Due to the constant coughing of a child, any parent will be in a state of permanent anxiety. It can be assumed that this is just a typical child's cough and give the child some medicated syrup. After a few days, it is clear that the child is not getting better, moms and dads take him to the pediatrician, who reports that the child has obstructive bronchitis. Parents often start to panic and fuss because they don't know anything about bronchitis. Fortunately, you can always refer to kroha.info. We will talk about obstructed childhood bronchitis, its symptoms, causes and treatment.
General information about bronchitis
For pediatricians, patients with bronchitis are part of their daily routine. Respiratory system infections are most common in children. Almost all babies and younger students get bronchitis more than once a year. Usually, with the beginning of a visit to kindergarten, there is a sharp accumulation of pathogens, and many parents feel that their child is constantly sick.
Obstructive bronchitis in children occurs much more often in winter than in summer, as everyone knows from personal experience. Cold outside air and dry heated indoor air increase the vulnerability of the bronchial mucosa to pathogens.
Whether the clinical course of bronchitis is uncomplicated or associated with bronchial obstruction is in part due to the child's genetic predisposition. Depending on the family history of bronchial asthma and allergies, the risk can be increased many times.
The health damage caused by exposure to tobacco smoke is a major point that should not be underestimated.
The bronchi carry air from the trachea (breathing tube) to the lungs. When these pathways become inflamed, mucus production is increased. This condition is called bronchitis.
Bronchitis is sometimes associated with bronchial obstruction. The risk of obstruction depends on the lumen of the inflamed bronchus: the smaller the lumen, the more likely clinically significant bronchial obstruction is. This condition is called obstructive bronchitis.
Broncho-obstructive signs can be caused by the following pathophysiological changes.
- The smooth muscles of the bronchus contract, leading to acute shortness of breath.
- The mucous membrane of the respiratory epithelium swells due to inflammation, which narrows the bronchial lumen.
- The increased mucus production also clogs the lumen.
In addition, due to inflammation in the respiratory epithelium, the function of the cilia is reduced and mucus cannot be transported adequately. Auscultation of the lung shows wheezing.
Causes
In 90% of cases, acute obstructive bronchitis in children occurs due to viruses, and the remaining 10% are bacterial infections. A child may have chronic bronchitis with obstruction if he has repeated bouts of acute bronchitis that remain undiagnosed and untreated. Other causes of chronic obstructive bronchitis include a child living in an area with persistent industrial pollution and passive inhalation of cigarette smoke.
Viral infections that are responsible for the development of obstructive bronchitis include:
- flu;
- parainfluenza;
- adenovirus;
- Coxsackie virus;
- rhinovirus;
- respiratory syncytial virus;
- herpes simplex virus;
- human bocavirus.
The child may develop a secondary bacterial infection resulting in obstructed bronchitis. However, this is rare in children who do not have immunodeficiency disorders or cystic fibrosis.
A child develops a bacterial infection due to the following bacteria:
- mycoplasma;
- chlamydia;
- haemophilus influenzae;
- moraxella catarrhalis;
- Pneumococcus.
Even air pollutants can lead to obstructive bronchitis in children. One of the main air pollutants that can cause bronchitis is cigarette smoke. Research shows that if a pregnant woman is exposed to cigarette smoke or cigarette smoke is present in the home after birth, it will cause relapse of obstructive bronchitis in babies.
Other causes of obstructive bronchitis in children:
- fungal infection;
- chronic aspiration;
- gastroesophageal reflux;
- allergies.
Is obstructive bronchitis contagious
Most children with obstructive bronchitis are contagious if the cause is an infectious agent such as a virus or bacteria. The infectious period for bacteria and viruses usually lasts as long as the patient has symptoms, although some viruses will be contagious for several days before symptoms appear. The contagious viruses causing obstructive bronchitis are listed in the causes section.
The contagion goes away when the symptoms subside. But bronchitis caused by exposure to pollutants, cigarette smoke, or other environmental substances is not contagious.
