Symptoms and treatment of purulent bronchitis. Chronic purulent bronchitis case history Chronic purulent bronchitis treatment

Purulent bronchitis- inflammatory changes in the bronchial tree, occurring with the formation and release of a purulent secret. The etiology of purulent bronchitis is always associated with the layering of a bacterial infection. With purulent bronchitis, patients are concerned about a wet cough with thick yellow-green sputum, subfebrile condition, sweating, shortness of breath. The diagnosis is established according to X-ray of the lungs, bronchoscopy, examination of bronchial washings and sputum. Treatment of purulent bronchitis includes courses of antimicrobial therapy, taking mucolytic and expectorant drugs, sanitation bronchoscopy, exercise therapy and breathing exercises, physiotherapy.

Purulent bronchitis

Purulent bronchitis is a clinical variety of acute or chronic bronchitis, characterized by coughing up purulent sputum. Depending on the type of inflammatory process in pulmonology, catarrhal and purulent bronchitis are distinguished, as well as rare variants of inflammation (hemorrhagic and fibrinous bronchitis). At the same time, purulent bronchitis can act as a primary, independent disease, as well as a secondary one that occurs against the background of concomitant inflammatory pathology of the respiratory tract (bronchiectasis, respiratory tuberculosis, chronic pneumonia, etc.). In view of the latter circumstance, it is not possible to judge the true prevalence of purulent bronchitis.

Causes of purulent bronchitis

In the development of purulent bronchitis, a combination of non-infectious and infectious, exogenous and endogenous factors is important. Among non-infectious exogenous effects, household and industrial pollutants, atmospheric air pollution, inhalation of tobacco smoke during active and passive smoking, climatic and weather conditions (overheating, hypothermia) are primarily distinguished. These factors have an irritating and damaging effect on the bronchial mucosa, thereby opening the way for the penetration of microbial flora. Violation of local reactivity is promoted by recurrent acute respiratory infections (influenza, parainfluenza, rhinovirus and respiratory syncytial infection). Endogenous causes predisposing to the development of purulent bronchitis include old age, alcohol abuse, obesity, hypovitaminosis, immunodeficiencies.

However, the leading role in the occurrence of purulent bronchitis is assigned to a bacterial infection, mainly pneumococcus, Pseudomonas aeruginosa and Haemophilus influenzae. Foci of infection in the nasopharynx (sinusitis, chronic tonsillitis), COPD (bronchiectasis, chronic abscess, smoker's bronchitis, chronic pneumonia) and specific processes (pulmonary tuberculosis) can support the course of the purulent-inflammatory process in the bronchi. Purulent bronchitis can develop as a result of improper treatment of acute bronchitis (with inadequate selection of antibiotics and microflora insensitivity to them), but more often this clinical form occurs in chronic bronchitis.

Prolonged irritation of the bronchial tree by mechanical, physical or chemical agents or adhesion of viral pathogens to bronchial epithelial cells cause a violation of the secretory function and self-purification (mucociliary clearance) of the latter. Due to the hyperfunction of secretory cells, the nature of bronchial secretion changes; there is hypercrinia (increased mucus formation) and dyskrinia (change in its viscosity and composition). Such metamorphoses contribute to a decrease in the protective properties of bronchial secretions, delay and reproduction of the bacterial flora in the bronchi. With microbial inflammation, the cellular composition of the contents of the bronchial tree undergoes changes - the number of neutrophilic leukocytes increases in it; sputum becomes purulent, viscous and poorly coughed up.

Symptoms of purulent bronchitis

The first episode of acute purulent bronchitis or an exacerbation of a chronic process is usually promoted by a cold, cooling, an allergic reaction, stress, activation of a chronic focus of infection, etc. Since a bronchial infection is usually descending, the appearance of symptoms of purulent bronchitis is often preceded by rhinitis, angina, tracheitis.

In the clinical picture of purulent bronchitis, intoxication syndrome, cough and shortness of breath play a leading role. In the acute period, subfebrile condition, weakness, sweating appear. Worried about a wet cough with thick yellow or greenish sputum, sometimes with an unpleasant odor. In chronic bronchitis, purulent sputum can be secreted constantly or occasionally (during periods of exacerbation of the inflammatory process); in the acute phase, its amount can reach 250 ml per day. When performing physical activity, a patient with purulent bronchitis develops shortness of breath, fatigue. In the anamnesis of some patients, there are indications of hemoptysis, which is explained by the increased vulnerability of the bronchial mucosa.

With a protracted course of a purulent process, due to the accumulation of secretion, hyperplastic and fibrous changes in the walls of the bronchi, bronchial obstruction may develop - purulent bronchitis becomes obstructive. In this case, shortness of breath becomes more pronounced, cough - hacking and less productive, breathing - wheezing. The addition of an obstructive component aggravates the course of purulent bronchitis, contributes to the formation of emphysema of the lungs and cor pulmonale.

Diagnosis of purulent bronchitis

Diagnosis of purulent bronchitis is based on an assessment of the anamnesis, symptoms (mainly the nature of sputum), physical and instrumental data. Often, patients clearly associate purulent inflammation in the bronchi with an episode of acute respiratory viral infections or indicate a history of chronic bronchitis. Auscultation of moist rales is characteristic, which may disappear after a productive expectoration of sputum.

Indicators of the general blood test change in the direction of moderate leukocytosis, a shift of the leukocyte leukocyte formula to the left, and an acceleration of ESR. A biochemical study in the blood serum reveals hyper-α1- and α2-globulinemia, an increase in CRP, seromucoid, haptoglobin and sialic acids.

