disease affecting the lower branches of the bronchi, the bronchioles, characterized by the development of acute inflammatory process, often leading to narrowing and obstruction (occlusion) of the bronchial tubes.
Bronchiolitis mainly occurs in children in the first three years of life.
Cause bronchiolitis viral infection of respiratory intitially, parainfluenza, adenovirus. Obstruction of the bronchioles is a response to a viral infection, and it protects the lung tissue from destruction at the death of the ciliated epithelium.
Bronchiolitis in children is very rarely accompanied by the development of bacterial pneumonia (less than 1%). When bronchiolitis bronchospasm plays a role in the development of obstruction than in chronic obstructive bronchitis.
Bronchiolitis caused by parainfluenza and respiratory intitially virus, observed in the first months of life, along with caused by adenovirus affects two – three years children.
Audible at a distance of obstructive syndrome is characterized by shortness of breath whistling, heavy breathing (about 70-90 breaths per minute), the exhalation is performed with the participation of auxiliary muscles, while drawn intercostal space and nadjanema the hole, the wings of the nose swell up when you inhale. May be perioral cyanosis. Cough spastic. The baby is restless.
Acute bronchiolitis develops without fever or small lifts. Fever causes febrile adenovirus, it lasts a few days. When bronchiolitis, which was caused by other viruses, temperature is short, usually within two days. Externally, the child looks seriously ill, and the severity of the condition depends on the severity of respiratory failure.
Characteristic signs of this disease are elongated whistling exhale, boxed shade of percussion sound, moist rales, namely finely krepitiruyuschie and they are heard at the height of inspiration. On the severity of the disease evidenced by the participation of auxiliary muscles during respiration.
For favorable, obstructive changes rapidly diminish and disappear in 7-10 day of the disease.
Obliterative bronchiolitis more frequently becomes chronic. The epithelium of bronchioles affected to a considerable extent, granulomatous reaction and exudate obstructs the lumen of the bronchi.
In children, this type of bronchiolitis due to adenovirus infection. The mucous membrane of the bronchial tubes is completely destroyed, fibrous tissue fills their lumen. Lung tissue either retains the airiness, or collapses and sklerosiruta. In the later stages reveal a continuous hardening of the lung or emphysema. The acute phase of bronchiolitis obliterans is manifested by a change of respiration on the background of febrile temperature, as well as conjunctivitis and nasopharyngitis as manifestations of adenovirus infection.
After improving the long-term remains respiratory insufficiency due to the changes in the bronchioles. The constant changes of the arterioles in the affected part of the lung after 1.5-2 months lead to the development of super transparent lung (Macleod’s syndrome).
Obliterative bronchiolitis complicated by pneumothorax, mediastinal emphysema, bacterial pneumonia.
Diagnosis is based on examination and x-ray examination of the lungs, describing the signs of obstructive syndrome and exclusion of pneumonia.
Bronchiolitis – a disease accompanied by respiratory failure, the treatment is carried out in a hospital
- using antiviral drugs (interferon, ribavirin) because the disease develops on the background of viral infection
- antibacterial therapy is not shown, but the antibiotics are prescribed if the illness is severe and there is a suspected bacterial cause of the disease or are there other pockets of bacterial inflammation, for example, otitis media
- oxygen therapy
- inhalation berodual with the use of the inhaler – nebulizer relieve the obstruction
- in severe cases infusion therapy is used to combat respiratory failure and withdrawal intoxication
- in complex therapy used antihistamines (suprastin, lomilan, zodak), multivitamins, symptomatic therapy.