Tracheitis: symptoms, treatment. How to treat tracheitis
- Etiology of tracheitis
- The mechanism of development of tracheitis
- Tracheitis classification
- Tracheitis symptoms
- Complications of tracheitis
- Diagnosis of tracheitis
- Tracheitis treatment
- Tracheitis Prevention
Tracheitis (tracheitis) - an inflammatory lesion of the tracheal mucosa, mainly of an infectious nature, manifested by irritation of the epithelium, dry paroxysmal cough or with sputum, chest pain, 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 membrane of the pharynx, nasopharynx, larynx, or bronchi is inflamed. Joining bronchitis, laryngitis or rhinitis, combined pathologies are formed in the form of tracheobronchitis, laryngotracheitis, rinofaringotracheitis. Allergic tracheitis often develops simultaneously with rhinitis and conjunctivitis of the same nature of occurrence.
Etiology of tracheitis
The causative agents of infectious tracheitis are viruses and bacteria. Inflammation of a bacterial nature is provoked mainly by staphylococcus, streptococcus or pneumococcus, sometimes Pfeyfer sticks. Since the majority of microorganisms that cause inflammatory damage to the respiratory tract are unstable in the external environment, infection often occurs only during direct contact with a sick person.
The trachea can be inflamed due to acute viral infection, measles, flu, scarlet fever, rubella or chicken pox. Although most often tracheitis begins with the activation of its conditionally pathogenic microflora, constantly residing in the respiratory tract.
Some factors can provoke the development of tracheitis:
- being in a wet, badly heated room for a long time;
- breathing in cold, too dry or humid air;
- irritation of the respiratory tract with toxic vapors or gases;
- infectious, contact, food and other types of allergens;
- tobacco smoke when smoking;
- increased dustiness of air.
Reduction of immunity due to chronic foci of infection (tonsillitis, otitis, periodontitis, sinusitis, frontitis), immunodeficiencies (due to radiation exposure, chemotherapy, AIDS, HIV infection), somatic diseases (diabetes, rheumatism, kidney pathologies) may contribute to the development of tracheitis of infectious genesis. , cirrhosis of the liver), acute or chronic infections (sore throats, tuberculosis), prolonged involuntary administration of immunosuppressants in the treatment of systemic autoimmune diseases (scleroderma, red lupus) Anki, vasculitis).
Allergic tracheitis is a kind of reaction of the body to various types of allergens: pollen; industrial, and more often house dust; microparticles of skin and animal hair; chemicals that are necessarily in the air at various hazardous industries.
The mechanism of development of tracheitis
Normally, the inhaled air first enters the nose, where it is warmed, cleaned, and moistened. The dust particles are deposited on the epithelium villi, then during sneezing or during the hygienic cleaning of the nose are mechanically removed from the nasal passages. Certain diseases or deformations of the structures of the nose make it difficult to nasal breathing and violate the mechanism of purification. It occurs with rhinitis, adenoids, sinusitis, various tumors, Joan atresia, septal curvature, 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 hypothermia or irritation of the mucous membrane, causing the development of inflammation of the trachea.
The acute process is morphologically manifested by infiltration, redness and swelling of the ciliated epithelium, on the surface of which a large amount of mucus accumulates. In viral lesions, such as flu, ecchymosis can occur - minor hemorrhages.
In chronic tracheitis, both hypertrophy and mucosal atrophy are possible. Swelling of the epithelium, dilation of blood vessels, excretion of purulent secretion is observed with the hypertrophic form of tracheitis. This is accompanied by a cough with copious sputum.
Morphological changes in the atrophic variant are different. Atrophy of the mucous membrane occurs, as a result of which it becomes thinner, becoming shining, smooth, changing its color from the usual - pink - to dull-gray. Sometimes it becomes covered with small dry crusts, because of what a person begins to torment a debilitating dry cough.
Acute tracheitis begins suddenly, in comparison with chronic all the symptoms are pronounced. It lasts for about two weeks, after which either recovery occurs, or the disease becomes chronic. 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 treatment, as well as its effectiveness.