X-ray data of the lungs in the diagnosis of purulent bronchitis are not indicative. On radiographs, an increase in the pattern and expansion of the roots of the lungs, signs of emphysema and peribronchial pneumosclerosis can be determined. Much more importance is attached to the results of bronchoscopy. During endoscopic examination of the bronchi, signs of purulent endobronchitis are revealed: hyperemia and swelling of the mucosa, an abundance of purulent contents in the bronchi (after aspiration, the purulent secret again fills the lumen of the bronchi).

Conducting bronchoscopy without fail is supplemented by the sampling of bronchial secretions for subsequent microscopic, cytological and bacteriological examination. This is especially valuable when patients (especially children) for some reason cannot take sputum for analysis on their own. Instrumental and laboratory studies make it possible to distinguish purulent bronchitis from secondary bronchitis in BEB, tuberculosis, endobronchial cancer, and pneumonia.

Treatment of purulent bronchitis

In the acute period, it is necessary to observe bed rest, to exclude smoking and other factors that irritate the bronchi. Hospitalization is advisable in case of severe intoxication and respiratory failure, especially in elderly patients.

The main method of therapy for purulent bronchitis is empirical antibiotic therapy with drugs of the aminopenicillin group (ampicillin, amoxicillin), combined preparations of amoxicillin with clavulanic acid and ampicillin with sulbactam, macrolides (azithromycin, clarithromycin), fluoroquinolones (sparfloxacin, levofloxacin), third-generation cephalosporins (cefotaxime, cefepime) . These drugs have activity against the most common pathogens of purulent bronchitis (S. Pneumoniae, H. influenzae, M. catarrhalis) and the ability to create a high concentration of the active substance in bronchial secretions.

In order to increase the hydration of sputum and improve its evacuation from the bronchial tree, mucolytics and expectorants (acetylcysteine, ambroxol, bromhexine, etc.), drug inhalations are prescribed. The speedy elimination of the purulent process in the bronchi is facilitated by sanation bronchoscopy with bronchoalveolar lavage, local administration of antimicrobial and secretolytic drugs.

Pathogenetic treatment is combined with the use of biostimulants and multivitamins, exercise therapy and breathing exercises. After the acute manifestations of purulent bronchitis subside, chest massage, physical methods of therapy (inductothermy, microwave therapy, electrophoresis) are added. In severe forms of purulent bronchitis, extracorporeal hemocorrection (UVR of blood, hemosorption, plasmapheresis) may be required.

Forecast and prevention of purulent bronchitis

The prognosis for purulent bronchitis for life is relatively favorable; ability to work is lost only during periods of exacerbations. However, a long course of purulent bronchitis significantly reduces the quality of life, can lead to repeated pneumonia, the development of DN, emphysema, and pulmonary hypertension.

Measures of primary prevention of purulent bronchitis include a ban on smoking, improvement of working conditions, reduction of dust and gas pollution in the environment, seasonal vaccination against influenza, treatment of nasopharyngeal infections, etc. Secondary prevention is aimed at preventing exacerbations of chronic bronchitis under the supervision of a pulmonologist.

How to treat chronic purulent bronchitis in the acute stage and what problems the patient may have

If bronchitis is accompanied by a strong cough with copious purulent sputum, doctors diagnose purulent bronchitis of an acute inflammatory form with a bacterial lesion of the mucous membrane of the organ.

In the event of unfavorable developments purulent bronchitis develops into a chronic stage.

Is this situation dangerous?

Chronic purulent bronchitis - features of the disease

The main difference between chronic purulent bronchitis and a simple form is the sluggish nature of the disease. Pathology passes with hidden symptoms and clearly declares itself with annual relapses. Exacerbations last more than 3 months. They pass with a painful cough and increased mucus.

Symptoms of chronic purulent bronchitis

Chronic purulent bronchitis is characterized by a protracted process and increased blockage of the bronchi (obstruction). Bronchial obstruction causes increased production and accumulation of sputum. With an exacerbation of the disease, when coughing, up to 250-300 ml of mucus can be separated daily.

Symptoms of chronic purulent bronchitis vary and depend on the type and duration of the inflammatory process. These include:

tachycardia;
lack of appetite;
blanching of the epidermis;
change in taste sensations;
unpleasant odor from the mouth;
agonizing cough with bouts of shortness of breath;
slight increase in body temperature;
increased sweating especially at night;
constant fatigue with asthenic symptoms;
soreness in the chest area, aggravated by coughing.

A recurrence of chronic purulent bronchitis can begin even after the slightest hypothermia of the body.. This situation is especially dangerous for the elderly and debilitated people. In such individuals, the process causes a sharp deterioration in respiratory function and the development of obstructive bronchitis.

The complication is manifested by lengthening of inspiration and intense breathing, accompanied by bulging of the veins and dry whistling sounds during breathing.

Chronic mucopurulent bronchitis in the acute stage - risk factors

The frivolity of the patient himself is involved in the transition of purulent bronchitis into a chronic form.

Illiterate treatment, and sometimes no therapy at all, becomes the main basis for the development of a chronic form of pathology.

The following provocative factors add to the threat:

abrupt climate change;
chest injury;
diseases of the immune system;
long smoking (and passive as well);
prolonged stress, overwork;
a long course of chemotherapy;
additionally developed infection;
predisposition to allergic manifestations;
transferred infectious diseases: whooping cough, influenza, measles;
living in areas with unfavorable environmental conditions.

