Symptoms of acute tracheitis in adults and children. Chronic tracheitis

Types of tracheitis

There are several classifications of this disease:

• according to duration, tracheitis is divided into acute and chronic, the latter most often occurs with periods of exacerbation and remission;
• according to its etiology (reason), it can be infectious or non-infectious;
• Based on the nature of changes in the mucous membrane, they distinguish between catarrhal (when the surface layer of the mucous membrane becomes inflamed), hyperplastic (when the mucous membrane becomes inflamed and thickens) and atrophic tracheitis (when the mucous membrane becomes thinner and loses a significant number of cells capable of performing its functions).

The approach to its treatment depends on the type of disease.

Description of the disease

The trachea is a tubular organ that connects the larynx and bronchi and serves to conduct air into the lungs.
When allergens or infectious agents come into contact with the tracheal mucosa, a diffuse inflammatory process develops that covers the entire organ. Due to irritation of the nerve endings, a protective reflex is formed - cough. With tracheitis, it is dry and unproductive. Tracheitis can be infectious (caused by fungi, bacteria, viruses, protozoa) and non-infectious (allergic). Depending on the course, there is an acute form (severe symptoms for a short time) and a chronic form (long-term moderate or mild symptoms). As a rule, chronic occurs against the background of serious systemic diseases or with inadequate acute therapy.

In pediatric otolaryngology and pediatrics, inflammation of the respiratory tube rarely develops in isolation. More often this occurs against the background of ARVI, when not only the trachea is affected, but also other organs of the respiratory system. In young patients, tracheobronchitis and laryngotracheitis are more often diagnosed.

Long-term inflammation of the tracheal mucosa leads to its morphological changes. Chronic tracheitis occurs with hypertrophic processes (thickening of the mucosa) or atrophic (thinning of the membranes).

Infection is the main cause of tracheitis

In most cases, tracheitis is infectious in nature. The cause of inflammation of the mucous membrane is viruses and bacteria; associations of different pathogens are possible, that is, the presence of both a viral and bacterial infection at the same time. During the ARVI season, tracheitis in a child occurs as a result of infection with influenza viruses and other types of viruses, the number of which is very large. Subsequently, the addition of a secondary bacterial infection (streptococcal, staphylococcal, etc.) is often noted.

Diet for tracheitis

If you have tracheitis, you must avoid eating foods that irritate the larynx: sweets, mayonnaise and other sauces, chips, spicy and salty foods, fried foods. It is important that the food is not very cold or hot. It is not advisable to eat honey. Compotes, heated milk, and berry fruit drinks at room temperature are acceptable to drink.

The daily diet of a child/adult suffering from tracheitis should include:

• vegetable soups;
• porridge;
• dairy products;
• fresh fruits and vegetables (not sour);
• eggs.

What else can cause tracheitis?

Tracheitis in a child can also be non-infectious in nature. Its appearance is sometimes provoked by foreign bodies in the respiratory tract and medical manipulations during anesthesia affecting the trachea. A common cause of tracheitis is the child inhaling icy or dry hot air, chemically active fumes (from household and industrial chemicals, reagents, paints and varnishes). Continued contact with irritating aggressive substances maintains chronic inflammation. Another possible cause of non-infectious tracheitis in a child is allergies. Inhalation of an allergen triggers a hypersensitivity reaction, which leads to swelling of the mucous membrane of the larynx, trachea and bronchi.

Causes

The cause of inflammation can be not only infectious agents, but also physical factors. Any damage to the trachea entails an inflammatory process.

Among the reasons are:

• viral infections (influenza, parainfluenza, measles);
• bacterial infections (Haemophilus influenzae, staphylococci, Corynebacterium diphtheria);
• allergic reactions (treated by an allergist);
• inhaling too hot or cold air;
• reflux of stomach contents into the respiratory tract (postoperative period, vomiting during sleep);
• foreign body damage;
• neck injuries;
• tracheal intubation, tracheostomy.

Viral infections play the role of a “pioneer” in the development of tracheitis. Viruses damage the mucous membrane of the trachea, exposing the underlying layers. They are not protected from the invasion of bacterial microflora, so bacteria easily settle and multiply in them. As a result, the disease is of a mixed, bacterial-viral nature.

