Tracheitis: symptoms, treatment. How to treat a tracheitis
- Etiology of tracheitis
- Mechanism of development of tracheitis
- Classification of tracheitis
- Symptoms of tracheitis
- Complications of tracheitis
- Diagnosis of tracheitis
- Treatment of tracheitis
- Prophylaxis of tracheitis
Tracheitis (tracheitis) - an inflammatory lesion of the mucosal trachea of a predominantly infectious nature, manifested by irritation of the epithelium, dry paroxysmal coughing or with sputum discharge, pain behind the breastbone, febrile temperature.
Tracheitis rarely occurs in the form of an independent disease. In most cases, a complex lesion is diagnosed: along with the trachea, the mucous throat, nasopharynx, larynx or bronchi become inflamed. Joining bronchitis, laryngitis, or rhinitis, concomitant pathologies are formed in the form of tracheobronchitis, laryngotracheitis, and rhinopharyngotracheitis. Allergic tracheitis often develops simultaneously with rhinitis and conjunctivitis of the same origin.
Etiology of tracheitis
Infectious tracheitis is caused by viruses and bacteria. Inflammation of a bacterial nature is provoked mainly by staphylococci, streptococci or pneumococci, sometimes Pfeifer's wand. Since the bulk of microorganisms that cause inflammatory airway damage are not very stable in the external environment, infection often occurs only during direct contact with a sick person.
Trachea can become inflamed with a background of acute viral infection, measles, influenza, scarlet fever, rubella or chicken pox. Although most often tracheitis begins with the activation of its opportunistic microflora, which is constantly located in the respiratory tract.
Some factors may provoke the development of tracheitis:
- finding a long time in a damp, poorly heated room;
- inhalation of cold, too dry or moist air;
- irritation of the respiratory tract by toxic vapors or gases;
- infectious, contact, food and other types of allergens;
- hypothermia of the body;
- tobacco smoke when smoking;
- increased dust content of the air.
To promote the development of tracheitis of infectious genesis may decrease immunity, resulting from chronic foci of infection (tonsillitis, otitis, parodontitis, sinusitis, frontal sinusitis), immunodeficiencies (due to radiation exposure, chemotherapy, AIDS, HIV infection), somatic diseases (diabetes, rheumatism, renal pathology , cirrhosis of the liver), acute or chronic infections (angina, tuberculosis), prolonged forced intake of immunosuppressors in the treatment of systemic autoimmune diseases (scleroderma, red wolf anki, vasculitis).
Allergic tracheitis is a unique reaction of the organism to various kinds of allergens: pollen of plants; industrial, and more often home dust; microparticles of the skin and animal hair; chemical substances, which are necessarily in the air in various harmful industries.
Mechanism of development of tracheitis
Normally, the inhaled air first enters the nose, where it is warmed, cleansed and moistened. Particles of dust settle on the fibers of the epithelium, then during the sneezing or hygienic cleaning of the nose are mechanically removed from the nasal passages. Certain diseases or deformities of the structures of the nose impede nasal breathing and disrupt the cleansing mechanism. This occurs with rhinitis, adenoids, sinusitis, various tumors, atresia of the choana, curvature of the septum, anomalies of the structures of the nose. As a result, the inhaled air immediately passes into the larynx and further into the trachea, leading to supercooling or irritation of the mucous membrane, provoking the development of tracheal inflammation.
The acute process is morphologically manifested by infiltration, reddening and swelling of the ciliated epithelium, on the surface of which a large amount of mucus accumulates. In case of viral infection, for example, the flu, ecchymoses can be observed - small hemorrhages.
With chronic tracheitis, both hypertrophy and atrophy of the mucosa are possible. Swelling of the epithelium, vasodilation, secretion of a purulent secretion is observed in the hypertrophic form of the tracheitis. This is accompanied by a cough with profuse sputum.
Morphological changes in the atrophic variant are different. There is atrophy of the mucosa, as a result of which it becomes thinner, becoming shiny, smooth, its color changes from the usual - pink - to a dull-grayish. Sometimes it is covered with small dry crusts, because of which a person begins to suffer a debilitating dry cough.
Acute tracheitis begins suddenly, in comparison with chronic all symptoms are pronounced. To last about two weeks, after which either recovery comes, or the disease turns into a chronic form. It depends on the form of the inflammatory lesion, the functioning of the patient's immune system, the presence of concomitant diseases, the adequacy and timeliness of the treatment, and its effectiveness.