Purulent chronic bronchitis develops over time, gradually covering all organs of the respiratory system. This process is dangerous and insidious, especially during a relapse. The infection easily provokes the development of pneumonia, emphysema.

If alarming symptoms are detected, you should immediately consult a doctor and treat the disease.

Treatment of chronic purulent obstructive bronchitis

Before proceeding with the main drug therapy, doctors find out the cause that led to the development of the chronic form of purulent bronchitis.

For example, if purulent chronic bronchitis of a smoker is detected, therapy will be useless until the patient breaks up the addiction.

When choosing medicines, doctors are guided by the age of the patient, the duration of the disease and the factors that caused the transition of purulent bronchitis into a chronic form.

Antibiotics. They are prescribed if the disease was caused by a bacterial infection. Before prescribing antibiotic treatment, a sputum test is performed to determine its sensitivity to antibiotics.

If there is no time for sputum analysis, and chronic purulent bronchitis is in the relapse stage, physicians give preference to broad-spectrum antibiotics of the penicillin group: Amoxiclav, Amoxicar, Amoxicillin Sandoz, Flemoxin, Augmentin.

Expectorants. To improve the patency of the bronchi and cope with the difficulties that arise in the withdrawal of sputum, the patient is prescribed expectorants of a number of mucolytics.

Mucolytics act on the structure of the mucus and break down the negative compounds that make the mucus sticky.

The following mucolytic drugs are more often prescribed: Carbocysteine, Acetylcysteine, Ambroxol, Bromhexine.

Antiviral drugs. They are used if the pathological process is viral in nature. This treatment makes sense during periods of remission of the pathology. More often, doctors prescribe the following drugs: leukocyte interferon, Amiksin, Tsitovir-3, Lokferon, Remantadine.

In the treatment of chronic purulent bronchitis in the acute stage, therapeutic bronchoscopy is performed using endotracheal infusion. Sanitation of the bronchi is carried out using a rubber catheter or a special laryngeal syringe. The frequency of procedures depends on the volume of mucus discharge and the severity of suppuration.

After sanitation and expectoration of sputum, antiseptic preparations are injected into the bronchi: solutions of dioxidine, furacilin or Kalanchoe juice. If the pathology is accompanied by an expansion of the bronchi (bronchiectasis), after treatment with antiseptics, an antibiotic solution (3-5 ml) is also injected into the bronchi.

Therapy of the pathological process is a complex measure, including physiotherapeutic methods: electrophoresis, UHF, inhalations, IKV-therapy, massages and physiotherapy exercises. Treatment of chronic bronchitis at home can be combined with the use of traditional medicine methods.

Problems of a patient with chronic purulent bronchitis - advice from healers

Folk healers it is advised to use animal fat as an effective means of sputum removal. Fats can be taken orally as rich broths and as an external rub.

Herbs. Medicinal preparations with sage, chamomile, thyme, plantain, licorice and lime blossom will be a good help in the fight for health. Herbs can be used in combination or individually. To prepare a healing drink, you need to steam a tablespoon of herbs ½ liter of boiling water, leave for a quarter of an hour and drink three times a day.

Healing tea. Tea made from bran helps to cope with the manifestations of purulent bronchitis. Take bran (400 g), brew with boiling water (1.5 l) and leave the mass for half an hour. The medicine should be taken after meals 3-4 times a day.

amazing aloe. This recipe is for adults only (not recommended for pregnant women). Four large leaves of the plant should be poured with a bottle of strong red wine and placed in a dark place for 4-5 days. The finished medicine should be taken 30 ml before meals 3-4 times a day.

miraculous fig. Take 10 figs, pour hot milk (500 ml). Simmer the mass over low heat until thickened for 10-15 minutes. Take a tablespoon three times a day. This medicine perfectly relieves bouts of painful coughing and helps to remove sputum.

famous radish. The recipe for cough from black radish and honey is known to many. This medicine restores the work of the bronchi and removes sputum. The top of the vegetable is cut off and a recess is made into which honey is poured.

The recess filled with sweet mass should be closed with a cut off top and left for 3-4 days (or baked in the oven). Take a lot of teaspoon 4-5 times a day. Instead of radish, you can use beets.

A competent approach to combating the manifestations of purulent chronic bronchitis includes preventive measures. Attentive attitude to your health will help to avoid the manifestation of recurrent conditions and get rid of the disease sooner.

Prevention measures

Whatever measures are used in the treatment of chronic purulent bronchitis, in order to achieve effective results, the patient should follow the following recommendations:

Treat otolaryngitis early.
During the off-season, take vitamin complexes.
Be sure to vaccinate during seasonal epidemics.
Protect your body from hypothermia and drafts.
Forget about bad habits (smoking, excessive alcohol consumption).
Maintain a nutritious diet with limited carbohydrate and salt intake.
Drink more warm liquids. It is better to opt for decoctions, herbal teas and freshly squeezed juices.
Every day to be in the fresh air, do not forget to carry out wet cleaning and regularly ventilate the living quarters.

In the presence of chronic purulent bronchitis, be sure to go to the spa treatment, preferably on the Black Sea coast with the opportunity to visit salt caves and carry out mud therapy. With all the advice and a competent approach to therapy, it will be possible to forget about the pathology after 1-1.5 months of treatment.

Features of the treatment of chronic purulent bronchitis

Treatment of chronic purulent bronchitis responds well enough to antibiotic therapy. But in some cases, surgery may be needed to combat this disease. It all depends on the etiology and stage of development of the pathology.

What is purulent bronchitis?

