Fine bronchitis
Fine bronchitis is an inflammation of the smallest air passages of the lungs, the fine bronchi. It occurs most often in children younger than two years of age and presents with coughing, wheezing, and shortness of breath. This inflammation is usually caused by respiratory syncytial virus. Treatment is usually supportive and involves nebulized inhaled epinephrine or hypertonic saline.
Signs Typically, infants and children under two years of age present with one or two more days of coughing, wheezing, and shortness of breath. The child may not be able to breathe for several days. After acute illness, the airway usually remains sensitive for several weeks, causing recurrent episodes of coughing and wheezing.
Etiology
The disease is usually referred to as acute viral bronchiolitis and is a common illness in infancy and childhood. It is most commonly caused by respiratory syncytial virus (RSV, also known as the human pneumonia virus). Other viruses that may also cause this disease include parapneumovirus, influenza, parainfluenza virus, coronavirus, adenovirus, and rhinovirus.
A recent study by Perth’s Telethon Child Health Institute has shown an 11% increase in hospitalization rates for this disease in children born this way.
The diagnosis is usually made by clinical examination. Chest X-rays are useful in ruling out pneumonia, but are of little use in routine cases.
Direct immunofluorescence of RSV in nasopharyngeal secretions has a sensitivity of 61% and a specificity of 89%. Identification of groups positive for respiratory syncytial virus can help: disease surveillance, concentration in groups in hospital wards (“centralized isolation”), prevention of cross-infection, prediction of whether the course of the disease has reached its peak, reduction of the need for other diagnostic procedures (conferring confidence in the determination of the disease).
Less than 6% of infants and children between two and three months of age with capillary bronchitis, while being infected with bacteria secondary (usually urinary tract infections).
Prevention
Preventive measures for capillary bronchitis rely heavily on reducing the transmission of viruses that cause respiratory infections (i.e., washing hands and avoiding contact with those who have symptoms of respiratory infections). In addition to good hygiene practices, improving the immune system is a powerful preventive tool. One way to improve the body’s immune system is through breastfeeding, especially during the first month of life. Immunizations, which can be used for premature infants who meet certain conditions (with heart and respiratory diseases), such as respiratory syncytial virus monoclonal antibody (an RSV monoclonal antibody). Passive immunotherapy requires monthly injections every winter time.
Management and control of capillary bronchitis, usually focusing on symptoms rather than the infection itself (supportive therapy), because the infection will progress as usual and the symptoms will cause complications.
Inhaled epinephrine Nebulized inhaled epinephrine (racemic and levo(1)-epinephrine) has been shown to reduce hospitalization rates.
Inhalation of hypertonic saline Inhalation of hypertonic saline (3%) appears to be effective in improving clinical outcomes and reducing the length of hospital stay.
Other drugs No evidence is available to support the use of other drugs at this time.
Ineffective treatment Ribavirin is an antiviral drug that appears to be ineffective in fine bronchiectasis. Complex fine bronchitis with bacterial infection is treated with antibiotics. However, there is no effect on the underlying viral infection. Corticosteroids, for which there is no evidence of benefit, are not recommended for the treatment of fine bronchitis. dna enzymes are ineffective.
Epidemiology 90% of patients are between 1 month and 9 months of age. Fine bronchitis is the most common cause of hospitalization before 1 year of age. It is prevalent in the winter months.
Bronchiolitis Bronchiolitis is an inflammation of the mucous membrane of the bronchi (the passage that carries airflow from the trachea into the lungs). Bronchitis can be divided into two categories, acute and chronic, each with its own etiology, pathology and treatment.
Acute bronchitis is characterized by coughing, with or without sputum, and coughing up mucus from the respiratory tract. Acute bronchitis often occurs during an acute viral illness, such as the common cold or influenza. Viruses cause about 90% of acute bronchitis cases, while bacteria cause less than 10% of cases.
Chronic bronchitis, a type of chronic obstructive pulmonary disease, is characterized by a productive cough that persists for three months or more each year for at least two years. Chronic bronchitis is most commonly caused by repetitive airway damage from inhalation of various irritants. Cigarette smoking is the most common cause, followed by air pollution and occupational exposure to irritants.
