Infectious asthma refers to chronic diseases of the respiratory system. It is accompanied by a number of symptoms, the degree of their manifestation depends on the action of internal and external negative factors.
It is very important to carry out timely diagnosis and treatment of the disease, eliminate the effect of allergens. Only in this case can one count on alleviating the patient’s condition.
Most people with chronic pathological processes in the bronchi suffer from an infectious-allergic form of asthma. Most often, the disease occurs in patients over 30 years of age. It refers to diseases mixed type, occurs under the influence of external and internal provoking factors.
The disease develops against the background of an existing acute respiratory viral infection or cold. The presence of an infectious process in the body serves as a powerful impetus for the development of allergic asthma. Symptoms are increasing in nature and appear as external allergens act.
With the active proliferation of pathogenic microorganisms in the bronchi, an inflammatory process begins to develop, and the structure of their tissues changes. There is severe swelling of the mucous membrane, because of this the person does not receive the necessary oxygen, and suffocation begins. Against this background, the body’s defenses are significantly reduced, and immunity drops significantly. When exposed to an external irritant, a severe allergy begins.
It is worth noting that this type of asthma is very rare among children. It is very important to diagnose the pathology in time and begin its treatment. In advanced cases, therapy becomes very complicated.
Causes and provoking factors
As described above, this type of asthma is infectious in nature. The reasons for the development of pathology are the simultaneous action of external and internal factors. The latter include pathogenic microorganisms. Untreated bronchitis under the influence of external irritants develops into infectious-allergic asthma.
The main reasons for the development of the disease, which doctors identify, are:
- genetic predisposition;
- chronic infectious process in the bronchi;
- bad ecology;
- professional activities that involve the presence of aggressive substances in the air;
- lung diseases;
- poor nutrition;
- excess weight.
Often the allergens are bacteria themselves and other microorganisms. This mostly applies to mold fungi. They tend to release spores, which, when they enter the human respiratory tract, cause suffocation. Attacks occur when the patient is in a room with mold.
Infectious-allergic asthma can also be provoked by long course drug therapy. IN in this case The respiratory muscles become tense and the patient constantly coughs.
Often external irritants are nervous stress or strong physical exertion. In this case, the patient suffers from a dry cough, however, by taking only mucolytics, the process of further progression of this form of asthma can be accelerated.
Clinical picture and symptoms
Symptoms of the infectious-allergic form of bronchial asthma develop as the provoking factors actively act. There are several stages in the development of the disease:
- At the first stage, the disease has all the signs of rhinitis: the patient feels severe discomfort and itching in the nose, suffers from frequent sneezing and congestion.
- Under the influence of external stimuli, the symptoms of the disease manifest. At this stage, there is severe shortness of breath, cough, difficulty breathing when exhaling, sputum does not come out, and the patient suffers from attacks of suffocation.
- At the stage of weakening of the symptoms of the disease, a productive cough with discharge is observed. large quantity sputum. The patient feels much better, suffocation and other symptoms disappear discomfort. As a rule, this stage is achieved only with the help of medication.
A peculiarity of the course of this pathology is that coughing attacks become more active at night, when the patient assumes a horizontal position. Because of this, he cannot get enough sleep and becomes irritable. Often the next morning your head starts to hurt badly, and other signs of fatigue appear.
It is worth noting that during an acute attack the patient’s temperature may rise slightly. After coughing, the patient has difficulty breathing, wheezing and chest pain are clearly visible.
Diagnostics
The infectious-allergic form of bronchial asthma is very difficult to diagnose. The doctor who treats her is called a “pulmonologist.” At the first symptoms, you should immediately contact him for advice. After a visual examination and history taking, the patient is prescribed a number of mandatory studies:
- laboratory blood tests to identify a possible infectious process;
- listening to the patient's breathing (a patient with asthma has a clear wheezing breath);
- bacteriological examination of sputum;
- allergy tests.
One of informative methods diagnostics is peak flowmetry. Using a special device, the patient's breathing rate as he exhales is measured. In addition to basic research, it is very important to conduct differential diagnosis and exclude the presence of diseases with similar symptoms (pathologies of the heart, blood vessels, etc.).
It is worth noting that this disease is seasonal, and acute symptoms observed in the cold season.