Chronic purulent bronchitis is an inflammatory disease of the respiratory system characterized by diffuse lesions of the bronchial wall, abundant and permanent discharge of purulent sputum with bronchiectasis present in it. Often, pathology develops with illiterate, insufficient, or completely absent treatment of the acute form of bronchitis, or as a complication associated with colds.

The following provoking factors contribute to the appearance of purulent bronchitis in a chronic form:

chest trauma;
infectious processes in the body;
climate change;
a sharp change in temperature;
prolonged exposure to cold or, on the contrary, dry air;
a long course of chemotherapy treatment;
smoking;
exposure to pathogenic bacteria and microorganisms;
general hypothermia of the body;
violations and disorders in the functioning of the immune system;
exposure to chemicals and toxic substances;
adverse environmental factors and severe climatic conditions;
previous illnesses: flu, whooping cough or measles;
pathologies in the structure of the nasopharynx;
hereditary predisposition;
the presence of chronic infectious foci in the nasopharynx;
alcohol abuse;

The exacerbation of the disease can be caused by the following factors:

tendency to allergic reactions;
overwork;
psycho-emotional shock and frequent stressful situations;
the emergence and development of concomitant pathologies;
activation of a chronic infectious focus.

The pathological process develops gradually, however, in the absence of timely measures taken, it spreads to the entire respiratory system, affecting nearby organs and tissues. Therefore, it is extremely important to be able to recognize this serious, insidious disease in time in order to ensure its prompt and competent treatment.

The main signs of pathology

Symptoms of purulent bronchitis differ somewhat depending on the duration of the course and the form of the disease. In general, the following signs and manifestations are characteristic of the pathology under consideration:

prolonged cough;
abundant sputum (up to 250 ml) of a purulent-mucous nature;
development of shortness of breath;
general weakness;
increased sweating;
asthenia;
increase in body temperature;
chronic fatigue syndrome;
pain in the chest area, which occurs mainly during the coughing process;
the appearance of bad breath;
permanent lack of appetite;
dulling of taste buds;
myalgia of the chest;
general intoxication of the body;
tachycardia;
pallor of the skin.

Another characteristic feature that makes it possible to identify purulent chronic bronchitis is a cough with purulent discharge, the duration of which exceeds the time period of 3 months.

During an exacerbation of this disease, the patient experiences the following painful symptoms:

fever;
development of broncho-obstructive syndrome;
difficulty in the respiratory process;
an increase in the size of the bronchi;
the appearance of bloody streaks in the discharge of purulent sputum;
a change in the composition of the blood, manifested in an increase in the number of neutrophils, leukocytes, as well as the level of ESR;
the appearance of characteristic wheezing during breathing.

It should be emphasized that purulent bronchitis is a rather serious pathology, especially in the acute stage, it carries a potential danger not only to health, but also to the life of the patient. Therefore, if you find at least a few of the above signs, you should immediately seek medical help.

Diagnostic methods

Diagnosis of chronic purulent bronchitis is carried out on the basis of a thorough analysis of the overall clinical picture and the results of the anamnesis, in addition during a physical examination. However, given the fact that the pathology in question does not have pronounced, specific symptoms, and its signs are quite characteristic of a number of other diseases of the respiratory system, the following studies are assigned to the patient to establish an accurate diagnosis:

general and biochemical blood test;
fluorographic examination;
radiography of the chest area;
bronchoscopy;
study of bronchial patency;
sputum analysis;
bronchography;
computed tomography of the chest;
conducting serological tests;
bacterial and microscopic examination of sputum;
ultrasound procedure.

After the diagnosis, identification of the form and etiology of the disease, you can proceed to the direct treatment process.

Methods of treatment

The treatment of chronic purulent bronchitis requires a comprehensive and systematic approach that includes several therapeutic areas. To combat this pathology, a number of methods are used.

Medical treatment. The choice of drugs used largely depends on the main causative agent of the disease, which is detected during sputum studies. So, if the development of the pathology was provoked by the action of pathogenic bacteria, then the patient is prescribed antibiotics. The most commonly used drugs in this case include: Tienam, Sumamed, Ofloxacin, Amoxiclav, Azitrox, Cefazolin, Ciprofloxacin, Ceftriaxone.

In the event that the disease is viral in nature, then the following antiviral drugs are used to combat it: Amiksin, Groprinosin, Arbidol, Acetylcysteine.

In addition, mucolytics, antispasmodics, antihistamines and immunostimulants are used to combat chronic purulent bronchitis.

In order to clean the pulmonary esculapius from purulent contents, they use therapeutic bronchoscopy, the technique of endotracheal infusions.

In the treatment of the disease in question, the following methods are also used:

vitamin therapy;
carrying out inhalations;
physiotherapy;
IKV - therapy;
electrophoresis of bronchial and pulmonary roots using Dimexide solution;
phytotherapy;
massage, stimulating the process of discharge of sputum content;
physiotherapy;
carrying out thermal procedures.

In particularly severe and complex cases, surgical intervention may be indicated.

What contributes to favorable results?

Whichever of the therapeutic methods is used, in order to achieve the fastest and most favorable results, the patient is recommended to follow the following rules:

drink as much liquid as possible, preferring herbal teas and decoctions;
give up cigarettes and alcohol;
avoid hypothermia;
take vitamin and mineral complexes;
observe the rules of personal hygiene;
adhere to a certain diet, with a limited content in the daily diet of salt and carbohydrates;
more often to be in the fresh air and ventilate the room.