Obstructive bronchitis symptoms in children
Cough
The main manifestation of obstructive bronchitis is cough. It tends to be dry and unproductive at first. As the production of secretion increases, the mucus becomes less viscous, which makes the cough more moist. Some babies have such violent coughing fits that vomiting is possible. After obstructive bronchitis has regressed, an unpleasant dry cough may still persist for days or weeks. This is due to the transient hyperreactivity of the bronchial system due to inflammation caused by infection.
Shortness of breath and wheezing
Shortness of breath gradually increases with the severity of the disease. Typically, children with obstructive bronchitis, when active, cannot breathe normally and begin to cough. Resting breathlessness usually signals that COPD (chronic obstructive pulmonary disease) or emphysema has developed. A loud whistling sound is heard on exhalation, but in severe cases it can be heard on inhalation. It is caused by inflammation of the bronchi and narrowing of the respiratory tract.
Other symptoms
- Rattling sensation in the chest.
- Moderate fever.
- Runny nose.
- Poor sleep due to cough.
- Chest tightness and pain.
- A tickling sensation in the back of the throat, which makes swallowing painful.
- General feeling of unwell.
Obstructive bronchitis in children under one year of age is manifested by blue discoloration of the tips of the ears and nose, nails and lips
The above symptoms are especially dangerous for children under one year old, since the body is not yet strong, immunity is not formed. This causes the rapid progression of obstructed bronchitis.
Diagnostics
Obstructive bronchitis may be suspected in patients with acute respiratory infection with cough. However, since many of the more serious lower respiratory tract diseases cause coughing, obstructive bronchitis should be considered a diagnosis of exclusion.
- Cytological examination of sputum in the diagnosis of obstructive bronchitis will be useful for persistent coughing. The mucus that the child coughs up will be analyzed for infections and other pathological components.
- A chest X-ray helps the doctor rule out pneumonia or other lung infection. If someone in the family smokes, this study is done to rule out lung problems due to exposure to secondhand smoke.
- Bronchoscopy may be required to rule out foreign body aspiration, tuberculosis, tumors, and other chronic diseases of the tracheobronchial tree and lungs.
- A pulmonary function test is a breathing test that uses a device known as a spirometer. The doctor will ask the child to blow into the device to measure the amount of air that his lungs can hold and to determine how quickly the child can exhale. This helps the doctor identify obstruction in children.
- Sometimes children with obstructive bronchitis can suffer from cyanosis. In this state, the oxygen in the blood is insufficient, which gives the skin a bluish tint. If the doctor observes a bluish skin tone, they will perform a test called pulse oximetry. It helps measure the amount of oxygen in the baby's blood. This is a painless, non-invasive test that involves attaching a small probe to your child's finger or nose.
How and how to treat obstructive bronchitis in children
In general, bronchitis can be treated symptomatically because in most cases it is caused by a viral infection for which there is no specific treatment.
To accomplish this, your doctor will prescribe a combination of drugs that open up the bronchial airways and soften mucus to make it easier to cough up. Bed rest is recommended.
The most effective means of controlling cough and sputum production in patients with chronic obstructive bronchitis is to prevent environmental irritants, especially cigarette smoke.
Treatment for obstructive bronchitis in children includes a number of medications.
Bronchodilators
Obstructed bronchitis makes it difficult for a child to breathe due to a narrowing of the respiratory tract. Therefore, the doctor will prescribe bronchodilators.
They widen the inflamed airways and reduce swelling. This allows the baby to breathe more freely without wheezing, pain or discomfort.
Studies (albeit limited) have shown the benefit of bronchodilators and a possible superiority with antibiotics for relieving bronchitis symptoms.
Albuterol and Metaproterenol relax the smooth muscles of the bronchi, having little effect on the contractile ability of the heart.
Theophylline and Ipratropium are used to control manifestations such as chronic cough, shortness of breath, bronchospasm in stable patients with chronic obstructive bronchitis.
Systemic corticosteroids
These are Prednisone, Prednisone, Dexamethasone.
For children with an exacerbation of chronic obstructive bronchitis, a short course of systemic corticosteroid therapy is possible to relieve wheezing and inflammation.