Features of the treatment of infectious asthma
Therapy for infectious-dependent forms of bronchial asthma consists of taking medications aimed at destroying the cause inflammatory process. The pathogen is identified using bacterial culture of sputum. At this stage, the bronchi are sanitized and antibacterial drugs wide range actions.
The course of treatment and dosage is selected by the doctor individually. Mandatory measures are also taken to treat inflammation in the oral and nasal cavities. All these actions relate to etiological therapy and are prescribed when asthma attacks occur and at the stage of exacerbation of asthma.
After the infection is destroyed, pathogenetic therapy is prescribed. It is carried out at the stage of sputum formation and the onset of a productive cough. The patient is prescribed mucolytics, bronchodilators and glucocorticosteroids.
Together, they help relieve symptoms of bronchial obstruction and improve the removal of accumulated mucus. Many asthmatics are prescribed medications in aerosol form. They relieve attacks of shortness of breath and restore normal breathing.
A mandatory condition for the treatment of such asthma is a visit to a physiotherapy room. The patient is prescribed classes physical therapy, massage course, etc. During the period of remission, recovery in sanatorium-resort institutions is indicated. There are special sanatoriums for the treatment of asthmatics. Visiting salt caves and using other climatotherapy methods will be very useful.
In most cases, patients with asthma are constantly monitored by a pulmonologist and are treated at the exacerbation stage.
It is worth noting that improvement in the condition of a patient with infectious-allergic asthma is observed only 3-5 days after the start of treatment. To relieve spasms in the bronchi, drugs from the group of bronchodilators are used. Treatment of children with this diagnosis is carried out under strict medical supervision.
Directions in treatment
It is strictly forbidden to self-medicate, as this leads to the development of serious complications and deterioration of the patient’s condition. It is important to remember that mucolytics are not recommended to be taken immediately before bed, as they promote the activation of the cough reflex and prevent the patient from sleeping fully. Drugs in this group are taken several hours before bedtime.
In case of infectious-allergic asthma, the patient’s immunity is greatly weakened, so it is advisable to use various vitamin complexes and immunomodulators. They have a positive effect on the functioning of the body and speed up the healing process.
To improve sputum discharge, inhalations with glucocorticosteroids or bronchodilators are prescribed. It would be useful to use decoctions based on medicinal plants with mucolytic, anti-inflammatory and expectorant effects. Folk remedies should be taken after prior consultation with your doctor. To relieve stress and nervous tension Experts recommend drinking chamomile or mint tea.
Since asthma belongs to the group allergic diseases, then in the composition complex therapy will be mandatory antihistamines. Depending on the nature of the allergen, they are used in the form of tablets, capsules, injections. Also, to quickly remove the allergen from the body, enterosorbents are prescribed. For rhinitis or conjunctivitis, medications are used in the form of drops. The course of treatment and dosage is selected by the doctor individually, based on the severity of the disease and symptoms. The goal of this therapy is to completely eliminate allergy symptoms.
Be sure to monitor your diet and sleep patterns during the treatment period. Moderate physical activity and walks are recommended. fresh air, proper rest and nutrition. At the remission stage, it is recommended to limit the patient from the influence of potentially dangerous provoking factors. Treatment of children is carried out according to the same scheme as for adults, with adjustment of the dose and type of drug.
Preventive measures
There are a number of rules, the implementation of which significantly reduces the risk of developing an infectious-allergic form of bronchial asthma in humans:
- avoid contact with potential allergens (smoke, animal hair, dust, etc.);
- Healthy food;
- avoid nervous tension and stressful situations;
- treat colds in a timely manner;
- regularly ventilate the room, do wet cleaning;
- At the first symptoms, do not hesitate to contact a specialist.
In the presence of genetic predisposition for bronchial asthma it is necessary to carry out preventive actions, which are aimed at reducing the impact of external and internal stimuli.
When identifying diseases of the respiratory organs, doctors often diagnose asthma, but in half of the cases it is infectious-related bronchial asthma, which is easily confused with bronchial asthma. So, what are the differences and similarities between these diseases?
With bronchial asthma, the clinical picture is as follows. This disease is allergic and manifests itself only occasionally, in the form of attacks of suffocation. The cause of allergic bronchial asthma is obstruction of the bronchial tubes due to swelling of the mucous membranes respiratory tract and bronchi, accumulation of secretions in them. Almost 70% of children who apply for medical assistance upon any manifestation allergic reaction, in the future they will be diagnosed with bronchial asthma. Moreover, the course of the disease itself is more complex in a child than in an adult.
