| disease | Acute Bronchitis in Children |
Acute tracheitis and bronchitis are common respiratory diseases in children. In infants and young children, they often occur secondary to upper respiratory tract infections and acute infectious diseases such as measles and whooping cough. The bronchioles may also be affected simultaneously.
bubble_chart Etiology
The disease cause
is mostly caused by mixed infections of viruses and bacteria. According to epidemiological investigations, the primary pathogens include nasal diseases virus, respiratory syncytial virus, influenza virus, and rubella virus, among others. The more common bacteria are pneumococcus, hemolytic streptococcus, staphylococcus, Haemophilus influenzae, Salmonella, and diphtheria bacillus, among others. Additionally, sudden temperature changes, air pollution, the anatomical and physiological characteristics of children's respiratory tracts, allergic factors, and compromised immune function are all contributing factors to this disease.
bubble_chart Clinical Manifestations
Common in infants and children over 6 months of age, it is mostly caused by respiratory viruses. The onset can be acute or gradual, with early symptoms resembling upper respiratory tract infections, such as nasal discharge and dry cough. After 2-3 days, the cough gradually worsens, accompanied by increased secretions, initially presenting as white sticky sputum, which may later become purulent. Fever may or may not be present, and the degree of fever varies. Children may complain of headache, chest pain, and fatigue. Appetite decreases, and sleep becomes restless. Infants and young children often experience vomiting and diarrhea. The course of the illness lasts about 5-10 days, but can sometimes persist for around 3 weeks.
Examination: Chest X-ray: Increased lung markings or normal, occasionally with thickened hilar shadows.
Peripheral blood white blood cell count is normal or low; when caused by bacteria or complicated by bacterial infection, the total white blood cell count increases, with elevated neutrophils.
bubble_chart Treatment Measures
Treatment
(1) Control infection.
For acute bronchitis caused by bacterial infection, the following antibacterial drugs can be selected: SMZco 0.05/kg/day divided into two oral doses, penicillin 30,000-50,000 U/mg/day divided into two intramuscular injections, or midecamycin and erythromycin 30-50mg/kg/day divided into 3-4 oral doses.
If there is no clear bacterial infection or in cases of mixed infection, ribavirin 10-15 mg/kg/day divided into two intramuscular injections or 5 mg/kg/day divided into two doses for aerosol inhalation can be used. Alternatively, a-interferon 200,000 U/day intramuscular injection may be tried.
(2) Symptomatic treatment.
1. Relieving cough and dispelling phlegm: If the phlegm is thick and difficult to expectorate, aerosol inhalation can be used along with 10% ammonium chloride mixture, bisolvon, or pediatric strong expectorant (1-2 tablets for ages 2-4, 2-3 tablets for ages 5-8). For frequent dry cough that affects sleep and rest, a small amount of antitussive medication such as promethazine or chlorpromazine 0.5-1mg/kg/dose, 2-3 times daily can be taken. Care should be taken to avoid excessive dosage or prolonged use, which may affect the physiological activity of cilia and hinder the expulsion of secretions.
2. Relieving spasms.
Aminophylline: 2-4mg/kg/dose, 3-4 times daily orally.
Salbutamol: For children under 6 years old, 1-2mg/day divided into 3-4 oral doses or 0.1mg/kg/dose. Salbutamol aerosol (0.5%, 1 puff = 0.1 mg) 1-2 puffs/dose, 2-3 times daily.