It should be emphasized that in the absence of the necessary therapy, the chronic form of purulent bronchitis invariably leads to the development of such complications and concomitant diseases as infectious pneumonia, abscess formation, pulmonary pathologies, bronchiectasis, disorders in the functioning of the cardiovascular system, tuberculosis and others. Therefore, it is extremely important to provide the patient with timely and correct treatment.

- this is an inflammation of the bronchial tree, proceeding with the formation and release of a purulent secret. The etiology of purulent bronchitis is always associated with the layering of a bacterial infection. With purulent bronchitis, patients are concerned about a wet cough with thick yellow-green sputum, subfebrile condition, sweating, shortness of breath. The diagnosis is established according to X-ray of the lungs, bronchoscopy, examination of bronchial washings and sputum. Treatment of purulent bronchitis includes courses of antimicrobial therapy, taking mucolytic and expectorant drugs, sanitation bronchoscopy, exercise therapy and breathing exercises, physiotherapy.

ICD-10

J41 J41.1 J41.8

General information

The reasons

Pathogenesis

Symptoms of purulent bronchitis

The first episode of acute purulent bronchitis or an exacerbation of a chronic process is usually promoted by a cold, cooling, an allergic reaction, stress, activation of a chronic focus of infection, etc. Since bronchial infection is usually descending, the appearance of symptoms of purulent bronchitis is often preceded by pharyngitis, rhinitis, tracheitis.

Complications

Diagnostics

Treatment of purulent bronchitis

Forecast and prevention

Measures of primary prevention of purulent bronchitis include a ban on smoking, improvement of working conditions, reduction of dust and gas pollution in the environment, seasonal influenza vaccination, treatment of nasopharyngeal infections, etc. Secondary prevention is aimed at preventing exacerbations of chronic bronchitis under the supervision of a pulmonologist.

This is one of the most severe and dangerous varieties of this disease.

Purulent bronchitis is a disease characterized by an inflammatory process localized in the bronchi, in which the patient coughs up exudate (sputum) containing pus.

This form of the disease can be acute or chronic. However, most often it does not occur immediately. In this case, it is the chronic form of purulent bronchitis that develops.

The obstructive form of purulent bronchitis is the most severe. As a rule, it develops in older people older than 60-65 years.

Causes

Purulent bronchitis is directly related to a bacterial infection. It is the activity of pathogenic (pathogenic) bacteria that explains the appearance of pus in the sputum.

Most often, the purulent form of bronchitis is a complication that occurs with improper treatment of the disease. Attempts to cure a strong and prolonged cough on their own can lead to its development. Moreover, the longer such self-treatment lasts, the higher the likelihood of an adult patient or child developing chronic purulent bronchitis. Also, one of the reasons that led to its appearance may be the flu or acute respiratory infections transferred on the legs.

It is also worth mentioning the risk factors that can directly affect the appearance of this form of the disease. These include:

unfavorable ecology;
chronic runny nose;
frequent colds;
smoking cigarettes and tobacco;
weak immune system.

Often, when talking with a patient, a doctor can build a chain of events that led to the appearance of purulent bronchitis. In general, it can be accurately described in words - an inattentive attitude to one's own health.

Symptoms and signs

Purulent bronchitis has bright and unambiguous symptoms, the main of which are shortness of breath and pus that appears in expectorant sputum.

If you observe such a picture in yourself or someone close, you should visit a qualified doctor as soon as possible. He will make an accurate diagnosis and prescribe the appropriate treatment for the case.

Other symptoms of purulent bronchitis are:

moist cough;
body temperature 37-38 degrees;
decrease in working capacity;
increased sweating.

Some patients may experience pain in the chest muscles. This manifestation of the disease is associated with their overexertion, which occurs with frequent coughing.

In the most advanced cases, patients may experience obstruction or, in other words, a violation of the normal patency of the bronchi. This situation leads to the accumulation of an excessive amount of mucous secretion. This pathological condition indicates that the patient has developed purulent obstructive chronic bronchitis.

If in this case you do not consult a doctor, then after a short period of time the patient will develop full-fledged pneumonia.

Proper Treatment

Since purulent bronchitis is associated with the activity of pathogenic bacteria, its treatment is never complete without the appointment of antibiotic drugs. It is strictly forbidden to choose an antibiotic on your own.

This is due to the fact that there is no antibiotic agent that works equally well on any pathogenic bacterium. Thus, only a qualified doctor can prescribe the right antibiotic.

Also, in the medical treatment of chronic purulent bronchitis, mucolytic or expectorant drugs are often used. The task of mucolytics is to thin the sputum. This will simplify its discharge during coughing and alleviate the patient's condition.

Antihistamines may be prescribed. Most often this is done when purulent bronchitis in parallel has an allergic origin. In this case, there is a need to relieve tissue swelling and eliminate other allergy symptoms.

Along with drug treatment, physiotherapy procedures may be prescribed. These include:

carrying out inhalations;
chest and back warming;
electrophoresis;
IKV and UHF.

Such an integrated approach in most cases gives good results.

If the patient is being treated on an outpatient basis (at home), then compliance with the regimen established by the attending physician is very important. Its requirements may be:

plentiful warm and sweet drink;
proper diet;
regular walks in the fresh air.

Possible Complications

First of all, they can be expressed in the development of pneumonia and obstructive pulmonary disease.

Purulent bronchitis is an inflammatory disease that affects the bronchial tree. This pathological process, most often, is the result of an acute or chronic form. However, it is not excluded that such a pathological process can act as an independent disease.