In the case of infectious asthma, the first attack occurs in a child only after an acute infection enters the body, namely the organs of the respiratory system. It is also possible that the infection is not the main cause, but only prepares the body to simplify the impact of external allergens on it. At the same time, the permeability of the mucous membranes of the bronchi increases in the child. There are cases when infection acts as an irritant. But modern research prove that those same bacteria and their metabolic products in the baby’s body become allergens.
Infection-related asthma and its symptoms
As with other types, infectious-related asthma is characterized by the presence of attacks of suffocation or difficulty breathing. If this happens, the person immediately seeks help. Or parents monitor the child’s condition, and in case of exacerbation of the disease, contact a doctor. However, in half of the cases you may not even be aware of the presence of asthma, because it sometimes occurs without pronounced attacks of suffocation. In such a situation, the main symptom is the frequency of acute respiratory diseases. A period of frequent illness is also considered a characteristic indicator of the presence of asthma. The patient may suffer from acute respiratory infections from summer to autumn, while winter and spring pass in the complete absence of the disease.
The main symptoms of asthma are cough and difficulty breathing, which appear not just like that, but when the environment changes, environment(e.g. dusty environment, contact with pets).
Sometimes the presence of asthma can only be signaled by a cough. This symptom typical for young children or adolescents. In this case, the cough occurs most often at night.
There is a type of asthma called bronchial asthma of physical exertion. This means that the main symptoms (cough, suffocation) do not occur during the action of the allergen or physical activity, but after some time, during rest.
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Treatment of infectious bronchial asthma
A very important step during the diagnosis of bronchial asthma is the detection of an infectious focus. In most cases, it is located in the lungs, but can also be localized in the nasal cavity, gallbladder. Tuberculosis is considered one of the types of allergic infections. There are cases in medicine where, with surgical intervention or timely treatment of a disease, a patient was relieved of bronchial asthma.
Improvement of the child's condition and full treatment carried out using complex therapy. This includes taking bronchodilators, performing breathing exercises to maintain normal functioning of the respiratory organs and tracts between attacks. An important point of therapy is inhalation. They help ease breathing during physical activity and reduce the effect of bronchospasm on the general condition of the body.
In the treatment of infectious bronchial asthma, anti-inflammatory drugs are often prescribed. They fight infection very well, but the downside is that they don’t start working right away. Such medications significantly improve the condition on the third to fifth day after starting treatment, so for quick fix they are not suitable for an attack. But bronchodilators have an immediate effect on muscle cells body, relieve spasms, which helps stop the attack. These drugs are well accepted by the patient’s body, but overall allergic inflammation do not affect, therefore, a set of procedures is necessary to eliminate the cause.
And even when doctors notice an improvement in the clinical picture, it is necessary to continue monitoring with functional studies.
The thing is that lung function in its recovery significantly lags behind improvement general condition body. For example, often a child who no longer feels regular attacks of suffocation breathes freely and does not complain of difficulty breathing. physical activity, functional studies still show obvious disturbances in the respiratory system. Even with the complete cessation of whistling and wheezing in the lungs, the patient cannot be considered completely healthy.
This clinical picture indicates that after a course of treatment it is necessary to undergo a course of recovery. Modern methods treatments offer herbal medicine to correct possible pulmonary dysfunctions, taking into account the patient’s age and the characteristics of the diagnosis. Those plants that are used to create anti-inflammatory drugs can cope with infectious bronchial asthma. These are St. John's wort, marshmallow, medicinal calendula, elecampane, large plantain, naked licorice and other herbs that can remove infections from the body.
This variant of bronchial asthma develops when an infectious disease (viral or bacterial) of the respiratory tract activates internal pathological processes non-allergic in nature, leading to the development of asthma.
Occurs in 50% of all cases of bronchial asthma.
1.2. Basic clinical manifestations bronchial asthma.
Clinical manifestations of bronchial asthma are periodic attacks of suffocation, wheezing more pronounced when exhaling, coughing, and a feeling of tightness in the chest.
There are several periods of bronchial asthma:
1. The period of harbingers.
2. Attack of suffocation.
3. Post-attack period.
4. Interictal period.
The main clinical manifestations of bronchial asthma.