Neck injuries and other mechanical damage to the trachea also expose the submucosal layer, making it easier for pathogenic bacteria. In the case of tracheostomy during artificial ventilation, the trachea is often colonized by microorganisms that are resistant to most modern antibiotics. As a result, inflammation lasts a long time and is difficult to treat.

Predisposing factors

The development of tracheitis is promoted by:

• general hypothermia;
• decreased immunity;
• lack of vitamins;
• rickets in a child;
• impaired nasal breathing (with chronic runny nose, severe curvature of the nasal septum, adenoids);
• tendency to allergic reactions;
• long-term use of inhalers with glucocorticosteroids (hormonal anti-inflammatory drugs), which is sometimes necessary in the treatment of bronchial asthma;
• living in an area with unfavorable environmental conditions;
• presence of a smoker in the family.

All this does not cause clinically significant inflammation of the tracheal wall, but disrupts its barrier function and facilitates the penetration of pathogens.

Manifestation of the disease

With tracheitis, the child experiences shallow rapid breathing. The acute form of the disease is accompanied by an increase in temperature, sometimes up to febrile levels - 38.6–39.0 degrees, but usually there is a low-grade fever - no more than 37.5 degrees. The temperature rises in the late afternoon - in the afternoon.

There are no symptoms of intoxication or they are not expressed. The person feels overwhelmed, weak and gets tired faster than usual. The greatest discomfort is associated with a painful cough, which leads to headaches and sleep disturbances. If the trachea is damaged in combination with pharyngitis, the throat becomes sore and it hurts to swallow.

The addition of laryngitis causes hoarseness, reactive lymphadenitis causes enlargement of regional lymph nodes. Dispersal of the inflammation process into large bronchi contributes to the appearance of the clinical picture of tracheobronchitis, which is expressed by elevated temperature and persistent cough. On percussion and auscultation, dry diffuse rales are obvious at the tracheal bifurcation and the projection of the bronchi.

Among the elderly population, young children and those who have problems with the immune system, complications often arise in the form of expansion of inflammation into the lung tissue and alveoli. Such situations are characterized by bronchopneumonia or bronchitis.

Chronic tracheitis is characterized by a persistent, severe cough. During the day it may not bother you, but at night and in the morning it will prevent a person from fully recovering and resting.

In the hypertrophic form, a paroxysmal cough and sputum discharge are possible; in the atrophic form, a persistent dry cough is possible, caused by irritation of the mucous membrane due to a crust that has formed on it.

The chronic process is accompanied by a feeling of pain in the trachea and low-grade fever. The manifestation of the allergic form is a persistent paroxysmal cough, severe pain behind the sternum and in the throat. At the peak of the attack, children are likely to vomit. This form of tracheitis often develops in parallel with allergic lesions of the nasal epithelium, cornea and conjunctivitis.

Symptoms of tracheitis

• Cough.
• Pain in the trachea (behind the sternum), discomfort when inhaling.
• Sleep disturbances in a child, which with tracheitis is associated with coughing attacks.
• Hoarse breathing.
• General weakness, loss of appetite.
• Increased body temperature - from subfebrile (37–37.5°C) to fever (38–39°C). But this is not a mandatory symptom of tracheitis and rather refers to signs of a primary infection.

Any of these manifestations is a reason to consult a doctor.

Symptoms

Most often, inflammation of the trachea occurs in an acute form. Chronic is rare for them.

The acute form occurs after a short period of malaise, a runny nose, and pain when swallowing. Possible increase in body temperature. Clinical manifestations largely depend on the causative agent of the disease. So, with the flu, signs of tracheitis come to the fore. Worries about a raw dry cough, severe intoxication, high fever, body aches.

With parainfluenza, there are symptoms of laryngitis:

• hoarseness of voice,
• dysphonia,
• barking cough.

Bacterial tracheitis tends to drag on and may be a consequence of untreated ARVI.

• Initially, the cough with tracheitis is dry and unproductive. There is either little sputum or it is difficult to separate. Viral sputum is always light and transparent. Bacterial sputum is purulent, yellow or yellow-green. With the flu, streaks of blood may appear in it.
• The child may cough in fits and starts, especially if they inhale cold air, laugh, cry, or get scared. The cough becomes more frequent at night when he lies down. In the morning, accumulated phlegm gives it a damp character.
• Older children may complain of a sore throat and a feeling of rawness in the chest.
• The temperature in children can remain at a subfebrile level (no more than 38 ° C) or rise to high numbers. Young children react more sharply and vividly to infection.