Treatment is prescribed only by a doctor, after all the necessary laboratory and diagnostic measures have been taken. Complications can be avoided if therapeutic measures are started in a timely manner.

Etiology

The etiological factors for the development of this inflammatory process can be divided into external and internal. Internal etiological reasons include:

damage to the body by a bacterial infection - and Haemophilus influenzae,;
chronic abscess;
acute respiratory infections;
various allergic reactions.

External etiological factors that can provoke the development of an acute or chronic form of purulent bronchitis include the following:

a weakened immune system, against which there is a frequent infection of the body with various diseases;
active or passive smoking;
frequent hypothermia;
recurrent respiratory infections.

Separately, it is necessary to highlight the predisposing factors for the development of such an ailment:

elderly age;
frequent alcohol abuse, as this reduces the protective functions of the body;
long-term treatment with "heavy" medicines;
genetic predisposition to such diseases;
living in an ecologically unfavorable zone;
a history of otolaryngological diseases in a chronic form;

Regardless of what caused the development of purulent bronchitis, treatment with antibiotics only at home, without a doctor's prescription, is strongly discouraged, as this is fraught with the development of concomitant complications.

Symptoms

At the initial stages of the development of the pathological process, the clinical picture is almost identical, which is why many patients do not seek medical help in a timely manner, which ultimately leads to complications.

Symptoms of purulent bronchitis are characterized by the following clinical manifestations:

wet cough, in which the sputum is thick, mucopurulent consistency;
increased sweating;
dyspnea;
difficult, in more complex cases, shallow, wheezing breathing;
subfebrile or elevated body temperature;
weakness, almost constant malaise;
drowsiness;
muscle pain, which may be due to a strong, often recurring cough.

It should be noted that in the absence of the correct therapeutic measures, the purulent form of bronchitis turns into, which has extremely negative prognosis for human health. The situation is aggravated if the disease is diagnosed in a child.

It should be noted that a similar clinical picture may also be present in other otolaryngological diseases that have a similar etiology, but radically differ in treatment tactics. Based on this, it should be understood that self-treatment, without an accurate diagnosis, can lead to the development of serious complications.

Diagnostics

How to treat purulent bronchitis in adults and children can only be said by a qualified doctor, after carrying out all the necessary diagnostic measures and an accurate diagnosis.

Initially, a physical examination of the patient is carried out with the collection of a general history, clarification of the current clinical picture. Important - if the patient has taken any drugs to eliminate symptoms without a doctor's prescription, the clinician should be notified about this before the start of diagnostic measures.

The diagnostic program may include the following research methods:

general clinical and biochemical blood test;
sputum sampling for microscopic, bacteriological and cytological examination;
endoscopic examination of the bronchi.

In some cases, differential diagnosis may be required to exclude or confirm the following diseases:

endobronchial cancer.

The tactics of treatment is chosen only after receiving the results of diagnostic measures and an accurate diagnosis.

Treatment

As a rule, the treatment of this disease is carried out by conservative methods. Regardless of the etiology of the disease, antibiotics are used in the treatment of purulent bronchitis, which are selected individually.

In addition, the following drugs may be included in drug therapy:

mucolytics;
expectorants;
restorative.

Be sure to prescribe medications to improve sputum discharge.

Particular attention should be paid to the fact that antibiotics for purulent bronchitis should be used only strictly according to the doctor's prescription.

As for the treatment of folk remedies, they can also be used, but only after consultation with the attending physician and as an addition to the main course of treatment.

Provided that therapeutic measures are started in a timely manner, the prognosis is favorable, the risk of complications is minimized. Otherwise, the purulent form of the disease can become obstructive with associated complications.

Prevention

You can prevent the development of such a disease in the upper respiratory tract if you follow these recommendations:

timely and correctly treat all otolaryngological ailments;
strengthen the immune system;
do not self-medicate.

At the first clinical manifestations, you need to seek medical help.

Is everything correct in the article from a medical point of view?

Answer only if you have proven medical knowledge

Diseases with similar symptoms:

Asthma is a chronic disease that is characterized by short-term attacks of suffocation, caused by spasms in the bronchi and swelling of the mucous membrane. This disease does not have a certain risk group and age restrictions. But, as medical practice shows, women suffer from asthma 2 times more often. According to official figures, there are more than 300 million people with asthma in the world today. The first symptoms of the disease appear most often in childhood. Older people suffer the disease much more difficult.

Chronic obstructive bronchitis is a disease of the bronchi and lungs, characterized by a partially irreversible restriction of airflow in the bronchopulmonary system, which is constantly progressing. The main symptoms of this pathology in the lungs are shortness of breath and cough with viscous sputum.

Chronic obstructive bronchitis is common throughout the world and occurs on average in 250-330 persons per 100,000 population.

The lowest incidence of reported cases is less than 110 per 100,000 and covers countries such as Canada, Alaska, southwestern South America, France, Germany, Bulgaria, the Arabian Peninsula, Asian Russia and Japan.

The United States, Argentina, Uruguay, Brazil, Great Britain, Norway, Poland, the Czech Republic, Slovakia, and African countries are average in terms of the spread of the disease, where the incidence of cases is 110-550 per 100,000 population.

The highest incidence of chronic obstructive bronchitis occurs in Europe (Ukraine, Belarus, Russia), Asia (China, Mongolia, Tibet, Nepal, India, Indonesia, Iran, Iraq), Australia, Oceania and is 550–1350 or more per 100,000 population.

More often people of middle and old age get sick, in men chronic obstructive bronchitis occurs 3-4 times more often than in women.