1. The period of precursors begins a few hours or 1-2 days before the attack and manifests itself:
Insomnia, increased irritability, anxiety;
Sometimes a depressed state, weakness, drowsiness;
Sore throat, heaviness and feeling of constriction in the chest;
Sweating, headache, tachycardia, respiratory arrhythmia;
Allergic lesions of the skin and mucous membranes (rash, itching, rhinitis, conjunctivitis).
2. Period of suffocation:
Occurs suddenly, often at night or in the evening, with general anxiety and excitement;
The cough intensifies, which becomes jerky, irritating, often painful, a feeling of lack of air occurs, expiratory shortness of breath occurs (exhalation becomes several times longer than inhalation), auxiliary muscles are included in the act of breathing, episodes of whistling, labored breathing are heard, repeated, the child takes a forced position ( orthoptic);
Physical changes in the lungs: by auscultation, high-pitched whistling rales are heard in the lungs during exhalation, by percussion - a boxy tint of percussion sound is determined above the lungs;
Cardiovascular changes vascular system: tachycardia, muffled heart sounds, increased blood pressure;
The skin is pale gray in color, there is perioral cyanosis, cyanosis of the lips, ears, hands.
The attack usually ends with the discharge of thick, viscous sputum and gradual relief of breathing.
The duration of the attack varies from a few minutes to several hours or days.
If an attack of bronchial asthma is not stopped within 6 hours, then they speak of the development of status asthmaticus.
3. In the post-attack period the following are noted:
General weakness, drowsiness, lethargy;
Changes in the respiratory system: heard by auscultation
bronchial breathing, scattered dry rales are heard on exhalation;
Changes in the cardiovascular system: bradycardia, hypotension.
But oh full recovery breathing can only be judged by the results of peak flowmetry.
4. In the interictal period, the patient’s well-being depends on the severity of the disease and the function of external respiration.
Atopic bronchial asthma– one of the varieties of bronchial asthma, in the occurrence of which the main role is played by a hereditarily determined predisposition to the development of allergic reactions.
Atopic asthma is characterized by increased bronchial reactivity and associated reversible obstruction (narrowing of the bronchi), symptoms of which are periodic attacks of suffocation, dry nonproductive cough, and wheezing.
1.3. The peculiarity of the clinical picture of atopic bronchial asthma in children early age associated with anatomical and physiological age characteristics bronchopulmonary apparatus. The bronchi are narrow, the cartilage is pliable. The right bronchus occupies an almost vertical position, it serves as a continuation of the trachea, and is significantly wider than the left one. The mucous membrane of the bronchi is dry due to an insufficient number of mucous glands, but is rich in blood vessels, which causes easy occurrence of stenotic phenomena. At an early age the lungs are rich connective tissue, are abundantly supplied with blood vessels, capillaries and lymphatic slits are wide, elastic tissue, especially in the circumference of the alveoli, is poorly developed. All these features are the reason for the leading role of swelling of the bronchial mucosa and relatively less pronounced manifestations of bronchospasm during an attack of bronchial asthma in children under 3 years of age. In bronchial asthma, the most severe respiratory failure is observed with severe expiratory shortness of breath. Bronchial asthma can develop typically as in adults only at school age with characteristic sudden nocturnal attacks of shortness of breath, which forces the patient to take an orthopneic position. Soon after the onset of the attack, wheezing sounds are heard from a distance, accompanied by a painful cough. After a few hours the attack passes, all that remains is moist cough with symptoms of bronchitis.
In preschool and school age Most often, asthma is expressed by the picture of asthmatic bronchitis. Less commonly, this wet form of asthma occurs in infants, in whom it can be diagnosed as trivial. acute bronchitis, spastic bronchitis and bronchopneumonia. About half of children with an initial diagnosis of spastic bronchitis, but later, with age, turn out to be sick with atopic bronchial asthma. In turn, asthma patients usually recover spontaneously before puberty and only completely. small part Children with atsmatic bronchitis, when they grow up, suffer from typical atopic bronchial asthma.