Inhaled corticosteroids
Corticosteroids are the most powerful anti-inflammatory drugs. Inhalation forms are active locally, practically do not penetrate into the systemic circulation. In children who are stable with chronic obstructive bronchitis, treatment with a long-acting bronchodilator in combination with an inhaled corticosteroid may help relieve chronic cough.
Beclomethasone induces direct relaxation of smooth muscle and may decrease the activity and number of inflammatory cells, which decreases respiratory hyperreactivity.
Fluticasone has an extremely strong vasoconstrictor and anti-inflammatory activity.
Budesonide reduces inflammation in the respiratory tract by inhibiting multiple types of inflammatory cells and decreasing the production of neurotransmitters that are involved in the asthmatic response.
Mucolytics
Mucolytic drugs cause the bronchial mucus (phlegm) to thin out to make it easier to cough up. Among mucolytics, the best known are Acetylcysteine, Bromhexine and Ambroxol.
- Acetylcysteine has anti-inflammatory effects.
- Bromhexine activates enzymes that break down mucus molecules and stimulate glandular cells to increase mucus production by decreasing mucus viscosity.
- Ambroxol is the result of the breakdown of bromhexine. In addition to its effects, it stimulates the production of surfactant (the substance that lines the inside of the lung alveoli). This helps the lungs absorb and absorb oxygen.
Some herbal substances, such as ivy, are also considered mucolytic agents. In general, the therapeutic value of all these so-called cough syrups should not be overstated. It is much more important for children to drink and inhale enough.
Antibiotics
Antibiotics for obstructive bronchitis in children are prescribed in case of a bacterial infection. The choice of the appropriate antibiotic depends on the age of the child, because different age groups have their own predominant pathogenic group.
After receiving an antibioticogram, antibiotic therapy can be determined according to the sensitivity and resistance of the bacteria. Bacterial spectra also differ between community-acquired and nosocomial infections. Sometimes it is impossible to distinguish between viral and bacterial infections, since the clinical picture and blood parameters can be very similar. In this situation, the child will be treated with an antibiotic, although this is just a viral infection with a high fever.
Amoxicillin and Clavulanate (Augmentin)
It is a semi-synthetic antibiotic with a wide spectrum of bactericidal activity, covering both gram-negative and gram-positive microorganisms. It works by stopping the growth of bacteria.
It is a good alternative antibiotic for children with allergies or intolerance to the macrolide category. It is generally well tolerated and provides good coverage for most infectious pathogens, but is ineffective against Mycoplasma and Legionella species. The half-life of an oral dose is 1-1.3 hours. It penetrates well into tissues, but does not pass the blood-brain barrier, which makes it useless in the fight against neuroinfection.
Erythromycin
Erythromycin belongs to the macrolide group. Macrolide antibiotics inhibit the growth or kill sensitive bacteria by decreasing the production of important proteins the bacteria need to survive. It is prescribed for streptococcal, staphylococcal, mycoplasma and chlamydial infections.
Azithromycin
Used to treat certain mild or moderate bacterial infections (including sinusitis, pneumonia). It is a macrolide antibiotic that works by stopping the growth of bacteria.
Do not give this medicine to a child younger than 6 months old.
Tetracycline
Tetracycline acts on gram-positive and gram-negative organisms, as well as on mycoplasma, chlamydial infections.
In certain cases, tetracycline is used if penicillin or another antibiotic cannot be used to treat severe infections such as clostridium, listeria, and others.
It is less effective than Erythromycin.
Tetracycline works best when taken on an empty stomach one hour before or 2 hours after a meal. Each dose should be taken with a full glass of water (240 ml). It is not recommended to lie down for 10 minutes after taking this medication. For this reason, you should not take the dose right before bed.
Tetracycline can make your skin more sensitive to sunlight. Use sunscreen and protective clothing when you need to be in the sun.
Children under 8 years of age should not take tetracycline. Tetracycline can cause permanent tooth discoloration and may also affect a child's growth.
Cefditorin
This drug belongs to a class of drugs known as cephalosporin antibiotics.
It is prescribed for exacerbation of chronic bronchitis, which is caused by susceptible strains of S pyogenes.
Cefditoren works best when taken with food.
This drug is not recommended for longer use (several months) due to the increased risk of side effects.
