bubble_chart Overview

Acute tracheobronchitis is an acute inflammation of the tracheobronchial mucosa caused by viral or bacterial infections, physical or chemical irritants, or allergic reactions.

bubble_chart Etiology

Catching a cold and excessive fatigue can weaken the physiological defense mechanisms of the upper respiratory tract, providing an opportunity for infections to develop. Therefore, the onset of illness is more common during the cold season. In healthy adults, it is mostly caused by adenovirus or influenza virus, while in children, respiratory syncytial virus or parainfluenza virus is more common. Viral infections inhibit the phagocytic activity of alveolar macrophages and the vitality of ciliated cells, allowing bacteria such as Haemophilus influenzae and pneumococci to invade the respiratory tract. Inhalation of secretions from sinusitis or tonsil infections can also cause this disease. Physical and chemical irritants such as excessively cold air, dust, and certain irritating gases are also likely to cause this disease. Allergies to bacteria and proteins can also lead to the disease. Larvae of parasites such as hookworms and roundworms migrating in the lungs can also cause bronchitis. Children with recurrent acute tracheobronchitis should be evaluated for rare diseases such as cystic fibrosis or hypogammaglobulinemia.

bubble_chart Pathological Changes

The tracheal and bronchial mucous membranes are congested and edematous, with injury and shedding of ciliated epithelial cells, hypertrophy of mucous glands, increased secretions, and infiltration of lymphocytes and neutrophils. After the inflammation subsides, the structure and function of the tracheal and bronchial mucous membranes can return to normal.

bubble_chart Clinical Manifestations

The onset of the disease is often preceded by symptoms of upper respiratory tract infection, such as stuffy nose, sneezing, sore throat, and hoarseness. Systemic symptoms are mild, including only grade I fear of cold, fever, headache, and general body aches. The cough starts mildly, is irritating, and produces little sputum. After 1 to 2 days, the cough worsens, and the sputum changes from mucus to mucopurulent. In more severe cases, paroxysmal coughing often occurs upon waking up, changing sleeping positions, inhaling cold air, or after physical activity. Sometimes, coughing persists throughout the day. Severe coughing may be accompanied by nausea, vomiting, or pain in the chest and abdominal muscles. When accompanied by bronchospasm, there may be wheezing and shortness of breath. Acute tracheobronchitis is generally self-limiting, with fever and general discomfort subsiding within 3 to 5 days, although the cough may sometimes persist for several weeks before resolving.

When mucus secretions are present in the larger bronchi, coarse dry rales may be heard, which disappear after coughing. When watery secretions accumulate in the small bronchi, moist rales are heard in the lungs.

Chest X-rays may show no abnormalities or only increased lung markings. In viral infections, blood lymphocytes may increase, while in bacterial infections, the total white blood cell count and the proportion of neutrophils may rise.

bubble_chart Treatment Measures

Since respiratory viral infections are often the predisposing factors for bacterial tracheobronchitis, engaging in regular physical exercise and undergoing cold resistance training to enhance constitution are effective measures for preventing respiratory infections. Proper labor protection should be implemented to prevent the escape of harmful gases, acid mist, and dust to safeguard workers' health.

If systemic symptoms are present, appropriate rest should be taken, keeping warm and drinking plenty of water. For irritating coughs, steam inhalation or ultrasonic nebulization with saline solution is recommended. For dry coughs, 25mg of Carbetapentane, 10mg of Caramiphen, or 15-30mg of Codeine can be used three times a day. For phlegm-expelling, 10ml of Brown Mixture, 8-16mg of Bromhexine, or 30mg of Ambroxol can be used three times daily. If bronchospasm occurs, 0.1g of Aminophylline, 2.5mg of Terbutaline, or 2.4mg of Salbutamol can be taken orally three times a day.

For fever and body aches, 0.3-0.6g of Aspirin or one tablet of Coldrex can be taken three times a day. If a bacterial infection is present, appropriate antibiotics such as Cefradine or Amoxicillin can be used.

bubble_chart Differentiation

Various diseases such as subcutaneous node, lung cancer, mycoplasma pneumonia, lung abscess, measles, whooping cough, acute tonsillitis, etc., should be differentiated from acute bronchitis.

The symptoms of the common cold are quite similar to those of acute tracheo-bronchitis, but the systemic symptoms are more pronounced, with fever, headache, and general body aches being more noticeable; the white blood cell count is reduced. Diagnosis can be confirmed based on epidemiological history, complement fixation tests, and virus isolation.