Tracheitis is an inflammatory process in the upper respiratory tract with damage to the tracheal mucosa. The etiology of the disease can be viral or bacterial, it can occur due to various acute viral or bacterial infections or influenza. The life-threatening tracheitis is not dangerous if it is diagnosed in a timely manner and the necessary therapy is carried out.
The trachea is a pneumatic tube formed by cartilaginous semirings between the bronchi and the pharynx. Very rarely, tracheitis occurs as an independent disease, this can occur due to hypothermia of the body, inhalation of dry, hot or too cold air. In addition to the viral or bacterial nature, pathology can also occur as an allergic reaction to external stimuli.
Classification by origin
Primary and secondary tracheitis
Under primary tracheitis refers to pathology, which arose as a result of the defeat of the trachea only. Other respiratory organs remain intact and cannot serve as a source of disease. Primary tracheitis is an independent disease that is almost never characteristic of the acute form of pathology.
Secondary tracheitis occurs against the background of other diseases of the upper respiratory tract inflammatory or infectious nature. In addition to the trachea, the lungs, bronchi, sinuses, larynx, pharynx and other organs may suffer for the second time.
Viral tracheitis is defined as an acute form of the disease that occurs in acute respiratory viral infectious diseases and influenza. This type of pathology is very contagious and is usually transmitted by airborne droplets. Symptoms of this type of pathology always depend on the type of pathogen and the severity of the underlying infection. The most common symptoms are paroxysmal cough, which is unproductive at the onset of the disease, and, when resolved, is accompanied by sputum that goes away for several days, and acute rhinitis with rhinorrhea, abundant mucous discharge from the nose and nasal breathing.
Viral tracheitis is not necessary in the standard case to treat any specific ways. Usually, after the body produces antibodies against the incoming virus, the active phase of the disease passes. Therefore, in the normal course of a viral disease, the patient is enough to treat mucolytics for rest and warm drinking, and in the case of a paroxysmal dry cough, you can take an antitussive drug to alleviate the symptom.
Most often, the bacterial type of tracheitis occurs as a secondary infection after suffering flu or other acute respiratory viral infections, in which any bacterial infection (Staphylococcus aureus, streptococcus, and hemophilus bacillus) can act as a causative agent. This type of tracheitis is not as infectious as viral; it can only be transmitted to a healthy person from a patient in close contact. In symptomatology, bacterial tracheitis practically does not differ from viral, except for the appearance of purulent sputum at a certain stage of the disease.
A rare type of tracheitis is a fungal type of disease. Most often, it can occur with a reduced level of immunity with the activation of fungi of the candida, aspergillosis or actinomycosis families in the body. The disease of aspergillus etiology mainly simultaneously spreads to the mucous membranes of the bronchi and trachea, causing tracheobronchitis. In actinomycous tracheitis, the pathogens enter the tracheal zone from the esophagus, and Candida penetrates the esophagus from the oral cavity, pharynx, and larynx.
Allergies can also lead to inflammatory processes in the tracheal mucosa. In turn, allergic reactions can be the result of food allergies in children, hereditary predisposition, contact with various chemicals, prolonged infections and other substances. Allergic tracheitis can occur in acute form, or, with prolonged and constant contact with sensitizing substances, become chronic.
Causes of illness
Pathogens of pathology
The causes of tracheitis can be a variety of pathogens, as well as internal and external factors:
- bacterial microorganisms;
- viral infections;
- allergens of a different nature;
- work in hazardous working conditions;
- polluted air;
- the presence of too dry or too humid air;
- complications of respiratory viral diseases.
In this case, the causative agents of viral tracheitis most often become:
- acute viral respiratory infections;
- parainfluenza, influenza;
- scarlet fever;
The causative agents of bacterial tracheitis are most often:
- hemophilus bacillus;
Negative factors can also easily cause tracheitis. It often becomes a consequence of diseases provoking disturbed nasal breathing, for example, rhinitis, sinusitis, adenoiditis, tumors and other things. Diseases that cause secondary immunodeficiency, many somatic diseases, as well as seasonal allergies, tobacco smoke and adverse environmental conditions (cold, dryness and humidity, dust, etc.) are capable of causing tracheitis.