The prognosis for working capacity and life is unfavorable. As the pathological process progresses in the lungs, efficiency is gradually lost. Adequate, timely treatment started only for a short time stops the course of the disease. Death occurs from complications (cor pulmonale, emphysema, etc.).

Chronic obstructive bronchitis in adults occurs due to many negative effects on the lungs, both from the environment and directly from the body, and therefore the causes of the disease are conventionally divided into two groups:

External factors:

High risk occupations:

mining industry;
builders;
miners;
metallurgists;
workers in the pulp and paper industry;
railroad workers;
pharmaceutical industry workers.

Frequent SARS (acute respiratory viral infections);
adenovirus infection;
Chronic deficiency of vitamin C;
Previously transferred mononucleosis.

Internal factors:

Hereditary predisposition, which is based on a deficiency of alpha1-antitrypsin - a substance that blocks enzymes that break down protein in the bronchial tree and thereby prevent the destruction of lung tissue;
Prematurity - the lungs fully develop only by 38-39 weeks of pregnancy (9 months);
HIV infection (human immunodeficiency virus);
Bronchial asthma, which is accompanied by an increase in the level of class E immunoglobulin;
Bronchial hyperreactivity is a persistent increase in the formation of mucus in the bronchial tree.

Disease classification

Severity based on symptoms:

0 degree - no severity - shortness of breath occurs with an intense load on the body;
1 degree - mild severity - shortness of breath occurs when lifting or when walking relatively fast;
Grade 2 - moderate severity - shortness of breath forces patients to move at a slower speed compared to healthy people of the same age group;
Grade 3 - severe - shortness of breath requires patients to stop during normal walking every 100 m;
Grade 4 - very severe - shortness of breath occurs when eating, changing clothes or turning in bed. Such patients do not leave the room.

The stages of the disease, depending on the study of the function of external respiration by spirometry - the measurement of volume and speed parameters of respiration. (This method will be described in detail in the section "Modern methods of examination", i.e. the diagnosis of the disease).

Stage I is easy.

Tiffno index less than 70%;
FEV 1 more than 80%;
The absence of the main symptoms of the disease - sputum, shortness of breath and cough.

II stage - medium.

Tiffno index less than 70%;
FEV 1 less than 80%;
The presence or absence of the main symptoms of the disease - sputum, shortness of breath and cough.

III stage - heavy.

Tiffno index less than 70%;
FEV 1 less than 50%;

Stage IV is extremely difficult.

Tiffno index less than 70%;
FEV 1 less than 30%;
Chronic respiratory failure;
The presence of the main symptoms of the disease - sputum, shortness of breath and cough.

Symptoms of the disease

Chronic obstructive bronchitis occurs with a constant alternation of 2 phases of the disease - exacerbation and remission, depending on the phase, the symptoms also differ.

Signs in the period of exacerbation:

slight increase in body temperature;
general weakness;
headache;
dizziness;
nausea;
aches, chills, increased sweating;
decrease in working capacity;
shortness of breath with minimal exertion;
cough with the release of viscous purulent sputum (yellow).

Symptoms in remission:

shortness of breath with increased exertion;
cough, mainly in the morning, sputum is serous in nature (clear or white).

Concomitant symptoms of damage to other organs from oxygen starvation, resulting from damage to the bronchopulmonary system:

Signs of damage to the cardiovascular system - an increase in blood pressure, an increase in heart rate, pain in the heart, a feeling of palpitations, cyanosis of the nose, lips, fingertips;
Signs of damage to the urinary system - pain in the lumbar region, swelling of the lower extremities;
Signs of damage to the central nervous system - impaired consciousness, shallow breathing, decreased memory and attention, impaired vision, hallucinations;
Signs of damage to the digestive system - yellowness of the skin, lack of appetite, bloating, abdominal pain.

Modern methods of examination

Adult patients with a disease such as chronic obstructive bronchitis are observed at the place of residence or work by a general practitioner. When contacting the clinic for diagnosis and treatment, they can be observed by local therapists, family doctors or pulmonologists. In case of inpatient treatment, they should be in specialized pulmonology departments.

The algorithm for examining such patients:

Diagnostic survey and collection of complaints;
Diagnostic examination of the patient, including percussion (tapping) and auscultation (listening) of the chest.

With percussion, a box sound appears, which means increased airiness of the lungs.

On auscultation, hard breathing and dry, whistling or buzzing rales are observed.

Diagnostic laboratory examination:

Complete blood count, which will be characterized by an increase in leukocytes, a shift of the leukocyte formula to the left and an increase in ESR (erythrocyte sedimentation rate);
General urine analysis, in which there will be an increase in squamous cells and leukocytes in the field of view, as well as the possible appearance of mucus and traces of protein;
General sputum analysis, which will be characterized by the presence of a large number of neutrophils and leukocytes.

Diagnostic instrumental examination:

The patient is asked to breathe into a tube connected to a computer program that immediately displays a graph of inhalation and exhalation. During the examination, the doctor gives commands to patients, which consist in changing the speed and depth of breathing.

The main indicators that can be determined using spirometry:

VC (vital capacity) is the total amount of air inhaled and exhaled from the lungs during calm deep breathing;
FVC (forced vital capacity) is the total amount of air inhaled and exhaled from the lungs during deep, rapid breathing;
FEV 1 (forced expiratory volume in 1 second) - the volume of air during a sharp exhalation after a calm deep breath;
Tiffno index - the ratio of FEV 1 to VC. This parameter is a diagnostic criterion for determining the severity of the disease;
POS (Peak Volume Velocity) is the maximum airflow velocity achieved with a sudden exhalation after a deep inhalation.

