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Clinic and the classification of acute bronchitis
Clinic and the classification of acute bronchitis
On the etiology of acute bronchitis should be distinguished:
infectious origin;
viral,
bacterial,
viral and bacterial;
due to physical and chemical hazards;
mixed (eg, a combination of physical, chemical factors and infections);
unspecified nature.
On the pathogenesis can be identified so-called primary bronchitis, which are separate disease, and secondary bronchitis, complicated by other pathological processes. Almost all acute bronchitis, which can be regarded as independent entities that are diffuse.
The level of destruction acute bronchitis can be divided into:
By the nature of the inflammatory process can be divided into acute bronchitis, catarrh and purulent. The functional features of acute bronchitis should be divided into non-obstructive (with a relatively good prognosis PWM), and obstructive, usually accompanied by involvement in inflammation of small bronchi and bronchioles, with a relatively unfavorable clinical prognosis of .
And finally, the current options: 1) ostrotekuschy (usually no more than 2 weeks), 2) prolonged (up to a month or more), and 3) recurrent (3 or more times during the year).
More seriously and adversely acute lesions occur ¬ of small bronchi, which tend to be obstructive in nature. Most acute bronchial catarrh has character, pus forms are rare, usually associated with streptococcal infection, in combination with a virus (viral and streptococcal Association).
Clinic of acute bronchitis
The clinical picture of acute bronchitis is defined by the peculiarities of the etiological factor, the nature, severity and extent of damage the mucous membrane of the bronchial tree, the level of lesion, severity of intoxication and respiratory failure, the rate of disease development.
Acute bronchitis may develop within a few hours, but can grow and gradually, over several days. In the most typical cases where the cause of acute bronchitis is an infection, the symptoms of acute respiratory disease preceded the manifestation of acute bronchitis, at least they are developing simultaneously. Typical of the general state of health violations: malaise, weakness, chills, and fever. At the same time there may be other manifestations of acute respiratory disease of the upper respiratory tract, runny nose, sore throat when swallowing, hoarseness of voice.
The main and most persistent symptom of acute bronchitis is a cough - initially dry. Cough appears at the beginning of the disease, carried through the illness and is the latest manifestation of myocardial Deseases for convalescents. With the simultaneous defeat of laryngeal cough acquires a peculiar shade of barking. Cough bronchitis is caused by irritation or inflammation of the mucous membrane of the trachea and major bronchi due to irritation of sensory nerve endings. Paroxysms cough usually end department scant mucous expectoration.
Often there is tenderness in the upper part of the abdominal wall, as well as in the lower chest, respectively, the place of attachment of the diaphragm, due to overexertion of the muscles during cough attacks. After several days of illness cough becomes more soft and moist, as more regularly separated expectoration of mucous or muco-purulent character. The appearance of dyspnea, as a rule, evidence of airflow obstruction join associated with involvement in the disease of small bronchi. In this sense, the presence of cough and sputum in one case, and shortness of breath - in the other may indicate the level of bronchial lesions, ie, the primary lesion of the large bronchial tubes ABI ABI combination.
Changes in the other organs and systems in acute bronchitis is usually absent or reflect the common viral and bacterial and other intoxication. The same can be said about the blood picture.
Radiographic changes in acute bronchitis is usually absent. In protracted course of acute bronchitis re-radiography is important for timely diagnosis of pneumonia join.
The features of the clinical picture of allergic bronchitis are the lack of well-known signs of inflammation (muco-purulent and purulent sputum, neutrophilic leukocytosis, shift to stab leukocyte counts, elevated erythrocyte sedimentation rate, etc.), the tendency to allergic reactions and other allergic manifestations, including the laboratory study.
Bronchiolitis is usually as a part of the heavy defeat of the bronchial tree, sometimes it develops itself.
For acute bronchiolitis is characterized by severe shortness of breath, which increases sharply at low physical effort, racking cough with scanty mucous expectoration, chest pain associated with overexertion of respiratory muscles. There have puffiness face, cyanosis of the ears, nose, fingers, toes. Breathing intense, with the participation of auxiliary muscles. The rib cage as if fixed in a position of deep breaths, with a raised shoulder belt. Percussion tone to the tympanic shade. The lower limit of light is lowered, the mobility of the diaphragm is limited. Auscultation of breath is often weakened, in the lower divisions can listen melkopuzyrchatys wheezing.
Reducing sonorities respiratory noise is usually accompanied by the growth of the clinical manifestations of respiratory failure and poor prognosis. Radiologically determined acute swelling of light curtain can be increased lung markings. When complications of pneumonia, bronchiolitis microfocal X-ray pattern similar to miliary tuberculosis of the lungs. Bronchiolitis during prolonged and severe, the prognosis is often poor, especially in the elderly.