Typical for bronchial asthma is suffocation, which occurs due to boronchospasm. Characteristic of asthma is the fact that it begins with catarrhal phenomena - slightly elevated temperature, runny nose and cough, after which severe mixed, but predominantly expiratory shortness of breath occurs suddenly or to a certain extent gradually. During an attack, signs of enphysema are detected in the lungs, whistling dry rales in two phases of breathing and more scanty medium wet rales without a focus. There is no leukocytosis in the blood picture, the number of eosinophilic cells is increased. Their number is also increased in sputum, where Charcot-Leiden crystals are sometimes found. At the first attack of bronchial asthma, it is not always possible to make a diagnosis and the disease is most often mistaken for spastic bronchitis. However, with repeated attacks of bronchitis with spastic characteristics, you should always think about asthmatic phenomena. IN differential diagnosis asthma in children, one should always take into account a transient, eozonophilic infiltrate of the lung, which can occur with the presence of tachydyspnea, leading to a real asthmatic attack. In other cases, eozonophilic infiltrate is an incidental finding during an X-ray examination for fever and cough (Table 2).
table 2
Typically, in young children, exacerbation of atopic asthma is preceded by a pre-attack period, which can be manifested by changes in behavior, sleep disturbances (insomnia or drowsiness), lack of appetite, the appearance of itchy rashes, catarrhal syndrome: runny nose with bouts of sneezing, paroxysmal cough, itching of the nasal mucosa and conjunctiva of the eyes. , sometimes - a rise in temperature to subfebrile levels. The duration of the pre-attack period can vary from several hours to several days. Knowledge of the individual clinical characteristics of the precursor period in some cases makes it possible, with the help of timely therapy, to relieve the exacerbation of allergic bronchitis before the appearance of a detailed clinical picture of the disease.
1.4. Laboratory and instrumental examination patients with atopic bronchial asthma.
The diagnosis is made based on clinical data and laboratory tests.
Skin allergy tests are performed (scarification, nasal, intradermal).
In a clinical blood test: eosinophilia is detected, there may be leukocytosis, acceleration of ROE.
In the analysis of sputum - Kurshman spirals - consist of a dense shiny thread and a spiral-shaped mantle enveloping it, Charcot-Leyden crystals - colorless rhombic crystals of different sizes, formed from the breakdown of eosinophil products.
When radiography of organs chest– an increase in the pulmonary pattern is detected.
The mandatory examination includes spirometry - determination of the vital capacity of the lungs. (See Appendix 1.)
At home, to monitor the course of the disease, daily measurement of peak expiratory flow using a peak flow meter is recommended. (See Appendix 2.)
Between attacks of bronchial asthma, chest X-ray is normal. Sometimes, in the case of obstruction of a large bronchus by viscous mucus, shadowing caused by partial or segmental atelectasis is observed.
To rule out the diagnosis of pneumothorax, every patient with asthma undergoes a chest x-ray, a rare but potentially fatal complication of overexpansion caused by severe breathing problems in asthma. Chest X-ray can reveal mediastinum and subcutaneous emphysema in very severe disease.
The breath-hold test involves determining the time during which breathing can be completely held. Spirometry determines maximum amount air exhaled into the spirometer tube after a maximum inhalation. Determining the vital capacity of the lungs in children is usually possible only from 5-6 years of age. Such tests play an important role in the diagnosis and treatment of patients with asthma.
Infectious-allergic bronchial asthma is a special form of the disease, the formation of which is facilitated by the penetration of pathogenic microflora into the respiratory tract and an aggressive reaction immune system person. According to statistics, it accounts for 60-85% of all cases of bronchial asthma.
Causes
Provocateurs, penetrating into the bronchi, stimulate the production of immunoglobulins, inflammatory mediators, attract immunocompetent cells, which subsequently gives clinical picture allergies with the formation of bronchospasm. Provoking factors include:
- bacteria (mycobacteria, streptococci);
- protozoa (giardia, plasmodia);
- viruses (causative agents of herpes);
- mushrooms (mold);
- helminths (roundworms).
Separately, risk factors are identified, the presence of which increases the risk of developing the disease. They include heredity, genetic predisposition, endocrine organ dysfunction, stress, and glucocorticoid use.
Vaccination and diagnostic tests can also provoke allergies. The age of the patient decides a lot. Infectious-allergic bronchial asthma more often appears in children, since their immune system is still imperfect and is able to respond inadequately to external stimuli.