Trimethoprim-sulfamethoxazole
Used to treat a certain type of pneumonia (Pneumocystis pneumonia) in immunocompromised patients. This medication is a combination of 2 antibiotics: sulfamethoxazole and trimethoprim. Like tetracycline, it has activity against whooping cough, but does not work against mycoplasma infections.
You should drink plenty of fluids while taking this drug to reduce your risk of kidney stones.
Do not give this medication to a child younger than 2 months old.
Amoxicillin
This drug is a penicillin-type antibiotic.
Derived from ampicillin, it has a similar antibacterial spectrum (some gram-positive and gram-negative organisms). It has a bactericidal effect similar to penicillin, acting on susceptible bacteria during the multiplication stage, it has excellent bioavailability and resistance to stomach acid, a broader spectrum of activity than penicillin.
Amoxicillin is less active than penicillin against Streptococcus pneumococcus; penicillin-resistant strains are also resistant to amoxicillin, but higher doses may be effective. The drug is more effective against gram-negative organisms (eg, N meningitidis, H influenzae) than penicillin.
Clarithromycin
Semi-synthetic macrolide antibiotic. It is also used to prevent certain bacterial infections.
Doxycycline
It is a synthetic broad-spectrum bacteriostatic antibiotic in the tetracycline class.
Doxycycline should be used by children under 8 only in cases of severe or life-threatening conditions. This medicine may cause persistent yellowing or discoloration of teeth in children.
Antibiotics work best when the amount of the drug in the body is kept constant. Therefore, antibacterial drugs should be taken at the same time every day.
Antibiotics are required until the prescribed course is completed, even if the symptoms disappear after a few days. Stopping the medication too early will allow the bacteria to continue to grow, leading to a relapse of the infection.
Analgesics / Antipyretic
Analgesics and antipyretics are often helpful in relieving the apathy, malaise, and fever associated with illness.
- Ibuprofen. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It reduces the production of substances that cause inflammation and pain in the body. Ibuprofen is used to lower fever and treat inflammation or pain.
- Paracetamol. Paracetamol is an analgesic and antipyretic agent. Children under 12 years of age should not take more than 5 doses in 24 hours. Use only the recommended amount of milligrams for the child's age and weight.
Do not give these drugs to a child under 2 years of age without consulting a specialist.
Nasal drops
Saline nasal drops are used to moisturize and cleanse the nasal mucosa. Vasoconstrictor nasal drops should be given if the Eustachian tube swells in response to an upper respiratory infection to ensure ventilation of the middle ear. These drops should not be given for more than 7 days, otherwise they can lead to irreversible damage to the mucosa.
Oxygen therapy
In the case of severe bronchial obstruction with spasms of the bronchial muscles, edema of the bronchial mucosa and the formation of viscous secretions, ventilation in the respiratory tract and diffusion in the alveoli may be impaired. This causes partial or systemic oxygen deprivation. If the pulse oximetry test detects that the oxygen saturation of the blood is too low, additional oxygen is needed.
This therapy is performed to provide the body with additional oxygen so that tissues and cells receive a sufficient amount of it through the blood.
Oxygen is usually supplied through nasal cannulas. If young children cannot tolerate nasal prongs, a mask may be used, especially while sleeping.
Chronic bronchitis treatment helps to minimize all symptoms, but you must realize that the symptoms will never go away. They will keep coming back and your child will need regular and long-term treatment.
Why is obstructive bronchitis in children dangerous?
A child has a high risk of complications from obstructive bronchitis if:
- has had a cough for more than three weeks;
- he coughs so hard that he cannot sleep well;
- the child wheezes;
- it is difficult for him to breathe;
- the baby has a fever of 38 degrees and above;
- he coughs up bloody mucus.
Children with undiagnosed and uncontrolled obstructive bronchitis are at risk of developing pneumonia, and chronic obstructive bronchitis can lead to chronic obstructive pulmonary disease (COPD).
Pneumonia
Statistics show that out of every 20 cases of obstructive bronchitis, 1 pneumonia develops. It is a secondary bacterial infection of the lung caused by bronchitis. The bacteria infect the tiny air sacs (alveoli) of the lungs. Babies and children have a higher chance of developing pneumonia because their immune system is not strong enough to fight infection.