The most important symptom of the tracheal psychogenic form is a long and painful cough. In order not to make a mistake and correctly identify the psychogenic cough, it is necessary to pay attention to the specific features of psychosomatic tracheitis:
- a strong cough during the day and the absence of it at night, emotional overstrain, unpleasant conversation, physical exertion - all this can provoke a coughing fit;
- cough lasts a very long time and is not treated with any drugs;
- during a medical examination there are no violations related to the respiratory system, there are no changes in the analyzes.
The human body has the ability to produce a protective reaction to various actions or statements of others, and one of these reactions can be a cough.
Ways of infection
The contagiousness of tracheitis directly depends on the cause of the disease. With a bacterial etiology of the disease, the probability of infecting a healthy person is practically non-existent; this becomes possible only with very close contact with the patient, when bacteria can be transmitted through kissing or through common utensils.
Viral tracheitis is very contagious, it is transmitted easily by airborne droplets. For example, an enterovirus or adenovirus is transmitted from person to person, even at a distance, provided they are in the same room. Talking, coughing and sneezing contribute to the spread of viruses in the air. Common devices also spread human-to-human infection.
The contagiousness of the chronic form of tracheitis is determined by the stage of the disease. With sustained remission and no recurrence, transmission of the disease is impossible.
The most common is airborne infection of tracheitis. When sneezing and coughing viruses, the concentration of which in the sputum is very high, spread to the environment and die in it. However, if a healthy person is nearby, the particles of saliva or sputum get into the body with inhaled air and the person becomes ill.
Thus, airborne infection occurs when talking at short distances, using cutlery at the same time, sometimes with handshakes or using common towels. The causative agents of tracheitis can cause not only this pathology, but also inflammation of all organs of the respiratory tract.
In the acute period of the disease, the patient is most contagious. At this time, it releases into the environment the maximum amount of the pathogen. This period is characterized by the onset of the initial symptoms of the disease - sore throat, dry cough, general malaise. The acute period lasts up to 5 days. It is preceded by an incubation period during which the patient is already infected, but the disease still does not manifest itself. This period can last for tracheitis from 1 to 10 days. At this time, the danger to others a sick person is not.
Symptoms of the disease
The main symptom of tracheitis is paroxysmal cough. At the onset of the disease, the cough is unproductive, then scant sputum appears, at night and in the morning the intensity of the attacks increases significantly, as with loud conversations, laughter, crying, and deep breaths.
When coughing, the patient often feels sore throat and pain or burning in the sternum. Gradually, the viscosity of sputum decreases and it begins to move away more easily, which leads to a decrease in the cough itself and the painful sensations it creates in the chest and throat. This may indicate the resolution of the inflammatory process. Sometimes with tracheitis, inflammation can affect the mucous membrane of the larynx, which causes hoarseness. At the beginning of the disease most often there is an increase in body temperature and general weakness. If, against the background of tracheitis, bronchi are affected and tracheobronchitis occurs, the patient’s condition worsens and the clinical symptoms of bronchitis appear - the temperature rises, the cough quickens and becomes deeper, dyspnea is possible, and painful symptoms occur with each cough located behind the sternum.
Nature of the disease
Acute tracheitis occurs as a result of viral or bacterial infections in the mucous membrane of the trachea. The disease occurs suddenly, and its duration is usually about 14 days. This form of the disease rarely occurs on its own, it is mainly manifested as one of the symptoms in acute respiratory diseases and influenza.
The main cause of acute tracheitis is a viral infection, much less often this pathology is caused by staphylococci, streptococci or influenza bacilli. A distinctive feature of acute tracheitis from other inflammatory diseases localized in the upper respiratory tract is a painful paroxysmal cough that does not sleep at night, or begins in the early morning, often accompanied by chest pains. Periodically begin bouts of cough with a small sputum discharge.