In chronic course, periods of remission alternate with relapses. The disease becomes protracted. Patients with such a form are more tolerated because of the smoothness of the symptoms, but the period of exacerbation is lengthened, and it is difficult to predict its end. Although with proper treatment, recovery may occur no later than a month later.
Depending on the etiological factor of tracheitis is:
- mixed or bacterial viral.
The course of the disease may be:
The leading sign of acute inflammation of the trachea is a hacking cough, worse at night and in the morning. First, he dry "barking", in the subsequent with the release of thick sputum. In the first days of the disease, it has a slimy character, then becomes purulent, especially in bacterial or mixed tracheitis. A coughing spell can provoke a deep breath, sudden movement, crying, talking, laughing, crying, or a change in ambient temperature. When coughing and after the attack is over, the patient is worried about a sore throat and sternum area. Because of this, he tries to protect himself from sharp turns of the body, not to laugh, to breathe evenly and shallowly. Children have rapid and shallow breathing.
Acute onset of the disease is accompanied by a rise in temperature sometimes to febrile numbers (38.6–39.0 0 С), but more often there is subfebrile (not higher than 37.5 0 С). The temperature rises in the afternoon, towards evening. Symptoms of intoxication are absent or not expressed. A person gets tired faster than usual, feels weakness, weakness. But the greatest discomfort delivers a painful cough that leads to sleep disturbance and pain in the head.
If the tracheal lesion is combined with pharyngitis, then there is a sore throat, pain when swallowing, etc. Joining laryngitis is accompanied by hoarseness. With reactive lymphadenitis, the regional lymph nodes increase. The spread of the inflammatory process to the large bronchi leads to the clinical picture of tracheobronchitis, expressed in constant cough and higher temperature. Auscultation and percussion revealed diffuse dry rales in the projection of the bronchi and trachea bifurcation.
In young children, elderly people or having problems with the immune system, complications may develop in the form of inflammation spreading to the alveoli and lung tissue. In this case, bronchiolitis or bronchopneumonia develops.
The chronic process in the trachea is a consequence of acute. The main symptom of chronic tracheitis is a strong, persistent cough. And during the day it may not be. An agonizing cough begins at night and in the morning, making it difficult for a person to fully relax and rejuvenate. In hypertrophic form, paroxysmal cough with sputum discharge is observed, in atrophic form - dry and stubborn, caused by irritation of the mucous membranes formed on it. Chronic process is accompanied by subfebrile condition, pain in the trachea.
Allergic form manifests persistent paroxysmal cough, severe pain in the throat and behind the sternum. In children at the peak of the attack, vomiting is possible. Often this form of tracheitis develops simultaneously with allergic lesions of 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 may be complicated by laryngeal stenosis, which is especially characteristic of young children. When tracheobronchitis due to spasm and accumulation of a large amount of mucopurulent discharge in some develops 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. Often there is a combined lesion of the epithelium of the trachea + bronchi or bronchi, alveoli, and interstitial tissue of the lungs; bronchopneumonia or tracheobronchitis is diagnosed.
Malignant or benign endotracheal neoplasms appear as a result of a prolonged process of the chronic form of tracheitis, accompanied by morphological changes of the mucous membrane.
Prolonged exposure to allergens on the body in violation of sensitization, along with allergic tracheitis, leads to the emergence of more serious diseases - an allergic lesion of the bronchi with the transition to bronchial asthma, manifested by asthma attacks and severe shortness of breath.
Diagnosis of tracheitis
If there are signs of inflammation of the respiratory tract, you should contact your local GP who, after a physical examination, will certainly recommend visiting 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 (hay fever, atopic dermatitis), we can assume the allergic nature of tracheitis.
- Clinical analysis of blood . The indicators of this study help to determine the nature of the inflammatory lesion. Inflammatory reactions in tracheitis of allergic genesis are slightly expressed - ESR and white blood cells may be normal, but an increase in eosinophils is detected - eosinophilia. In infectious tracheitis, the analysis confirms inflammation - increased ESR, leukocytosis.
- Bacteriological examination of smears from the nose and throat to determine the type of pathogen.
- Sowing sputum on the microflora, followed by bacteriological analysis and determination of the sensitivity of microorganisms to antibiotics . Helps identify microbial or other agents and select rational antimicrobial therapy.
