Inflammation of the trachea may be due to allergic reactions or infection. Bacterial, allergic, fungal and viral tracheitis are fundamentally different from each other. In particular, local manifestations, the nature of the cough and possible complications are determined.
Temperature, coughing fits, malaise and burning sensation in the throat are the main manifestations of tracheitis of any etiology. It is possible to accurately determine the causative agent of the infection only by the results of microbiological examination, laryngotracheoscopy and radiography of the lungs. Treatment methods depend on the type of disease, the severity of the symptoms of inflammation, concomitant diseases and complications.
Etiology
As an independent disease, infectious tracheitis is rarely diagnosed. As a rule, during the examination, a complex lesion of several parts of the respiratory tract is observed at once. Inflammation of the trachea may be preceded by rhinitis, bronchitis, laryngitis, tonsillitis, ARVI, etc. Allergic tracheitis is most often accompanied by an allergic rhinitis or conjunctivitis.
Respiratory inflammation occurs when infectious agents and allergens enter the respiratory tract. It is worth noting that most of the causative agents of ENT pathology are unstable in the external environment, therefore, infection often occurs upon contact with the carrier of the infection. The factors that provoke inflammation of the trachea include:
- curvature of the nasal septum;
- exacerbation of chronic diseases;
- secondary immunodeficiencies;
- inhalation of tobacco smoke;
- dustiness of the air;
- tendency to allergic reactions;
- hypovitaminosis and iron deficiency anemia;
- overheating and hypothermia.
People suffering from diabetes mellitus, tuberculosis, heart failure and adenoiditis are more susceptible to tracheitis.
The appearance of infectious inflammation is favored by congestion in the nasopharynx. Therefore, chronic rhinitis, adenoids, sphenoiditis, and postnasal mucus leakage increase the risk of infection in the lower respiratory tract.
Classification
In otolaryngology, several forms of respiratory disease are distinguished: allergic, infectious and infectious-allergic. The greatest danger for children and adults is infectious-allergic inflammation of the trachea. In the course of the development of the disease, severe inflammation and edema of tissues occurs, therefore the trachea is often involved in the pathological process. In this regard, the patient may develop a false croup, characterized by attacks of suffocation.
Depending on the causative agent of the infection, the following types of septic inflammation of the trachea are distinguished:
- bacterial - provoked by pathogenic microbes (streptococcus, staphylococcus);
- viral - caused by pathogenic viruses (coronavirus, adenovirus);
- viral-bacterial - inflammation provokes several viral and bacterial pathogens at once.
By the nature of the course, acute and chronic tracheitis are distinguished. In acute inflammation of the trachea, the symptoms of the disease appear suddenly, the patient complains of hyperthermia (high temperature), dry spastic cough and signs of intoxication. But with timely treatment, inflammation can be eliminated within 10 days.
Prolonged, i.e. chronic tracheitis entails pathological changes in the tissues. In places of inflammation, fibrous adhesions are formed, which do not dissolve even after treatment. Symptoms of sluggish inflammation are mild. In the daytime, coughing practically does not bother and worsens either before bedtime or after waking up.
Viral tracheitis
Viral tracheitis is a highly contagious disease that can be transmitted by airborne droplets. Inflammation of the trachea is provoked by nonspecific infectious agents, therefore, even if another person is infected, related diseases, for example, flu, laryngitis or pharyngitis, may develop. The most common infectious agents include:
- adenoviruses;
- parainfluenza virus;
- coronaviruses;
- rhinoviruses;
- enteroviruses.
Often, the development of tracheitis is accompanied by other viral diseases - colds, flu, bronchitis, scarlet fever, pneumonia, chickenpox, etc. As the infection progresses, pathogens enter the lower airways and affect the tracheal mucosa. As a rule, complications do not arise in acute viral tissue inflammation. But if the disease is not treated, microbial flora can join the viruses. Mixed type tracheitis is more difficult to treat, so it is recommended to consult a specialist before significantly deteriorating health.
Typical manifestations of tracheal viral lesions include dry cough, headaches, redness of the throat mucosa, fever, weakness and lack of appetite. With complicated tracheitis, abscesses may occur in the lesions, indicating the multiplication of pyogenic microbes.
Purulent inflammation of the trachea can cause an abscess in the airways, which increases the risk of developing systemic inflammation, i.e. sepsis.
Bacterial tracheitis
ENT disease of bacterial genesis is caused mainly by cocci - Staphylococcus aureus, pneumococcus, meningococcus, etc. During reproduction, pathogenic microbes release toxic substances, as a result of which the patient develops symptoms of severe intoxication:
- joint and muscle pain;
- nausea;
- lack of appetite;
- stomach ache;
- stool problems.
