bronchiolitis

Bronchiolitis - acute inflammation of the bronchial tubes; It is considered as a severe form of acute bronchitis.

Etiology, pathogenesis. Pathogens - typically viruses (influenza, respiratory syncytial) or viral-bacterial infections. It may develop following inhalation of irritant gases, very cold air. Inflammation of the bronchioles in violation of their patency leads to serious violations of gas exchange and blood flow.

Symptoms within. Onset acute tracheobronchitis or background. Fever (38-39 ° C); dyspnea (40 or more breaths in 1 minute), breathing is shallow with auxiliary muscles. The rib cage is fixed in the position of inhalation with a raised shoulder girdle. Face puffy, cyanotic. Painful cough with scanty mucous expectoration, chest pain due to muscle tension and contraction of the diaphragm when coughing. Percussion sound with boxed shade, breathing weakened or stiff, abundant finely (subkrepitiruyuschie) nezvuchnye wheezing, wheezing on exhalation. There are growing signs of obstructive emphysema. For severe respiratory failure and pulmonary disorders are joining vnutrikardialnoy hemodynamics due to pulmonary hypertension. Radiologically determined increased pulmonary pattern in the lower divisions and in the roots of the lungs. There leukocytosis, increased erythrocyte sedimentation rate. The course is very difficult, the duration of illness up to 5-6 weeks. Possible death. Differentiate from miliary tuberculosis, pneumonia. Of decisive importance in the differential diagnosis belongs to the X-ray examination.

Treatment. Parenteral administration of antibiotics on the basis of the treatment of acute pneumonia. Oxygen therapy. Analeptic agents (kordiamin, sulfokamfokain) zufillin (5 ml of 2.4% solution / 2-3 times a day). Symptomatic therapy: the period of painful unproductive cough - antitussive (codeine, ethylmorphine hydrochloride), then expectorants and mucolytics; analgesics for pain; banks, mustard, alcohol compresses the chest, rubbing, such as turpentine ointment. If necessary - intensive care in a critical care unit.