What happens in the bronchi
The virus damages the cells of the bronchial mucosa, it swells and begins to produce more mucus. The cilia, which normally remove mucus upward, work less well, and the body turns on coughing as a way to clear the airways. In young children, the bronchi are narrow, and the mucous membrane is prone to swelling, so they are more likely to develop obstruction: the bronchial lumen narrows, exhalation becomes difficult and whistling appears. After recovery, the mucous membrane takes several weeks to recover, and during this time the cough may intensify with physical activity and cold air.
- Acute bronchitis - viral inflammation of the bronchial mucosa
- Obstructive bronchitis - with narrowing of the lumen and wheezing exhalation
- Bronchiolitis - damage to the smallest bronchi in children under two years of age
- Prolonged cough after infection - an option for normal recovery
- Recurrent bronchitis is a reason to look for asthma or another cause
Reasons and what increases the risk
The main cause is respiratory viruses, including rhinoviruses, influenza and parainfluenza viruses, and respiratory syncytial virus. Bacterial bronchitis in children is rare and is usually associated with specific pathogens, such as mycoplasma in schoolchildren. The risk is higher in children's groups and in the cold season, when viruses circulate more actively. Passive smoking stands out separately: tobacco smoke damages the mucous membrane and makes inflammation more severe and protracted. Polluted air, dust and low indoor humidity also have an effect.
- Respiratory viruses are the main cause
- Mycoplasma infection in school-age children
- Passive smoking in the family
- Kindergarten and school during the season of infections
- Polluted and dry air
- Chronic lung diseases and allergies
Symptoms and course
Usually, a runny nose, sore throat and low temperature appear first, and a cough begins on the second or third day. A dry cough becomes wet after a few days; in children, sputum is often not coughed up, but is swallowed, sometimes causing vomiting. The temperature in uncomplicated bronchitis is rarely high and does not last long. The general condition suffers moderately: the child remains active in the intervals between coughing attacks. If rapid breathing appears, the child becomes lethargic, and the temperature lasts longer than three days, pneumonia must be ruled out.
- Cough is the main symptom, first dry, then wet
- Runny nose and sore throat at the beginning of the disease
- Low-grade or moderately elevated temperature
- Wheezing and difficulty breathing due to obstruction
- Increased cough at night
- Residual cough for 2–3 weeks
Diagnostics
The diagnosis is made clinically: the doctor listens to the lungs, assesses the respiratory rate, the participation of auxiliary muscles and blood oxygen saturation. X-rays are not needed for typical bronchitis - they do not change tactics and provide unnecessary radiation exposure. An image is prescribed if pneumonia is suspected: high fever for more than three days, asymmetric wheezing, shortness of breath, serious condition. A blood test helps when you need to assess the severity of inflammation. If there are repeated episodes of obstruction, the child is referred to a pulmonologist or allergist to rule out bronchial asthma.
- Examination and auscultation of the lungs
- Measurement of respiratory rate and saturation
- Complete blood count and C-reactive protein if a bacterial infection is suspected
- Chest X-ray only when indicated
- Examination by a pulmonologist for relapses
- Allergy tests for suspected asthma
Treatment and care
The mainstay of treatment is routine home care: drinking enough fluids, maintaining cool, moist air, rinsing the nose with saline, and treating the fever if it makes you feel worse. Expectorants and cough suppressants in children have limited proven benefit, and some are contraindicated in early childhood, so their use is a physician's decision. For obstruction, inhalation of bronchodilators through a nebulizer is used. Antibiotics are only needed for confirmed bacterial infection or pneumonia. Jars, mustard plasters and rubbing with strong-smelling products are not recommended for children.
- Drink plenty of fluids and cool, moist air
- Rinse the nose with saline solution
- Antipyretics when you feel unwell
- Inhalations through a nebulizer as prescribed by a doctor
- No jars, mustard plasters or rubbing with essential oils
- Antibiotics - only as prescribed for proven indications
- Quitting smoking in the house and regular ventilation