Chronic tracheitis is a process of prolonged inflammation of the trachea. In this case, the chronic form of the disease is of two types - atrophic and hypertrophic. In case of atrophic chronic tracheitis, the mucous membranes of the trachea become thinner, at the same time they acquire a gray tint and in places become covered with crusts, which in this case cause coughing. In the hypertrophic form of chronic tracheitis, on the contrary, the vessels thicken and the mucous membrane of the larynx swells, which also provokes cough syndrome.
The course of chronic tracheitis depends primarily on the state of the human immune system. If the protective functions of the body work in the prescribed mode, then relapses rarely occur, mainly in the autumn. In remission in adults, the symptoms of the disease are practically absent. A small cough without sputum may occur. In adults, the symptoms of chronic tracheitis during exacerbation may be more pronounced than during the initial acute stage. But more often the disease is transferred much easier than during the initial appearance.
Regardless of the form of the disease, against the background of the spread of the inflammatory process down the respiratory system, a whole group of complications is possible.
Tracheobronchitis is an inflammatory process that simultaneously affects the mucous membranes of both the bronchi and the trachea. If the tracheitis turns into pneumonia, then the general state of health sharply and significantly worsens, there are pains in the human chest during breathing and coughing. Ignoring the symptoms of the disease, failure to provide timely medical care can provoke laryngeal stenosis or obstruction of the bronchial tree. Bronchopulmonary complications are accompanied by high fever, a strong cough, the appearance and rapid spread of pulmonary rales, and hard breathing in the lungs of a person.
Duration of tracheitis
In adults, tracheitis most often occurs acutely and ends by 10-14 days. When you transfer the disease "on the feet" and self-treatment instead of adequate therapy, you can achieve chronicity of the inflammatory process and the addition of various complications, which will necessarily affect the timing of the disease.
Prolonged pathology will always be expressed by increased cough and sparse sputum. Attacks most often can occur at night, their duration can take up to 30 minutes each. With the complication of tracheitis with pneumonia or bronchitis, the duration of the disease can reach 1-2 months.
In children of different ages, tracheitis can last a different amount of time. Schoolchildren usually get sick in the same way as with adult patients, and with inadequate therapy, the disease may be delayed for 3–4 weeks. Preschoolers and infants have an inadequate immune system and a weak cough reflex, so their duration of the disease can last up to 4-5 weeks and proceed with unexpressed symptoms - a slight cough with a small amount of sputum.
The diagnosis of tracheitis by the doctor is set based on several criteria. One of them is the patient's complaints about the paroxysmal unproductive night and morning cough, which eventually becomes wet with the separation of scanty sputum and which greatly intensifies with a deep breath, crying, laughing, screaming. Also a symptom of tracheitis for the doctor may be a complaint of chest pain cough. Anamnesis of the disease will demonstrate to the specialist the stages of the development of the disease and will help to clarify the cause of tracheitis. Physical examination of the patient in this case includes auscultation of the lungs for the presence of dry or moist rales, breathing rigidity, and a laryngoscopic examination of the larynx.
Also, to diagnose and exclude complications, the patient must undergo a complete blood count, which can suggest a viral or bacterial etiology of the disease. Among the additional diagnostic methods for tracheitis common:
- radiography of the lungs to exclude bronchitis or pneumonia;
- spirography or spirometry to assess lung ventilation and lung function (this is necessary to rule out asthma or chronic bronchial obstruction);
- sputum analysis to identify the causative agent and determine its sensitivity to antibiotics when necessary to use them.
In some cases, patients with tracheitis may be consulted by a pulmonologist.
Tracheitis treatment methods
Traditional treatment of tracheitis is based on non-drug and drug treatment.Non-pharmacological treatment includes the establishment of a rational drinking regime with increased fluid intake in the form of teas, compotes, fruit drinks, heated alkaline mineral waters without gas, lime tea. The second prerequisite is the complete cessation of smoking by the patient. It is also important to exclude those factors that can provoke a cough in each case, such as dust, smoke, and so on. It is necessary to eat fully, the food should be high-calorie and enriched with vitamins. Patients with this pathology are recommended a variety of physical therapy procedures.