Symptoms
Asthma is often a concern after acute respiratory viral infection(ARVI), patients complain of expiratory shortness of breath, increasing to suffocation, paroxysmal painful cough, chest pain, dizziness. Conventionally, the course of the disease can be divided into 3 stages: initial, exacerbation, final (recovery).
- Elementary. Symptoms include runny nose, sore throat, and occasional cough. The signs are not clearly expressed, for this reason it is very difficult to prevent the increase in attacks and the occurrence of complications.
- Exacerbation. Asthma is accompanied by severe shortness of breath and a dry cough. The patient takes a forced position - sits down, leans slightly on the edge of the bed with his hands, while his legs are lowered. A person can lie down, but to facilitate breathing, his head is always slightly raised.
- Final. Shortness of breath gradually passes, sputum appears. The condition improves independently or while taking specialized medications.
To select medications, the patient must consult a doctor and undergo a full examination.
Diagnosis of infectious-allergic bronchial asthma
Studying the body for the development of an allergic reaction is complex and involves undergoing the following examinations:
- collecting anamnesis, identifying the frequency and course of pathologies of the respiratory system, clarifying the presence of provoking factors and heredity;
- general examination, during which the doctor pays Special attention blossom skin, shape of the chest, changes during percussion and auscultation of the lungs;
- a general, biochemical and serological blood test, where immunoglobulins E may appear, the number of eosinophils may increase and markers of inflammation may appear;
- bacteriological, microscopic examination sputum, determination of pathogenic microflora in secretions, Kurshman spirals, Charcot-Leyden crystals;
- spirography to determine the functional activity of the lungs;
- radiography, computed tomography and magnetic resonance imaging for organ visualization and differential diagnosis.
Skin and inhalation tests are considered very informative, allowing one to accurately determine the etiology of the disease. The meaning of the method is very simple: the suspected allergen is introduced into the body in an inactivated form, after which its reaction is observed for several hours. If symptoms appear in the form of sneezing, itching, shortness of breath, the test is positive.
Principles of treatment
Therapy involves achieving several main goals: reducing bronchial obstruction, reducing oxygen starvation tissues, restoring normal breathing, drawing up a plan aimed at reducing the number of exacerbations.
Treatment includes taking the following groups drugs:
- Bronchodilators. They are administered using a special inhaler or nebulizer into the respiratory tract, which contributes to a direct effect on the walls of the bronchi.
- Glucocorticosteroids. Relieves inflammation in a short time. Medicines are indicated for prolonged course of bronchial asthma, with life-threatening exacerbations.
- Antibiotics. Needed to eliminate the cause of an allergic reaction. Before identifying the pathogen, empirical treatment with broad-spectrum antibacterial agents is carried out.
- Antihelminthic medications. Prescribed for ascariasis, opisthorchiasis and other similar pathologies.
- Mucolytics. Needed for thinning and better removal of sputum.
In severe cases of bronchial asthma, oxygen therapy may be required, as well as infusion therapy in case of severe intoxication of the body.
Prevention
Compliance with some medical recommendations will help avoid the formation of infectious-allergic bronchial asthma. The tips are as follows: eat properly, nutritiously; give up bad habits, in particular, from smoking; lead healthy image life; move more in the fresh air, do exercises in the morning; regularly carry out wet cleaning in the house, treat surfaces with special products that eliminate allergens; Protect yourself from stress factors as much as possible. It is imperative to treat acute inflammatory diseases affecting the organs of the respiratory system and do not use medications uncontrollably.
If you have a genetic predisposition, it is necessary to limit contact with potential allergens. Such patients are under clinical observation.
Infection-dependent bronchial asthma is chronic illness respiratory tract with a characteristic infectious-allergic form of the inflammatory process and increased reactivity of the bronchi to external and internal influences.
The development of this form of the disease is facilitated by numerous predisposing factors, among which hereditary predisposition in children is of no small importance. The infection-dependent form of bronchial asthma, unlike allergic asthma, involves infectious routes development, and the influence of allergens is of secondary importance.
Features of the course of the disease
The disease manifests itself as episodic bronchial obstruction with severe cough, suffocation and difficulty breathing. The infection-dependent form of bronchial asthma in adult patients is provoked by bacterial and viral infections, which include chronic pneumonia, bronchitis, ARVI, Chronic rhinitis etc. In children, this type of disease is quite rare.