Bacterial tracheitis is potentially more dangerous than viral disease. The fact is that bacteria provoke purulent inflammation of the trachea, as a result of which there is a risk of developing a pharyngeal abscess. In addition, patients have a high temperature (up to 40 ° C), as a result of which dehydration occurs. Young children may experience febrile seizures and hallucinations.
When the infection spreads, cartilage tissue is often affected, as a result of which epiglottitis and false croup develop.
With microbial damage to the trachea, patients may complain of:
- soreness and enlargement of the lymph nodes;
- fever and increased sweating;
- moist, spastic cough;
- white bloom on the walls of the laryngopharynx;
- severe sore throat when swallowing;
- enlargement and redness of the tonsils;
- labored breathing;
- copious secretion of sputum with pus.
Due to the edema of the mucous membranes, "wheezing" breathing occurs, which is called stridor. Over time, patients complain of lack of oxygen and dizziness. If the larynx is severely narrowed, emergency assistance and tracheal intubation may be required.
Fungal tracheitis
Tracheomycosis (fungal tracheitis) is a disease that is provoked by mold and yeast-like fungi. The causative agents of infection are Aspergillus, Actinomycetes or Candida fungi. A distinctive feature of fungal inflammation is the presence of a curdled plaque on the walls of the trachea.
As in the case of a viral disease, tracheomycosis often develops against the background of other diseases - fungal tonsillitis (tonsillomycosis) or pharyngitis (pharyngomycosis). The least aggressive is the candidal flora, which is quite simply eliminated with the help of antimycotics. Aspergillosis and actinomycosis provoke severe intoxication of the body and tracheal edema, resulting in symptoms of respiratory failure.
With actinomycosis, fistulas can form in the trachea, which can only be eliminated surgically.
As a rule, with a fungal infection of the respiratory system, severe pain in the throat does not occur until the mucous membrane is covered with manifestations. Pathogens multiply very quickly through spores, so the bronchi and pharynx can be involved in inflammation. This can cause broncho- and laryngospasm, which in some cases lead to acute asphyxia.
The manifestations of tracheitis of mycotic genesis include:
- paroxysmal cough;
- allergic rhinitis;
- labored breathing;
- burning and itching in the larynx;
- subfebrile condition (low temperature).
With the timely passage of antimycotic therapy, the fungal flora can be eliminated within 5-6 days. However, with the development of actinomycosis, the infection penetrates deeply into the tissues, therefore, to eliminate it, it is necessary to use antifungal agents of systemic action.
Chronic tracheitis
Prolonged tracheitis is a consequence of untimely and improper therapy of an acute form of ENT pathology. Chronic inflammation of the respiratory system is caused by microbes, in particular Staphylococcus aureus. The disease is characterized by a change in periods of exacerbation of inflammatory reactions and remissions.
Despite the practical absence of throat discomfort, chronic inflammation must be treated. Over time, pathological changes are observed in the tissues, in this regard, patients are diagnosed with one of two forms of sluggish tracheitis:
- hypertrophic - characterized by a strong thickening of the mucous membrane and a moist cough;
- atrophic - dystrophic changes occur in the mucous membrane, as a result of which the ciliated epithelium becomes thinner, and in some places it becomes crusted.
With prolonged remission, the external manifestations of the disease are practically absent. The cough can only appear in the evening or immediately after waking up. Temperature and symptoms of intoxication practically do not bother patients. But in the case of a decrease in the immune defense, microbes multiply rapidly, as a result of which an exacerbation of tracheitis occurs. With relapses, the symptoms of the disease are identical to those that appear in acute inflammation of the trachea.
Features of therapy
After a thorough examination of the patient, the attending physician will prescribe the appropriate treatment. The duration of therapy and the types of agents used are determined by the nature of the causative agent of the ENT disease. Viruses can be destroyed with antiviral agents, fungi with antimycotics, and microbes with antibiotics.
In addition to etiotropic agents that destroy the infection, symptomatic drugs are used. They stop coughing, reduce swelling, promote healing of mucous membranes and reduce the severity of signs of intoxication. Most often, the following medications are included in the therapy regimen:
- antiviral - "Arbidol", "Kagocel";
- antipyretic - "Paracetamol", "Nurofen";
- expectorants - "Ambrobene", "Alex Plus";
- antihistamines - "Diazolin", "Zirtek";
- antibiotics - "Amoxiclav", "Ceftriaxone";
- antimycotics - "Hepilor", "Levorin";
How to treat purulent tracheitis? Purulent forms of ENT disease are provoked by pyogenic microbes, therefore they are treated with antibiotics of the cephalosporin, macrolide and penicillin series.