In chronic course, remission periods alternate with relapses. The disease becomes lingering. Patients tolerate this form somewhat easier because of the smoothness of the symptoms, but the period of exacerbation is prolonged, it is difficult to predict its end. Although with competent treatment, recovery can occur no later than a month.
Classification of tracheitis
Depending on the etiological factor, the trachea is:
- mixed, or bacterial-viral.
The course of the disease can be:
Symptoms of tracheitis
The leading sign of acute inflammation of the trachea is a nasal cough that intensifies at night and in the mornings. At first it dry "barking", in the subsequent with allocation of a dense expectoration. In the first days of the disease, it has a mucous nature, then becomes purulent, especially in bacterial or mixed tracheitis. A coughing attack can trigger a deep breath, sudden movement, crying, talking, laughing, screaming or changing the temperature of the surrounding air. When coughing and after the end of the attack the patient is troubled by the sore pain in the throat and the sternum. Because of this, he tries to protect himself from sharp twists of the body, do not laugh, breathe smoothly and shallowly. Children experience rapid and shallow breathing.
An acute onset of the disease is accompanied by a rise in temperature sometimes to febrile digits (38.6-39.0 0 C), but more often there is a subfebrile condition (not higher than 37.5 0 C). The temperature rises in the afternoon, towards evening. Symptoms of intoxication are absent or not expressed. The person gets tired faster than usual, feels weak, broken. But the greatest discomfort is caused by a painful cough, leading to sleep disturbance and pain in the head.
If tracheal injury is combined with pharyngitis, there is a swelling in the throat, pain when swallowing, etc. Attachment of the laryngitis is accompanied by hoarseness of the voice. With reactive lymphadenitis, regional lymph nodes increase. The spread of the inflammatory process to the large bronchi leads to a clinical picture of the tracheobronchitis, manifested in a persistent cough and a higher temperature. With auscultation and percussion, diffuse dry wheezing occurs in the projection of the bronchi and bifurcation of the trachea.
In small children, elderly people, or having problems with the immune system, it is possible to develop complications in the form of the spread of inflammation to the alveoli and lung tissue. In this case, bronchiolitis or bronchopneumonia develops.
The chronic process in the trachea is a consequence of the acute. The main sign of chronic tracheitis is a strong cough of a persistent nature. And during the day it may not be. An agonizing cough begins at night and in the morning, preventing a person from fully resting and restoring strength. When hypertrophic form is observed paroxysmal cough with sputum discharge, with atrophic - dry and persistent, is caused by irritation of the mucosa formed on her crusts. Chronic course of the process is accompanied by a subfebrile condition, pain in the trachea.
The allergic form is manifested by persistent paroxysmal cough, expressed painful sensations in the pharynx and behind the breastbone. At children on peak of an attack vomiting is possible. Often this form of tracheitis develops simultaneously with allergic damage to the epithelium of the nose (rhinitis), conjunctiva ( conjunctivitis ) and cornea (keratitis).
Complications of tracheitis
Tracheitis as an independent disease rarely leads to any complications. In this regard, its combined forms are more dangerous. Thus, laryngotracheitis can be complicated by stenosis of the larynx, which is especially characteristic for young children. With tracheobronchitis due to spasm and congestion of a large amount of mucopurulent discharge, some develop obstruction of the respiratory tract.
The spread of the inflammatory process of infectious genesis to the respiratory organs located below leads to the development of pneumonia or bronchitis. More often there is a combined lesion of the epithelium of the trachea + bronchi or bronchi, alveoli and interstitial lung tissue, bronchopneumonia or tracheobronchitis is diagnosed.
Malignant or benign endotracheal neoplasms appear due to a protracted process of chronic tracheitis, accompanied by morphological changes in the mucosa.
Prolonged exposure to allergens on the body in violation of sensitization along with allergic tracheitis leads to the emergence of more serious diseases - allergic bronchial damage with the transition to bronchial asthma, manifested by attacks of suffocation and pronounced dyspnea.
Diagnosis of tracheitis
If signs of inflammation of the respiratory tract appear, you should consult a local therapist who, after a physical examination, will certainly recommend to visit an otolaryngologist. The diagnosis of tracheitis is established based on clinical and epidemiological data. Anamnesis collection helps to identify the cause of the disease, for example, based on the presence of allergic diseases (pollinosis, atopic dermatitis), one can assume the allergic nature of tracheitis.
- Clinical blood test . The indices of this study help determine the nature of the inflammatory lesion. Inflammatory reactions with tracheitis of allergic genesis are expressed insignificantly - ESR and leukocytes may be normal, but an increase in eosinophils-eosinophilia-is detected. With infectious tracheitis, the analysis confirms inflammation - an increase in ESR, leukocytosis.