If a child also has asthma or another condition that has weakened their immune system, they are at risk of developing pneumonia.
Pneumonia symptoms:
- high fever;
- shortness of breath, even at rest;
- fast pulse;
- lack of appetite;
- chest pain;
- cough;
- sweating and chills;
- lethargy.
When a child develops mild pneumonia, doctors will prescribe antibiotics, bed rest, and adequate fluid intake. This treatment takes place at home. However, if the infection is more severe, the child will need hospitalization to prevent respiratory failure.
Chronic obstructive pulmonary disease
Chronic obstructive bronchitis in children can develop into chronic obstructive pulmonary disease (COPD). This condition reduces the lungs' ability to function optimally and causes breathing difficulties. It also makes the baby more susceptible to other lung infections.
COPD is a progressive disease and symptoms worsen over time. Since the lungs are permanently damaged, treatment and lifestyle changes are the only way to slow the progression of the disease and allow the child to lead an active life.
Prevention of obstructive bronchitis in children
Bronchitis is not contagious. But the virus or bacteria that cause bronchitis are infectious. Therefore, the best way to prevent illness is to make sure that the baby is not infected with a bacteria or virus.
- Teach your child to wash their hands thoroughly with soap and water before eating.
- Provide your child with a healthy and nutritious diet so that their immunity is strong enough to fight infectious pathogens.
- Keep the child away from family members with flu or colds
- Do not allow family members to smoke indoors as passive inhalation of cigarette smoke can cause chronic obstructive bronchitis
- If you live in a very polluted area, have your child wear a face mask.
- Clean your baby's nose and sinuses with a nasal spray to remove allergens and pathogens from the nasal cilia.
- Supplement your child's diet with vitamin C to boost immunity.
Treatment of obstructive bronchitis in children with folk remedies
You can use home remedies for obstructive bronchitis to relieve symptoms of the infection. However, consult your doctor before using these methods. This is especially necessary if the child is receiving medication for an infection. Certain home remedies can interact with the medication, resulting in adverse side effects.
- Increase your fluid intake.
Coughing and fever can dehydrate a child. So give him plenty of fluids to drink. He should drink eight to ten glasses of water every day. It also helps thin mucus, making it easier for the body to eliminate it.
- Humidifier.
When your child has difficulty breathing while sleeping or playing, use a cool steam humidifier to keep the indoor air humid. This will help him breathe easier. However, periodically clean the humidifier to prevent the spread of germs.
- Cranberry juice.
Cranberry juice is high in vitamin C, which is an immune stimulant. This helps the child's immune system fight the infection.
- Honey.
Honey has anti-inflammatory and antibacterial properties. It can alleviate the phenomenon of inflammation of the mucous membrane of the respiratory tract, thereby minimizing cough. You can add honey to warm water and give it to your baby as a drink.
- Thyme.
Thyme will help clear mucus from the airways and strengthen the lungs. Boil some dried thyme in a bowl of water. Let it sit for 10 minutes. Strain. Mix the mixture with honey and give the child a drink.
- Turmeric.
Turmeric has been used for centuries to fight infections. Its antiseptic and anti-inflammatory properties help the child with colds. Mix a teaspoon of turmeric powder and a small amount of warm milk. Stir the turmeric well until it dissolves in the milk. Have your child drink the mixture in the morning on an empty stomach for best results.
- Magnesium sulfate.
Magnesium sulfate baths can relieve bronchial constriction and also detoxify the body. Add two cups of magnesium sulfate to the baby's bath water and let the baby sit in it for 30 minutes. Encourage him to inhale the steam for optimal results.
Don't give your child any home remedy that can suppress coughs. It is important for the child to cough up mucus as this will help him recover. If you want to calm his throat, honey should be enough.
Conclusion
Children's obstructive bronchitis is mild to severe with symptoms of respiratory failure. Do not ignore the child's cough, take him to the doctor. The last thing you want is to make the infection worse and lead to complications such as pneumonia and COPD. With early diagnosis and proper treatment, bronchitis should not be a cause for concern.
