Tracheitis - Causes, symptoms and treatment. MF.

Causes of tracheitis
Symptoms and complications
Diagnosis
Tracheitis treatment
Tracheitis prevention

One of the common manifestations of respiratory tract infections is tracheitis, and this syndrome characterizes the typical course of one of the annually expected epidemic infections - influenza.

Tracheitis is a clinical syndrome characterized by inflammatory changes in the mucosa of the trachea, which is a manifestation of respiratory infections, occurring both acutely and chronically.

Causes of tracheitis

There are several reasons for the development of tracheitis:

1) Infectious causes: viruses( influenza and others), bacteria( pneumococci, streptococci, staphylococci, hemophilus rod, Klebsiella and others), fungi.
2) Non-infectious causes( inhalation of supercooled air, inhalation of dust aerosol, chemicals, gases and vapors).

Risk factors for the development of tracheitis are similar to those for respiratory infections:

• natural factors( cold and windy weather);

• decreased local immunity( frequent colds);
• Immunodeficiency conditions( concomitant chronic diseases - liver diseases, diabetes mellitus, bronchial asthma, CHDF, pulmonary emphysema, oncological diseases and others, age-related immunodeficiency - young children, elderly persons);
• bad habits( smoking abuse to a greater extent, alcohol abuse).

Source of infection in infectious tracheitis is a sick person or carrier. Even if the patient has no signs of a health disorder, and apparently does not differ from a healthy person, the sick person has clinical signs of tracheitis and / or acute respiratory disease and becomes infectious from the first day of the onset of symptoms of the disease.

Infection mechanism - aerogenic with airborne or airborne transmission. Dangerous fines, sprayed when coughing and sneezing from the source of infection within a radius of 1.5-2 meters. We must not forget that in some infections, viruses can persist on objects of the environment( toys, furniture, scarves and towels, etc.).

Susceptibility is universal. Children and elderly people are more often ill( greater crowding in the collectives, imperfection of the immune system).Just as with respiratory infections in general, there is a winter-spring seasonality.

Anatomical structure and location of the trachea

Trachea( trachea) is a cartilaginous tube consisting of 15-20 cartilaginous rings, which are connected together by fibrous ligaments. The mucous membrane of the trachea( as well as the larynx) is covered with ciliated epithelium, it has an abundance of mucous glands and elements of lymphoid tissue. The trachea is located at the level of the sixth cervical vertebra, V of the thoracic vertebrae, the larynx is located on top, and the trachea divides at the bottom( bifurcation of the trachea) and passes into the bronchi. The diameter of the lumen of the trachea varies from 1.5 to 1.8 cm, and the length is about 11 cm. The main function is respiratory.

Trachea. Norm.

Pathological changes in the trachea with its inflammation are characterized by the appearance of edema of the mucous membrane, the fullness of the vessels( mucous membrane hyperemic), tissue infiltration( accumulation of inflammation cells), effusion to the surface of the mucous membrane of mucus of various numbers, with viral infection point hemorrhage( with influenza).If the process is long( chronic tracheitis), the mucosa becomes first hypertrophied, and subsequently atrophied. Hypertrophy of the mucosa is manifested by the abundant release of mucus-purulent mucus, pronounced swelling of the mucous membrane, hyperemia. With atrophy, the coat is pale with a grayish tinge, the mucus is small, the shell is covered with crusts, which causes constant irritation and coughing.

Clinical symptoms of tracheitis

Isolate acute and chronic tracheitis, which have their differences and features.

Acute tracheitis appears on the 2nd-2nd day of the disease after symptoms of roto- and nasopharynx, larynx. Patients have a temperature response from subfebrile( up to 38 °) to febrile fever( 38.5 ° and above).In parallel, there are symptoms of intoxication( weakness, sweating, chills, headaches and muscle pains).Patients can complain of stuffiness in the nose or rhinorrhea( flow from the nose), sore throat when swallowing, perspiration.

A characteristic symptom of tracheitis is the appearance on the background of the above complaints of dry cough more often at night, in the mornings due to the accumulation of mucus, coughing tends to increase. Despite the fact that there is mucus in the trachea, excretion with a cough is difficult. In children, coughing can be paroxysmal, and it can be provoked by crying, fright, the child's laughter, sharp movements, too cold air. Concomitant cough symptoms - a feeling of sadness behind the sternum, a swelling in the throat. Even a deep breath can trigger a paroxysmal dry sore cough, so in most patients breathing becomes shallow.

New symptoms can be associated with the involvement of neighboring respiratory tract. If the larynx is involved in the process, then cough becomes barking, painful, bronchitis appears on the bronchial inflammation( cough becomes more frequent, sputum appears - at first mucous, but from 3-5 days of the disease it becomes mucopurulent).With auscultation of the lungs, breathing becomes hard, dry or wet wheezing is heard.

Chronic tracheitis may be due to acute tracheitis, as well as other chronic inflammatory processes( inflammation of the sinuses of the nose, nasopharynx).Rarely patients are concerned about intoxication and temperature. In most cases, cough is the only symptom of the chronic form of tracheitis. Cough is dry, painful, in the morning. Patients suffer for years.

Complications of acute tracheitis

Isolated tracheitis rarely leads to complications, its combined forms are more dangerous. So, with laryngotracheitis, it is worthwhile to fear the possible development of stenosis of the larynx( especially in young children), with tracheobronchitis - obstruction of the respiratory tract due to accumulation of mucosal secretion and spasm.