- Bacteriological examination of swabs from the nose and throat to determine the type of pathogen.
- Sowing sputum on the microflora followed by bacteriological analysis and determining the sensitivity of microorganisms to antibiotics . Helps identify microbial or other agents and select a rational antimicrobial therapy.
- Sputum examination on KUB (acid-fast mycobacteria) . Microscopic examination can quickly confirm or disprove the presence of mycobacteria tuberculosis, although the method is less specific. In the case of culture, a species identification of acid-fast mycobacteria is carried out.
- Allergological tests . Different types of samples (qualitative, indirect, provocative and others) are aimed at determining the individual sensitivity of the organism to various allergens.
- Laryngotraoscopy is the leading diagnostic method. Examination of the trachea with a laryngoscope reveals flushing and swelling of the mucous membrane, with viral lesions of the petechiae - multiple point hemorrhages. At an atrophic form of chronic tracheitis, a thin and dry mucosa is observed, which has a pale pink and gray hue. The walls of the trachea are abundantly covered with dry crusts. A peculiarity of the hypertrophic form is cyanosis of the mucosa with its considerable thickening, because of which the boundaries between the tracheal rings are not visualized.
- Radiography of the lung is prescribed for suspected pneumonia or tuberculosis .
- Rhinoscopy with instrumental examination of the nasal cavity is indicated in combination with inflammation of the nasal passages and trachea.
- X-ray examination of the sinuses of the nose . Used as an additional study to confirm the inflammation of the paranasal sinuses.
- Pharyngoscopy is necessary for examination of mucous throat and pharynx with pharyngitis, tumors or the presence of a foreign body.
Accession of broncho-pulmonary complications requires treatment by a pulmonologist, development of tuberculosis - in a phthisiatrician, an allergist is engaged in the treatment of allergic tracheitis.
Treatment of tracheitis
Treatment objectives :
- detection and elimination of the etiological factor - allergen, viruses, bacteria;
- relief of symptoms of the disease;
- preventing the development of complications or transition to a chronic form.
Tracheitis is usually treated as an outpatient. Only in case of development of serious complications hospitalization in profile branch of a hospital is necessary. Bed rest is assigned only for the time of high temperature.
Etiotropic therapy , selected with regard to the pathogen, is considered the main one in treatment. Tracheitis of bacterial genesis is treated with antibiotics of the penicillin series ( amoxicillin , ampicillin), cephalosporins (cephalexin, ceftriaxone, cefazolin), macrolides (azithromycin). When tracheitis viral nature prescribe antiviral drugs (arbidol, interferon, kagocel, proteflazid). Allergic damage to the trachea is eliminated with antiallergic drugs (desoloratadine, suprastin, fenkarol).
Symptomatic therapy helps combat symptoms. Consists of taking antipyretics (paracetamol or aspirin at high temperature), antitussive drugs (libexin, sinecode). For expectoration and better excretion of sputum, expectorants and mucolytics (bromhexine, acetylcysteine, thermopsis, lazolvan, mucobene, licorice root or althea) are shown. Immunocorrective therapy is necessary for patients with a chronic form of tracheitis.
Local treatment consists in the use of aerosols (IRS-19, ketone or hexoral), drinking hot milk or alkaline solutions (mineral water), applying warming compresses (only after normalizing the temperature). Effective inhalation with essential oils, propolis or alkaline mineral water. The aerosol introduction of drugs into the respiratory tract through the nebulizer helps a lot. This physiotherapy apparatus divides the solutions into minute dispersed particles, which uniformly envelop the wall of the pharynx and the trachea. From fizioprotsedur apply electrophoresis, UHF, reflexotherapy, massage.
Drawing up the treatment regimen, the duration of therapy, the choice of drugs and their dosages in each specific case is determined strictly individually and depends on the age of the patient, the cause and form of the disease, the severity of the symptomatology, and the possible presence of concomitant pathologies aggravating the course of the tracheitis.
Prophylaxis of tracheitis
The main preventive measures are aimed at eliminating the causes that cause the development of tracheitis, and strengthening the immune system.
The following rules will help to avoid exacerbation of the disease:
- hardening of the body;
- avoiding hypothermia and being in rooms with a large accumulation of people in the autumn-winter period;
- the maximum restriction of contact with the allergen, on which the allergic reaction develops;
- to give up smoking;
- change of place of work, if this is harmful production;
timely and qualitative treatment of acute and chronic foci of infection.
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