Tracheobronchitis

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As tracheobronchitis (composition of fachsprachlich trachea , "windpipe" bronchi "branched airways" and itis indicating Greek suffix that an "inflammatory disease") is called a simultaneous inflammation of the trachea and bronchial mucosa, often is also the larynx with affected ( pseudo croup ). Tracheobronchitis is one of the most common respiratory diseases and usually has the same symptoms as bronchitis .

If, from a medical point of view, there is a sudden inflammation of the lower respiratory tract that is limited to the mucous membrane , it is acute tracheobronchitis . If this lasts longer than three months, it is called chronic tracheobronchitis . The acute illness is far more common than the chronic.

Epidemiology

Tracheobronchitis occurs seasonally more frequently in the cold winter months and often spreads like an epidemic . Adults develop tracheobronchitis on average one to three times per year. However, people often think it is a cold or bronchitis.

causes

The infection usually takes place via a droplet infection . In 90 to 95 percent of cases, tracheobronchitis is viral and only in 5 to 10 percent has it primarily a bacterial origin. It often occurs as part of a cold (flu-like infection) as well as real flu ( influenza ) or develops following a cold ( rhinitis ). Typical viral pathogens are therefore the following:

It is not uncommon for the originally viral infection to develop into a bacterial secondary infection or superinfection . In this case, a virus is the basis for additional bacterial infection . This can lead to serious complications such as laryngotracheobronchitis or pneumonia ( pneumonia ).

Pneumococci , Haemophilus influenzae , streptococci or mycoplasmas are often involved as bacterial triggers of tracheobronchitis .

In addition, the inhalation of irritant gases such as chlorine water or ammonia in higher concentrations can cause severe, mostly chronic tracheobronchitis. If air pollutants (e.g. sulfur dioxide , ozone or nitrogen oxides ) occur in an unnaturally high ambient concentration, as in smog , this can cause irritation of the mucous membranes, which can also promote respiratory diseases such as tracheobronchitis.

Symptoms

After a short incubation period (the time between infection and the appearance of the first symptoms) of 2 to 6 days, the first symptoms usually appear. Initially, patients usually complain of a general feeling of illness. Then the following symptoms often occur in combination:

Above all, the unproductive and painful cough at the beginning, which later becomes yellow-purulent and tough and can contain traces of blood, is a typical sign of tracheobronchitis. The barking cough often plagues those affected for weeks. Since the symptoms of tracheobronchitis overlap with those of many other diseases, it is almost impossible for people who have the disease to find out for themselves that they are actually suffering from tracheobronchitis instead of a cold or bronchitis.

Diagnosis

A diagnosis is usually made clinically. It is important to pay close attention to the signs of a narrowing of the bronchial system ( airway obstruction ) in order to ensure a differentiation from other diseases.

Differential diagnosis

Since the symptoms of tracheobronchitis that appear overlap with those of other diseases of the bronchial system, it is necessary to conduct a differential diagnosis . In particular, the cough that occurs should be carefully observed.

A recurring coughing up of blood ( recurrent hemoptysis ) and a cough that does not respond to any therapy ( therapy-refractory cough ) can just as well be signs of bronchial carcinoma , i.e. lung cancer, or foreign body aspiration and must therefore be ruled out in a differential diagnosis. The differentiation of severe tracheobronchitis from pneumonia ( bronchopneumonia ) is difficult and sometimes only possible during the course of the disease.

In addition, the exacerbation ( exacerbation ) of chronic bronchitis , the onset of bronchial asthma and, in rare cases, whooping cough can be further causes of a strong and prolonged cough and must be considered in a differential diagnosis.

treatment

Since tracheobronchitis is in most cases caused by a virus, treatment with antibiotics is usually not necessary. Even if there is evidence of a bacterial origin, antibiotics are only necessary under the following conditions:

  • additional infections in the throat, nose and ears
  • Elderly patients
  • Concomitant or underlying illnesses such as existing chronic bronchitis, cirrhosis of the liver or other serious heart, lung or blood diseases
  • existing immunodeficiency

The main focus of therapy is to alleviate the inflammation and the accompanying symptoms. However, tracheobronchitis usually heals after a few days, even without therapy. If you want to shorten the duration of the illness, you can use over-the-counter expectorant and anti-inflammatory drugs .

literature

  • Boesch, Dennis. Lungs and airways . Springer-Verlag, 2014, pp. 66–67.
  • Baenkler, Hanns-Wolf. Internal medicine: 299 synopses, 611 tables . Georg Thieme Verlag, 2001, pp. 404-406.
  • Adam, Dieter, ed. Respiratory infections: Basics and practice of antibiotic therapy; 39 tables. Georg Thieme Verlag, 2003, pp. 99-101.
  • Rello, Jordi. Infectious diseases in critical care. Eds. Marin Kollef, Emilio Díaz, and Alejandro Rodríguez. Springer-Verlag Berlin Heidelberg, 2007, pp. 385–387.
  • from Domarus, Alexander. Internal Medicine Floor Plan. Springer-Verlag, 2013, pp. 205–207.
  • Koletzko, Berthold: Pediatric and Adolescent Medicine . Springer-Verlag, 2013, p. 383.

Web links

Individual evidence

  1. ↑ Bösch, Dennis. Lungs and airways . Springer-Verlag, 2014, p. 66.
  2. ↑ Baenkler, Hanns-Wolf. Internal medicine: 299 synopses, 611 tables . Georg Thieme Verlag, 2001, p. 404.