bacteria Moraxella catarralis
Staph. аureus
Streptococcus
Enterococcus
Klebsiela pneumoniae
Pseudomonas aeruginosa
Candida albicans
Aspergillus
 Mechanism of occurrence and the development of infection

Penetration of the pathogen into the respiratory tract (tropism, virulence of the pathogen, massive
infection)

Fixation on the mucosal surface

Reproduction on the mucous membrane, damage to the epithelium of the respiratory tract
(the body responds with a protective inflammatory response and the creation of immune defenses)

Infection (occurs if the body's defenses are not enough)

Mucotsolar defense Immune defense
Clinical features
Dry cough that gradually softens with expectoration.
Unpleasant sensations behind the sternum.
Subfebrile temperature.
With tracheobronchitis - hoarseness of the voice.
Clinical features
Percussion: The sound is not changed Auscultatory:
Vesicular breathing, if swelling is expressed - hard.
With the defeat of large bronchi - dry rales which, with progression are replaced by wet
With the defeat of medium and small bronchi - wheezing
 Acute bronchiolitis
A variant of the course of obstructive bronchitis (more severe), characterized by diffuse (generalized)
lesions of small bronchi and bronchioles and the development of significant respiratory failure
Clinical features
Usually develops on 3-4 days of mild at first ARVI
Difficulty exhaling with a respiratory rate of up to 70 and above in 1 min.
Bloating of the wings of the nose, perioral cyanosis
Exhalation lengthening may be absent at high RR
Dry cough, sometimes with high spastic overtone
The peculiarity of the auscultatory picture:
against the background of whistling wheezing on exhalation,
there is an abundance of small moist wheezing on inhalation and at the very beginning
of exhalation on both sides (picture of a "wet lung")
On the R-gram - bloating of the lungs, increased broncho-vascular pattern
In 25-30% of cases - segmental (less often lobar) atelectasis
Hyperventilation (decrease in PaO2, PaCO2)
Recurrent bronchitis - bronchitis without obstruction, episodes of which are repeated 2-3 times within 1-2
years
against the background of acute respiratory viral infections, characterized by the duration of clinical
manifestations
(2 weeks or more)
Recurrent obstructive bronchitis - obstructive bronchitis whose episodes are repeated in young children
against the background of ARVI 3 or more times a year In practice:
3 episodes of simple or obstructive bronchitis per year
Infectious process in the bronchi develops into insolvency protective system and due to tropism
of pathogens to respiratory epithelium path
(virulence of the pathogen,
the massiveness of infection and the state of the defense mechanisms of the macroorganism)

 Rapid elimination of the pathogen

 Infectious disease
 Manifest
 Asymptomatic
 Subclinical
 Carrier
Symptomatic treatment
 half-bed mode
 dairy plant diet enriched with vitamins
 plentiful drink
 restoration of nasal breathing: suck the contents from the nose,
rinse the nose
use vasoconstrictor drops (3-4 days)
 antipyretic drugs at the rate of 15 mg / kg
 expectorant drugs over 5 years

 with obstruction-inhalation through a nebulizer (with berotek,

berodual, salbutamol)