Bronchiolitis

- acute inflammation of the bronchioles; considered as a severe form of acute bronchitis.

Etiology and pathogenesis of Bronchiolitis


Pathogens are usually viruses (influenza, respiratory syncytial) or viral and bacterial infections. Can develop after the inhalation of irritating gases very cold air. Inflammation of the bronchioles with a violation of their patency leads to severe violations of gas exchange and blood circulation.

Symptoms and course of Bronchiolitis

The onset of the disease is acute or against the background of tracheobronchitis. Fever (38-39 °C); severe shortness of breath (up to 40 or more breaths in 1 min), shallow breathing with the participation of auxiliary muscles. The chest is fixed in the position of inspiration with the shoulder girdle raised.

His face was puffy and cyanotic. Painful cough with scanty mucus, chest pain due to overstrain of the muscles and contraction of the diaphragm when coughing. Percussion sound with boxed shade, the breath weakened or stiff, abundant finely (subcriteria) neskuchnie rales, wheezing on the exhale.

Symptoms of obstructive emphysema are increasing. Severe respiratory failure is accompanied by disorders of pulmonary and viutricardial hemodynamics due to pulmonary hypertension.

Radiologically, the strengthening of the pulmonary pattern in the lower parts and in the area of the roots of the lungs is determined. There is leukocytosis, increased ESR. The course is very severe, the duration of the disease is up to 56 weeks. Possible fatal outcome.

Differential diagnosisof Bronchiolitis

It is carried out with miliary tuberculosis, pneumonia. In this case, the crucial importance belongs to the x-ray study.

TreatmentOf Bronchiolitis

It includes parenteral administration of antibiotics on the principle of treatment of acute pneumonia, oxygenotherapy, eufillin (5 ml of 2.4% solution in / in 2-3 times a day).

Symptomatic therapy: during a painful unproductive cough-antitussive (codeine, libexin, etc.), then expectorants and mucolytics; analgesics for pain; mustard plasters, etc. If necessary, intensive care in the intensive care unit.