Acute bronchitis Acute bronchitis is most often caused by viruses that infect the bronchial epithelium, resulting in inflammation and increased secretion of mucus. Cough, a common symptom of acute bronchitis, manifests itself by attempting to expel excess mucus from the lungs. Other common symptoms include sore throat, runny nose, nasal congestion (rhinitis), low-grade fever, pleurisy, body discomfort, and coughing up sputum.
Acute bronchitis is often seen during upper respiratory infections such as the common cold or flu (URI). About 90% of acute bronchitis cases are caused by viruses, including rhinovirus, adenovirus, and influenza virus. Bacteria, including Mycoplasma pneumoniae, Chlamydia pneumoniae, Clostridium perfringens, Streptococcus pneumoniae, and Haemophilus influenzae, account for about 10% of cases.
The treatment of acute bronchitis is primarily symptomatic. Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to treat fever and sore throat. Decongestants are useful in patients with nasal congestion, and expectorants are used to loosen mucus to increase sputum drainage. Although coughing helps with airway drainage, cough suppressants are used if the cough interferes with sleep or is irritating. In most cases, acute bronchitis resolves quickly, even without treatment.
Only about 5 to 10 percent of bronchitis is caused by a bacterial infection. In most cases, bronchitis is caused by a viral infection that is “self-limiting” and clears up on its own within a few weeks. Because it is viral, antibiotics are not often used. The use of antibiotics in patients without bacterial infection will promote the emergence of antibiotic-resistant bacteria, which may lead to greater morbidity and mortality. However, even in cases of viral bronchitis, in some patients, antibiotics are indicated to prevent the development of secondary bacterial infections.
Chronic bronchitis Chronic bronchitis, a type of chronic obstructive pulmonary disease, is defined as a productive cough that persists for 3 months or more per year for at least 2 years. Other symptoms include wheezing, shortness of breath, especially after exertion. The cough is often worse shortly after waking from sleep and has sputum, which is yellow or green, or with blood traces.
Chronic bronchitis caused by repeated damage or irritation of the bronchial epithelium of the airways results in chronic inflammation, edema (swelling), and increased mucus secretion by the cupulae. The airflow to and from the lungs is partially blocked because of swelling and excess mucus in the bronchi or because of reversible bronchospasm.
In most cases, chronic bronchitis is caused by smoking or other tobacco-related factors. Chronic inhalation of irritating gases or occupational exposure to dust or air pollution may also be the cause. About 5% of the population has chronic bronchitis, twice as many women as men.
Chronic bronchitis is treated symptomatically. Inflammation and edema of the respiratory epithelium may be reduced by the administration of glucocorticoids. Reduction of bronchospasm (reversible small bronchial narrowing due to bronchial smooth muscle contraction) to treat wheezing and shortness of breath, administration of bronchodilators such as inhaled beta-adrenergic agonists (e.g., salbutamol) and inhaled anticholinergic drugs (e.g., ipratropium bromide?). . Hypoxemia, where there is too little oxygen in the blood, can be treated with supplemental oxygen. Supplemental oxygen, however, may lead to a decrease in respiratory drive, resulting in increased carbon dioxide in the blood and subsequent respiratory acidosis.
The most effective way to prevent chronic bronchitis and other forms of COPD is to avoid smoking and other forms of tobacco factors.
On tests of the lungs, bronchitis may present with decreased FEV1 and FEV1/FVC. However, unlike other common obstructive diseases, such as asthma and emphysema, bronchitis rarely causes high residuals. This is because the airflow obstruction in bronchiectasis is due to increased resistance and, in general, does not cause premature airway collapse resulting in gas trapping in the lungs.
Prolonged bacterial bronchitis Prolonged bacterial bronchitis is defined as a chronic wet cough and is treated with antibiotics and aggressive bronchoalveolar lavage (BAL). It is usually caused by Streptococcus pneumoniae, Haemophilus influenzae, and Cataplasma.