Features of cough with tracheitis

Cough is a key symptom of tracheitis in a child. It is intrusive, often annoying, painful, with a rough, deep sound tint. A cough with tracheitis in a child may be unproductive (dry) or accompanied by the release of viscous, light sputum. Its color depends on the nature and cause of the inflammatory process. With bacterial tracheitis, the sputum released during coughing is usually greenish, and with viral tracheitis, it is white-gray and scanty. Coughing attacks with tracheitis often appear in the early morning hours and immediately after waking up. This is explained by physiological stagnation of blood in the child and weakening of drainage (release of sputum) of the respiratory tract during prolonged lying down. Swelling and accumulating mucus provoke a coughing attack.

Manifestations

Symptoms of tracheitis in children depend on the causative factor of the disease, the general condition of the body and the age of the child.

Young children are prone to a violent inflammatory reaction with the release of large amounts of mucus. Tracheitis in this case is accompanied by anxiety, loss of appetite and sleep, cough with copious sputum, snoring and noisy breathing.

Older children complain of a burning sensation in the chest, they are bothered by an obsessive cough with scanty, difficult to expectorate sputum. Coughing attacks most often occur at night and are often associated with laughing, crying, changing body position, inhaling cold air, or taking a deep breath.

The most pronounced intoxication is with tracheitis of influenza nature. The child's temperature rises sharply to 39-40 C, he becomes drowsy, capricious, and refuses to eat.

Diphtheria tracheitis occurs with minor general symptoms, but often leads to suffocation and death.

Fibrin films formed on the mucous membrane begin to be rejected after a few days and close the lumen of the trachea. The child cannot breathe in enough air, turns blue, becomes anxious and then loses consciousness. The situation is so dangerous that even in a medical facility it is not always possible to help the baby. The only way to prevent the disease is vaccination against diphtheria, which is included in the National Vaccination Calendar and is performed on all children with parental consent.

Treatment of tracheitis in children

Treatment of tracheitis in a child should be carried out under the supervision of a pediatrician. In severe cases, you may need the help of a pulmonologist - a doctor who treats diseases of the lungs and respiratory tract. Treatment of tracheitis includes medicinal and non-medicinal methods, the right combination of which can alleviate the child’s condition and cope with cough.

Medication methods

• To influence the infectious cause of the disease, antibacterial, antiviral or antifungal agents are prescribed. But with mild tracheitis, the doctor may decide to treat without the use of such drugs. In this case, the child will be under constant observation; if the condition worsens, the therapy will be adjusted.
• The main efforts in the treatment of tracheitis are aimed at relieving cough. For this, the child is prescribed mucolytics, which help thin and remove mucus. Antitussives for tracheitis are indicated in cases of debilitating cough. They are used strictly as prescribed by a doctor.
• When treating a child, cough remedies containing extracts of medicinal plants with mucolytic, expectorant and anti-inflammatory effects are also widely used. The components included in the composition complement and enhance each other's action. For example, Doctor MOM® cough syrup contains 10 carefully selected medicinal plant extracts. It helps to liquefy and remove mucus during tracheitis, and has an anti-inflammatory effect. Doctor MOM® cough syrup can be used to treat children from 3 years of age.

Non-drug methods

In addition to drug therapy for tracheitis, various physical procedures are used, a special massage to facilitate the discharge of sputum when coughing - all according to the doctor’s indications. It is important to remember that timely initiation of comprehensive treatment and compliance with the recommendations of a specialist is the key to successfully ridding a child of tracheitis. Self-medication of cough is fraught with the development of complications and a protracted course of the disease.

Diagnosis of tracheitis

Doctors have extensive experience in diagnosing and treating tracheitis in children.
Experts pay attention to finding the main causative factor, as well as circumstances that could aggravate inflammatory changes. When they are eliminated, tracheitis is treated quickly and does not lead to complications. Diagnosis of childhood tracheitis, as a rule, does not cause difficulties. The doctor focuses on the parents’ complaints and the child’s examination data. Additional information is provided by chest auscultation and a general clinical blood test. If serious changes in the respiratory organs are suspected, laryngo- and tracheobronchoscopy, chest x-ray, aspiration of tracheal contents (for virological or PCR analysis of mucus, culture on a nutrient medium) are performed. To clarify the etiology and characteristics of the course of the disease, consultations with a pulmonologist or allergist-immunologist may be required.