There is no specific therapy for drug therapy of viral tracheitis, with the exception of the influenza virus, in which anti-influenza specific drugs are used. In the case of the bacterial nature of the onset of pathology, antibiotics, more often in inhalation forms, mucolytics means for liquefying and facilitating the discharge of existing sputum, antitussives with an agonizing dry cough, inhalation with alkaline mineral waters to reduce inflammation and facilitate the discharge of sputum, antipyretic agents at body temperature above 38 degrees, immunomodulators to stimulate immunity with frequent exacerbations of chronic tracheitis.
It is important to remember that the use of antibiotics in case of a non-bacterial infection is fraught with the development of antibiotic-resistant pathogens of bacterial origin, which can pose a serious threat to people. You also can not use mucolytic drugs in combination with antitussive, because liquefied sputum in this case will begin to stagnate in the bronchi, which can cause the development of pneumonia.
How to avoid illness
Preventive measures for tracheitis can be methods aimed at preventing the disease of ARVI, hypothermia of the body, contact with dirty air. Timely vaccination with influenza, pneumococcal and antihemophilic vaccines helps to prevent the development of tracheitis. Vaccination is shown to representatives of the so-called "risk group" for tracheitis - the elderly, patients with immunodeficiency states, chronic pulmonary pathologies, cardiovascular problems, diabetes. It is best to be vaccinated between October and mid-November, since later the effectiveness of vaccine administration may decrease due to the possibility of contacts that have happened so far, which will lead to a decrease in the sufficiency of the immune response.
Also, for the prevention of tracheitis, you can take drugs that stimulate the immune system throughout the autumn-winter period. This is especially useful for those who are prone to frequent respiratory diseases or who suffer from chronic tracheitis.
Contraindications for tracheitis
There are a number of contraindications for treating tracheitis. For example, in case of tracheitis with non-productive cough, it is not recommended to take expectorant and mucolytic drugs. It is also impossible to combine the use of expectorant drugs with cough suppressants.
In the acute period of tracheitis, it is not recommended to resort to thermal and warming procedures. Physiotherapy effects in this pathology is possible only if the disease has passed into the recovery phase, and residual symptoms remain.
Improperly chosen treatment can provoke the occurrence of complications, in the form of bronchitis, pneumonia, as well as neoplasms, therefore, for tracheitis (and indeed for any cough), therapy should be chosen exclusively by the attending physician after a physical examination.
Acceleration of recovery will contribute to a certain diet with tracheitis. To help the body fight infection, it is important to increase the percentage of animal protein foods and reduce the amount of carbohydrates in the diet. On the basis of carbohydrates a favorable environment is formed for the growth of various pathogenic microorganisms, which complicates any inflammatory process, including tracheitis.
Food in the diet should be high-calorie and fortified. Cooking is required by steaming or cooking. It is very important to drink a lot. The daily amount of fluid consumed should be up to one and a half - two liters.
To form such a volume of liquid can water, teas, compotes, soups, juices.
The most useful in this pathology will be to eat wheat crackers, soups on vegetable or low-fat meat broths, cereals, boiled fish and meat of low-fat varieties, low-fat dairy products, eggs, fresh vegetables and fruits. You can drink any juices, compotes, decoctions, fruit drinks, jelly, green tea. Especially useful for tracheitis are decoctions of wild rose or chamomile.
Hazards and consequences
Often, after recovery, there is a long cough. This happens in half of all cases of disease transmission. It also does not exclude the possibility of transition from acute to chronic.
A particular danger is tracheitis during pregnancy. As with other infectious diseases, pathogens can infect the fetus and cause irreversible reactions and consequences. However, when pathology is detected at the initial stage, it is very easy to cure, preventing the long-term effect of pathogenic microorganisms on the fetus. That is why pregnant women are always at a special account with doctors, they need to carefully monitor their health and be sure to ask for help at the slightest change in their state of health.
Specialty: therapist, nephrologist.
Total experience: 18 years.
Place of work: Novorossiysk, medical center "Nefros".
Education: 1994-2000 Stavropol State Medical Academy.
- 2014 - "Therapy" full-time advanced training courses on the basis of the State Budgetary Medical Educational Institution of Higher Professional Training "Kuban State Medical University".
- 2014 - "Nephrology" full-time refresher courses on the basis of the Stavropol State Medical University.