The prognosis for timely treatment is favorable, the duration of the disease varies from 7 to 14 days.

Diagnosis of tracheitis

The diagnosis of tracheitis is most often clinico-epidemiological. When the patient is questioned, an epidemiological anamnesis is revealed( contact with a patient with ARVI and ARI), an anamnesis of life( presence of concomitant diseases, lifestyle, bad habits).Attention is drawn to the typical nature of complaints - the emergence of a dry, painful, sometimes paroxysmal, cough at night and in the morning, against the background of symptoms of ARI or ARVI.Children provoke coughing with external causes( crying, laughter, deep breath, change in air temperature, fear).Auscultation will be changes in tracheobronchitis( hard breathing, dry or wet rales).

Inflammation in tracheitis

Diagnosis is confirmed after laryngoscopy: mucous trachea is hyperemic, edematous, sometimes spotty hemorrhages, abundance of mucus, tissue infiltration( hypertrophied tracheitis).In the chronic process, the tracheal mucosa is pale gray, thin, and mucus is small, in places crusts( atrophied tracheitis).

Tracheitis in laryngoscopy

Paraclinic studies: general blood test( leukocytosis, changes in leukocyte formula depending on the cause that caused inflammation, increased ESR).

Treatment of tracheitis

1. Organizational-regime measures.
Light and moderate forms of tracheitis in combination with other symptoms of respiratory
infections are not hospitalized and treated at an outpatient level( at home), except for young children and persons with concomitant pathology( in these cases, the issue of hospitalization is decided individually).During the whole period of the disease, a sparing mechanically and chemically diet is shown( exception of acute, fatty, restriction of fried food), exceptionally warm drinks( fruit drinks, tea, compotes), plentiful drink. On the chest area, mustard plasters are shown. In the room where the patient is, regularly hold a wet cleaning and moistening the air( dry air provokes a cough), airing.

2. Drug treatment of tracheitis
• Etiotropic therapy is prescribed taking into account the causative agent of the disease. At the clinic of viral
infection, medicines with antiviral effect are shown( arbidol, isoprinosine, EU reaferon, viferon, cycloferon, influferon, viferon, amixin or lavomax, remantadine, aflubin and others).For bacterial reasons, antibacterial preparations of the beta-lactam group( augmentin, amoksiklav, fleumoklav, flemoksin and others), cephalosporins 1-3 generations( suprax, fortum, zinatsev and others), and if necessary parenteral administration. Narrowly specific antibiotics are administered individually in the case of a proven pathogen.
The choice of the drug, dosage and course of treatment is prescribed strictly by the attending physician in order to avoid complications and delay the healing process!

• To intensify etiotropic therapy for bacterial infection, IRS-19,
bronchomunal, erespal, and immunon are prescribed.
• Cough medications are prescribed taking into account tracheitis-related symptoms. When dry cough
without involvement in the bronchi process can be shown antitussives( sinecode, glauvent, tussin, tusuprex, libeksin, herbion with psyllium), in the presence of difficultly withdrawing sputum - mucolytics and expectorants( preparations of thermopsis, licorice, althaea, thyme,ipecacuanas, mucaltin, pertussin, broncholitin, gedelix, bronchocin, ascoril, bromhexine, ambroxol, lazolvan, ACC, mucobene).

3. Local therapy
• Inhalation therapy is performed with the appearance of the first symptoms of tracheitis. This can be as
steam inhalation, and inhalation with the help of a nebulizer( ultrasound inhaler).Inhalations are carried out for 5-10 minutes, depending on the selected inhaler 3-4 times a day for 5-7 days. Inhalations can be alkaline( drinking soda), with chamomile, sage, propolis. Medicinal products for inhalations are prescribed only by a doctor.
• Local aerosols( kametone, hexoral, etc.)

4. Folk remedies for tracheitis treatment

• inhalation of a prepared mixture of onions and garlic in natural form twice a day;
• inhalation with potato steam 2 times a day;
• black radish juice with honey( 1: 1) 3 times a day;
• irrigation of the oropharynx infusion of raspberry leaves, calendula 3-4 times a day( 1-2 tablespoons of leaves or flowers per 0.5 liters of boiling water - insist in a thermos for 1 hour);
• infusions of turn, thyme, chamomile, elecampane, leaves of mother-and-stepmother, licorice root( 1-2 tablespoons herb per 0.5 liter of boiling water in a thermos for 1 hour) - take 3 times a day before meals on1/3 cup of infusion;
• ingestion of carrots and cabbage juices;
• a decoction of kidneys and young shoots of pine( 15 pcs of kidneys per 1 cup of boiling water, boil for 15-20 minutes), take 4 times a day;
• crushed garlic in boiling milk - cool and take 1 tsp each.4 times a day
• honey inhalation, inhalation with eucalyptus.

Steam inhalations with tracheitis

Prevention of tracheitis

- Avoid overcooling, large concentrations of people in the autumn-winter-spring periods.
- Hardening of the body during the period of health( wiping, dousing with cool water).
- Timely treatment of chronic foci of infections and concomitant diseases.
- Timely treatment started in ARI and ARVI can prevent in some cases the onset of tracheitis.
- Healthy lifestyle( nutrition, outdoor activities, exercise, vitamins), combating bad habits.

The doctor infektsionist Bykova N.I.