In the sense that the classic signs of ARI, visible and audible by a person without special education, do not allow to be sure that this particular cough - certainly bronchitis. At the same time for a doctor, the diagnosis of bronchitis does not present any difficulties due to the inherent bronchial inflammation of typical auscultative symptoms. Symptoms of bronchitis in a child, his treatment - all this in an article.
Special signs
The word "bronchitis" is just a statement of the presence of inflammation of the bronchi, and inflammation is microbial (viral, bacterial) and allergic. Another specific nuance of the diagnosis of bronchitis is that the depth of the inflammatory process varies. Speech, for example, can go about tracheobronchitis, in which only the trachea and large bronchi are affected, but it is quite possible to spread the inflammatory process lower - to medium bronchi, small bronchi. The level of damage to the bronchial tree largely determines both the symptoms and severity of the disease. The deeper the inflammatory process - the narrower the airway at the site of inflammation. Accordingly, the probability of obstruction is much higher, it is more difficult to cough up phlegm, dyspnea is more pronounced.
On two fronts?
The principal feature of bronchitis caused by viruses or bacteria is a significant severity of the syndrome of common disorders. And this obvious fact is a completely logical explanation. Imagine two viruses. One is able to multiply on the mucous membrane of the nose, the second - on the mucous membrane of the bronchi. In the first case, the extent of the airways available to the virus is several centimeters (how much there is that nose!). In the second - a few meters of bronchial tree. It is not surprising that in bronchitis, in comparison with rhinitis, there are many times more damaged tissues, more toxins being absorbed into the blood, and so on. Hence - not so much a rule as a completely logical tendency to the fact that the syndrome of general disorders in the lesion of the lower respiratory tract is more pronounced than in the defeat of the upper respiratory tract. And one more law: it is extremely rare that the same microbe simultaneously caused an intense inflammatory process in both the bronchi and the nose. Therefore, a frequent cough with a slightly stuffy nose is most likely a bronchitis, but if the snot is a stream, then bronchitis is unlikely.
Cough as evidence
Since we started talking about a cough, we immediately note, more precisely, we repeat, that there is no specific bronchitis cough. Characteristics of cough vary with inflammation of the bronchi constantly. At the beginning of the illness, coughing, as a rule, is frequent, dry, short, painful, not bringing relief. As he recovers, he becomes moisturized and productive.
(Not) easy breathing
There are three mechanisms that cause labored breathing in the inflammatory process in the respiratory tract: edema, spasm, hypersecretion. And edema of the bronchial mucosa, and spasm of the bronchial muscles, and hypersecretion of sputum by the glands of the bronchial mucosa - all this (in varying degrees of severity) always takes place in bronchitis. It is not surprising that shortness of breath and difficulty breathing are frequent symptoms of inflammation of the bronchi that have their own specific characteristics. An important feature of breathing in bronchitis - if it is difficult, it is difficult not to inhale (as with croup), namely to exhale. Difficult breathing is a symptom of not only bronchitis, it is a common pattern in any inflammatory process in the lower respiratory tract. Here, in principle, it makes sense once again to recall and in bold letters write an important diagnostic rule:
♦ obstructed airborne - a typical symptom of upper respiratory tract damage;
♦ Shortness of breath is a typical symptom of lower respiratory tract infection.
It is clear that the inflammatory process can affect both the upper and lower respiratory tract. It is clear that the obstruction of the airways can reach a degree of severity when it will be difficult to breathe and exhale. And then shortness of breath will be mixed. But this is not a refutation of the given rule, but only its illustration. Difficult breathing in bronchitis is manifested, first of all, by the prolongation of exhalation. Another important feature is the appearance during the exhalation of the wheezing sound, which is a specific symptom of bronchospasm spasm.
In the zone of special attention
Bronchospasm is a very common symptom of bronchitis, especially characteristic of allergic bronchitis. In view of the importance, let us reiterate: an elongated, wheezing exhalation is a typical diagnostic sign of bronchospasm. The accumulation of bronchial mucus in the lumen of the bronchi leads to the appearance of a hoarse breathing, to a frequent cough, the productivity of which depends on the properties of sputum, sputum thick and dense - cough unproductive, sputum liquid - cough productive, bringing relief. A very typical symptom of bronchitis - the characteristics of breathing change significantly after episodes of coughing: breathed hoarsely and heavily, coughed, sputum went away, it became many times easier.
Hear everything!
Specific "bronchial" symptoms - shortness of breath, sputum due to congestion, wheezing, bronchospasm - is much easier to analyze during auscultation.The most important auscultative symptom of bronchial inflammation is hard breathing.The severity of this sign enables not only to answer the question: is there bronchitis or not, but also to evaluate the intensity of the inflammatory process, the loudness and frequency of breathing, the ratio of inspiration and expiration, a variety of dry and wet rales, the dynamics of the state after a cough, the presence or absence of br nhospazma - these obvious and affordable auscultatory symptoms allow an experienced doctor to answer many questions:
♦ Have bronchitis or not;
♦ Have bronchospasm or not;
♦ how much sputum, what she is, where she is;
♦ how pronounced the edema, spasm, hypersecretion, because of what is bad in this particular case, what should be eliminated and. accordingly, what preparations should be used in the first place - reducing edema, eliminating spasm or facilitating the departure of phlegm;
♦ at what level the bronchi are affected: large bronchi, medium, small or all:
♦ what are the manifestations of bronchitis in the right and left lungs: all are equally symmetrical, the right inflammation is deeper, there is more sputum on the left, more bronchospasm, and the like on the right. Concerning the last point, it should be noted that bronchitis in ARI is almost always bilateral, since it is simply impossible to imagine a situation in which a virus, a bacterium or an allergen will enter the right lung, but leave the left untouched.
A big difference
In the overwhelming majority of cases, when the doctor pronounces the word "bronchitis", and the child, respectively, is sick with bronchitis, it is a question of viral bronchitis. The share of viral bronchitis accounts for at least 99% of all (!) Bronchitis. And it is understandable and quite logical that the fact that viral bronchitis often develops against the background of ARVI. Almost the most dangerous variant of ARI in general and viral bronchitis in particular is the situation in which one virus causes both cereal and bronchitis simultaneously. This condition is called stenosing laryngotraheobronchitis. The list of viruses that can cause bronchitis is not limited to respiratory viruses. Allergic bronchitis develops suddenly, after contact with a certain source of allergy, but it can be a manifestation of an independent and specific disease - bronchial asthma. Such bronchitis, accompanied by violation of patency of the bronchi, which is allergic in nature, occurs against the background of bronchial asthma and is often accompanied by bronchospasm.