Acute bronchitis


I- Definition :

C & rsquo; is an acute inflammation of the bronchi and terminal bronchioles, d & rsquo; most often viral or viral-bacterial, d & rsquo; 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 (dgc differential with the & rsquo; bronchial asthma)
  • duration 4-5 J

wet phase :

  • Duration 3-4 J
  • Cough or dry or painful
  • Signs general s & rsquo; amend
  • 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 weeks seen months with & rsquo; & rsquo appearance; post-viral bronchial hyperresponsiveness
  • 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 concern than d & rsquo; other :
– Thrust d & rsquo; & rsquo exacerbation, chronic bronchitis (Table d & rsquo; IRA)
– Exacerbation des DDB : risk & rsquo; s OAP home & rsquo; poor left ventricular
– chest irradiation for neighborhood Cancer (his, thyroid, bronchi)

WE- Additional tests :

– FNS : normal, hyperleucocytose (bacterial), leucopénie (viral)
– ECB of & rsquo; sputum particularly among the & rsquo; respiratory failure
– Pulmonary radiography : aspect of dirty lung :

  • linear image rail
  • Image areal : thickening of airway walls
  • Opacities micronodular lesions predominant bases

Reflecting the & rsquo; inflammation of the interstitial tissue peribronchial

– 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 & rsquo; exacerbation and terrain

Preventive treatment :
– Vaccine every flu every year (autumns)
– Pneumococcal Vaccine every 5 years (spring)