X-ray of the organs of the chest cavity, which is characterized by the presence of dilated bronchi and increased airiness of the lung tissue.

Main types of treatment

For a disease such as chronic obstructive bronchitis, treatment is prescribed only by qualified specialists in a hospital or outpatient setting. Therapy should be combined, i.e. medical treatment must necessarily be supplemented with physiotherapy, which includes aromatherapy, inhalations, massages, warming up and exercise therapy (therapeutic exercises).

Medical treatment

The main goals of treatment are to prevent frequent exacerbations of chronic obstructive bronchitis, alleviate the symptoms of the disease, improve exercise tolerance on the body and reduce mortality.

Bronchodilators - drugs that dilate the bronchi:

M-cholinergic blockers (ipratropium bromide) - Atrovent, Ipravent have a bronchodilator effect by blocking m-cholinergic receptors in the smooth muscles of the bronchi. The drug is prescribed for adults in the form of an aerosol of 40 mcg (2 breaths) 4-6 times a day;
Short-acting beta2-agonists (salbutamol) - Salbuvent, Volmas, Ventolin - have a bronchodilatory effect by stimulating beta2-adrenergic receptors, which are located in the bronchial wall. For adults, the drug is prescribed by inhalation, 2-4 mg (1-2 breaths) up to 6 times a day;
Long-acting beta2-agonists (formoterol) - Atimos, Foradil have a pronounced bronchodilatory effect. Assigned to adults 2 breaths 2 times a day (morning and evening).

Glucocorticosteroids (hormonal drugs):

Combined preparations containing long-acting beta2-agonists and glucocorticosteroids:

Antibacterial drugs act on chronic foci of infection in the bronchi due to the accumulation of copious amounts of sputum, which serves as a nutrient medium for them. These drugs are prescribed only in the period of exacerbation of the disease.

2nd generation cephalosporins (cefuroxime, cefamandol);
3rd generation cephalosporins (cefotaxime, ceftriaxone);
2nd generation fluoroquinolones (ciprofloxacin, ofloxacin);
Respiratory fluoroquinolones (levofloxacin);
Aminoglycosides (amikacin).

Mucolytic drugs - drugs that stimulate the discharge of sputum from the bronchial tree:

Bromhexine (Solvin, Bronchostop) has antitussive, mucolytic and expectorant effects. It is prescribed in tablets of 8-16 mg 3-4 times a day;
Ambroxol (Abrol, Ambrotard) stimulates the thinning of sputum by lowering the viscosity, which contributes to its better excretion. It is prescribed 30 mg (1 tablet) 3 times a day;
Acetylcysteine (ACC) has antitussive and mucolytic effects. It is prescribed 200-400 mg 2-3 times a day or 800 mg 1 time per day.

Physiotherapy treatment

Essential oils used in aromatherapy include:

pine oil;
eucalyptus;
juniper;
sandalwood;
tea tree;
bergamot.

Complications of the disease

Emphysema is an increased airiness of the lung tissue, in which the elasticity of the bronchi is completely lost. With this complication, inhalation is easy, and in order to exhale it is necessary to make a significant effort;
Pulmonary heart - in conditions of oxygen starvation of the body, the myocardium (heart muscle) begins to contract more intensively in order to improve the blood supply to the internal organs and deliver the necessary amount of oxygen. Over time, the myocardium wears out, the chambers of the heart increase, the muscle layer becomes thin, which leads to disruption of the heart;
Pulmonary hypertension - an increase in pressure in the bronchi and alveoli due to the narrowing of blood vessels;
Lungs' cancer.

Disease prevention

giving up bad habits, and especially smoking;
moving to ecologically clean areas of cities;
the fight against occupational hazards or the transition to work that is not related to heavy industry in conditions of high dustiness of the air;
balanced diet;
playing sports;
timely diagnosis and treatment of diseases of the respiratory system;
annual preventive examinations with mandatory FLG (fluorography).

Symptoms and treatment of purulent bronchitis. Chronic purulent bronchitis case history Chronic purulent bronchitis treatment

Purulent bronchitis

Causes of purulent bronchitis

Symptoms of purulent bronchitis

Diagnosis of purulent bronchitis

Treatment of purulent bronchitis

Forecast and prevention of purulent bronchitis

How to treat chronic purulent bronchitis in the acute stage and what problems the patient may have

Chronic purulent bronchitis - features of the disease

Symptoms of chronic purulent bronchitis

Chronic mucopurulent bronchitis in the acute stage - risk factors

Treatment of chronic purulent obstructive bronchitis

Problems of a patient with chronic purulent bronchitis - advice from healers

Prevention measures

Features of the treatment of chronic purulent bronchitis

What is purulent bronchitis?

The main signs of pathology

Diagnostic methods

Methods of treatment

What contributes to favorable results?

ICD-10

General information

The reasons

Pathogenesis

Symptoms of purulent bronchitis

Complications

Diagnostics

Treatment of purulent bronchitis

Forecast and prevention

Causes

Symptoms and signs

Proper Treatment

Possible Complications

Etiology

Symptoms

Diagnostics

Treatment

Prevention

Disease classification

Symptoms of the disease

Modern methods of examination

Main types of treatment

Medical treatment

Physiotherapy treatment

Complications of the disease

Disease prevention

Video: Program "Live healthy", topic: "COPD - chronic obstructive pulmonary disease"