This form of the disease usually occurs between the ages of 30 and 40. An acute attack develops against the background of an infectious process with a gradual increase in symptoms. Bronchospasm is determined by a protracted course and reaches its peak 2-3 weeks after the first manifestations.
Symptoms of suffocation are quite severe and can transform into status asthmaticus. A characteristic symptomatology is a decrease in the frequency or complete disappearance of an attack of suffocation during a febrile state. Therefore, when attacks of suffocation intensify against the background of hyperthermia, it is necessary to exclude allergic symptoms, as well as syndromic asthmatic genesis and respiratory viral lesions of the respiratory tract.
In addition, there are a number of allergic diseases, especially in children who have hypersensitivity to fungi, viruses and bacteria. Infectious allergic asthma is no exception.
This disease, compared to atopic forms, is much more severe and is accompanied by complications. Choking increases gradually, but lasts quite a long time. In addition, an asthmatic attack is difficult to stop with the help of sympathomimetics and aminophylline. The cause of the development of an attack of suffocation may be previous infections, poor ecology and genetic predisposition.
Symptoms of the disease
With the development of infection-dependent bronchial asthma, the main negative symptoms are associated with the development of respiratory infections.
The most common symptom is severe shortness of breath with difficulty in exhaling followed by suffocation. In addition, symptoms can be expressed by a strong paroxysmal cough, which most often disturbs the patient at night, disturbing sleep.
In this case, the patient may feel compression in the chest area and pain when inhaling. Typically, a minimal amount of sputum is produced.
Asthma symptoms are conventionally divided into several periods
An asthma attack may stop on its own or with the help of medication.
Diagnostics
The diagnostic definition of infection-dependent bronchial asthma is, as a rule, quite difficult. Priority is carried out visual inspection pulmonologist. The history and symptoms of the disease are clarified.
The next step is an examination of the respiratory tract with the possible use of medicines. As a result of the examination, the expiratory type of shortness of breath is revealed. In mild cases, exhalation is much longer than inhalation and is accompanied by wheezing. In addition, prolonged exhalation slows down the breathing rate. With severe asthma, breathing, on the contrary, becomes frequent and ineffective. In this case, patients are unable to pronounce some words.
To diagnose infection-dependent bronchial asthma, the peak flowmetry method is often used. Using this drug, the maximum expiratory breathing rate is measured.
The patient can take measurements independently in the morning and evening time. It is recommended to keep a special diary to record the results. When examining a patient, the doctor conducts a thorough analysis of the measurements, which greatly facilitates the diagnosis of the disease. According to the results obtained, the most effective treatment tactics are selected.
In children, diagnosis is most often carried out using spirometry, which allows one to measure the volume of breathing and the degree of disturbances in the functioning of the respiratory system. With this type of diagnosis in children, the force of exhalation made with effort (forced) is assessed, as well as the total volume of air at maximum exhalation with forced vital capacity (VC). The lower these indicators are in children and adult patients, the more severe this form of the disease occurs.
Treatment tactics
Therapeutic treatment of infection-dependent bronchial asthma directly depends on the severity of symptoms and the addition of secondary infections. The principles of treatment are united by the etiology, pathogenesis and symptoms of the disease.
Depending on the severity of the process, treatment is divided into:
1. Etiological therapy
- Relieving inflammatory processes in the respiratory system and neutralizing exacerbations of chronic exacerbations;
- includes treatment of acute inflammatory process in the respiratory system, antibacterial agents, sanitation of the bronchi according to indications;
- sanitation of infectious foci oral cavity and nasal sinuses (it is especially important to carry out these activities in children, due to the special structure of the respiratory system);
- performing conservative treatment during remission, and, if impossible, surgical treatment.
2. Pathogenetic and symptomatic
- Carrying out specific methods of hyposensitization, regardless of remission or exacerbation;
- implementation of complex desensitizing nonspecific measures;
- relieving obstruction with bronchodilators and mucolytics;
- if necessary, prescribing glucocorticosteroid drugs (used with caution when treating children);
- strengthening the immune system with exercise therapy, spa treatment, massage, etc.
If the measures taken are ineffective, complications may occur in the form of status asthmaticus, characterized by acute respiratory failure, depression of consciousness (coma). In addition, if the disease progresses, emphysema and chronic respiratory failure are possible.