- Sputum test for KUB (acid resistant mycobacteria) . Microscopic examination can fairly quickly confirm or deny the presence of mycobacterium tuberculosis, although the method is less specific. A cultured identification of acid-resistant mycobacteria is carried out.
- Allergological tests . Different types of samples (qualitative, indirect, provocative and others) are aimed at determining the individual sensitivity of the body to various allergens.
- Laryngotracheoscopy is a leading diagnostic method. Examination of the trachea with a laryngoscope reveals hyperemia and edema of the mucous membrane, with viral lesions of petechiae - multiple point hemorrhages. In the atrophic form of chronic tracheitis, thin and dry mucous membranes are observed, having a pale pink color with a gray tinge. The walls of the trachea are abundantly covered with dry crusts. A feature of the hypertrophic form is cyanosis of the mucous membrane with its significant thickening, due to which the boundaries between the tracheal rings are not visible.
- Radiography of the lungs is prescribed for suspected pneumonia or tuberculosis .
- Rhinoscopy with instrumental examination of the nasal cavity is indicated for the combined inflammation of the nasal passages and trachea.
- X-ray examination of the sinuses . Used as an additional study to confirm inflammatory lesions of the paranasal sinuses.
- Pharyngoscopy is necessary for examining the mucous membrane of the pharynx and pharynx for pharyngitis, tumors or the presence of a foreign body.
The accession of broncho-pulmonary complications requires treatment by a pulmonologist, the development of tuberculosis by a TB specialist, and an allergist is engaged in treating allergic tracheitis.
Treatment goals :
- identification and elimination of the etiological factor - allergen, viruses, bacteria;
- stopping the symptoms of the disease;
- preventing the development of complications or the transition to the chronic form.
Tracheitis is usually treated on an outpatient basis. Only in the case of the development of serious complications, hospitalization in a specialized department of a hospital is necessary. Bed rest is assigned only at the time of preservation of high temperature.
Etiotropic therapy , selected based on the pathogen, is considered the main treatment. Tracheitis of bacterial genesis is treated with penicillin antibiotics ( amoxicillin , ampicillin), cephalosporins (cephalexin, ceftriaxone, cefazolin), macrolides (azithromycin). In case of viral tracheitis, antiviral drugs are prescribed (arbidol, interferon, kagotsel, proteflazid). Allergic lesion of the trachea is eliminated with the help of anti-allergic agents (dezoloratadin, suprastin, fenkarol).
Symptomatic therapy helps fight symptoms. Consists of taking antipyretics (paracetamol or aspirin at high temperature), antitussive drugs (libexin, synecode). To liquefy and better excretion of sputum, expectorant agents and mucolytics are shown (bromhexine, acetylcysteine, thermopsis, lasolvan, mucobene, licorice root or althea). Immunocorrective therapy is necessary for patients with chronic tracheitis.
Local treatment is the use of aerosols (IRS-19, kameton or hexoral), drinking hot milk or alkaline solutions (mineral water), applying warming compresses (only after the temperature normalizes). Effective inhalation with essential oils, propolis or alkaline mineral water. Good help aerosol medication in the respiratory tract through a nebulizer. This physiotherapeutic device divides solutions into the smallest dispersed particles, which uniformly envelop the pharyngeal and tracheal walls. From physiotherapy apply electrophoresis, UHF, reflexology, massage.
The mapping of treatment, the duration of therapy, the selection of drugs and their dosages in each case is determined strictly individually and depends on the patient's age, cause and form of the disease, severity of symptoms, and the possible presence of concomitant pathologies that aggravate the course of tracheitis.
The main preventive measures are aimed at eliminating the causes provoking the development of tracheitis, and strengthening the immune system.
It will help to avoid exacerbation of the disease compliance with the following rules:
- hardening of the body;
- avoiding hypothermia and being in rooms with large crowds in the autumn-winter period;
- maximum restriction of contact with the allergen, which develops an allergic reaction;
- to give up smoking;
- change of job if it is a harmful production;
timely and quality treatment of acute and chronic foci of infection.
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