I- Definition :
C’is an acute inflammation of the bronchi or terminal bronchioles, d’most often viral or viro-bacterial origin, d’benign course
The initial stage often associated with destruction epithelial cell migration from the peri-lesional, vasodilatation and hypersecretion of mucus are responsible for the catarrhal stage
II- Clinique :
After the catarrhal stage VAS occur signs of bronchitis :
dry phase (initial) :
- Cough painful dry hacking, nonproductive promoted by changes in ambient temperature
- Retro sternal pain was like burning
- dyspnea’effort
- Temperature increase (38-38,5) oscillating, control of viremia
- TIME (asthenia, cephalalgia, myalgie)
- A l’auscultation : groans sounding as they may be replaced by wheezing low frequency (differential dgc with l’bronchial asthma)
- duration 4-5 J
wet phase :
- Duration 3-4 J
- Cough or dry or painful
- General signs s’amendment
- Dyspnea disappears
- The cough becomes oily, bringing a sero-mucous expectoration which can become muco- purulent in case of bacterial superinfection
- Hemoptysis small abundance can sometimes appear and impose an endoscopy if the ground permits
III- Evolution :
- self-limiting, without sequelae
- The cough may persist for several weeks or even months with the’appearance’post-viral bronchial hyperreactivity
- Especially in a smoking, it can lead to chronic bronchitis table
IV- Etiology :
viral :
- Myxovirus
- Paramyxovirus
- cytomegalovirus
- adenovirus
bacterial :
- Hemophilus influenzae
- Streptococcus pneumoniae
- Chlamydia pneumoniae
- Mycoplasma pneumoniae
- Bordetella pertuisis
V- clinical form :
Some are more worrying than d’other :
– Thrust d’exacerbation d’chronic bronchitis (table d’IRA)
– Exacerbation des DDB : risk of’OAP at l’insufficient left ventricular
– chest irradiation for neighborhood Cancer (his, thyroid, bronchi)
WE- Additional tests :
– FNS : normal, hyperleucocytose (bacterial), leucopénie (viral)
– ECB from l’expectoration especially in the’insufficient breathing
– Pulmonary radiography : aspect of dirty lung :
- linear image rail
- Image areal : thickening of airway walls
- Opacities micronodular lesions predominant bases
Who translate l’inflammation of the peribronchial interstitial tissue
– Reviews on private land : Rx you sine, EFR, gasometry, fibroscopie, immunological assessment, sweat test, TDM)
VII- Treatment :
Symptomatic treatment : TRT mere acute bronchitis
– Antipyretic
– antitussive for 2-3 J then quickly replaced by mucolytics and muco-modifiers (anti-inflammatory action and sedative)
Cure : (complicated forms)
– Penicillin
– atypical germ : tetracycline, macrolide
– On land weakened : energetic ATBpie (combination therapy)
– Treat the’exacerbation and terrain
Preventive treatment :
– Vaccine every flu every year (autumns)
– Pneumococcal Vaccine every 5 years (spring)