OVERVIEW

What is wheezing bronchitis?

Wheezing bronchitis commonly occurs in infants and young children under 3 years old. It is an acute bronchitis accompanied by wheezing, mainly caused by microbial infections (such as viruses) and the unique anatomical characteristics of the respiratory system in young children. Symptoms include fever, cough, sputum production, wheezing, and difficulty breathing.

It can be treated by maintaining airway patency, anti-infection measures, relieving bronchospasm, and symptomatic supportive care. However, recurrence is likely with subsequent respiratory infections. Some children with wheezing bronchitis may develop bronchial asthma later in life.

Isolation is not required during the illness, but wheezing can significantly affect the patient's quality of life.

Is wheezing bronchitis common?

Yes, it is common, particularly in infants and young children under 3 years old with a history of eczema or other allergies.

SYMPTOMS

What are the common manifestations of asthmatic bronchitis?

• Common in infants and young children under 3 years old with a history of eczema or other allergies.
• Respiratory infection symptoms such as fever, cough, and sputum production are present.
• Wheezing dyspnea, chest tightness, and persistent wheezing symptoms occur, often milder during the day and worse at night.
• Physical examination may reveal nasal flaring, prolonged expiration, three-concave sign, and auscultation of wheezing and coarse rales in the lungs.
• Some children are prone to recurrence upon subsequent respiratory infections.
• The frequency of recurrence decreases with age until it no longer occurs, but some children may develop bronchial asthma later in life.

What other diseases can asthmatic bronchitis cause? Can asthmatic bronchitis cause pneumonia?

Infection can spread downward through the respiratory tract to the lungs, leading to pulmonary infection and causing pneumonia, which prolongs the course of the disease and increases treatment difficulty.

CAUSES

What are the causes of asthmatic bronchitis?

• Upper respiratory tract infections: Pathogens such as viruses (e.g., respiratory syncytial virus, influenza virus), mycoplasma, and bacteria (e.g., Streptococcus pneumoniae) may trigger it.
• Anatomical characteristics of infants and young children: Their trachea and bronchi are shorter and narrower than those of adults, with less elastic tissue support in the walls, making them prone to congestion and swelling after infection, leading to airway obstruction.
• Allergic predisposition: If the child or their relatives have a history of bronchial asthma, eczema, urticaria, or food/drug allergies, the child's airways may exhibit hyperreactivity. This means their airways are overly sensitive to certain irritants that would cause no or mild reactions in others, leading to airway constriction and wheezing.

Is asthmatic bronchitis hereditary?

It has a certain hereditary tendency, though the exact genetic mechanism remains unclear. It may be related to allergic predisposition and airway hypersensitivity. Affected children often have family members with a history of bronchial asthma, eczema, urticaria, or other allergic conditions.

Is asthmatic bronchitis contagious?

No, it is not contagious.

DIAGNOSIS

How is asthmatic bronchitis diagnosed?

Currently, there is no clear diagnostic standard in China. When diagnosing asthmatic bronchitis, clinicians mainly rely on the patient's medical history, clinical symptoms, and signs. For details, refer to the "Symptoms" section.

What tests are needed when asthmatic bronchitis is suspected?

• Complete blood count, liver and kidney function tests, blood biochemistry, C-reactive protein, procalcitonin, blood gas analysis, etc., to assess the patient's general condition, determine the severity of infection and possible pathogens, and prepare for medication.
• Throat swab, sputum culture, blood culture and related drug sensitivity tests, respiratory pathogen tests, etc., to identify the pathogen and aid in diagnosis and differential diagnosis.
• Chest imaging to evaluate lung conditions.
• If necessary, pulmonary function tests and bronchodilation tests may be performed to differentiate from bronchial asthma.

Which diseases can asthmatic bronchitis be easily confused with? How to differentiate them?

Due to shared symptoms like wheezing, this condition may be confused with bronchial asthma and bronchiolitis.

• Bronchial asthma: Often has an acute onset and recurrent episodes, with symptoms such as wheezing, chest tightness, and dyspnea during attacks. Widespread wheezing sounds are heard in the lungs. Bronchodilators and glucocorticoids are effective. Patients are usually asymptomatic between episodes. Differentiation is based on recurrent episodes, typical clinical manifestations, and bronchodilation test results.

• Bronchiolitis: Mainly presents with dyspnea and wheezing, but bronchodilators are ineffective.

TREATMENT

Which department should I visit for asthmatic bronchitis?

Children should generally go to the pediatrics or pediatric respiratory department, while adults should visit the respiratory medicine department.

How is asthmatic bronchitis treated?

• Keep the airways clear, pay attention to turning over and patting the back; rest adequately and strengthen nutrition.
• Anti-infection treatment: There are no specific antiviral drugs for asthmatic bronchitis caused by viral infections. For bacterial infections, antibacterial drugs such as penicillin and cephalosporins can be prescribed. For mycoplasma infections, the treatment course is 7–14 days, and the antibacterial drugs and duration should be adjusted based on the patient's culture, drug sensitivity results, and condition.
• Symptomatic and supportive treatment: Fever reduction (e.g., physical cooling, ibuprofen), expectoration (e.g., ambroxol), asthma relief (e.g., theophylline), and bronchodilators (e.g., budesonide, terbutaline).

Does asthmatic bronchitis require nebulization therapy?

It is a common treatment for respiratory diseases, mainly used for tracheobronchial conditions with wheezing symptoms, including asthmatic bronchitis.

Commonly used drugs include inhaled corticosteroids (e.g., budesonide) and bronchodilators (e.g., terbutaline), with adjustments made based on symptom relief.

Systemic side effects are relatively mild. To prevent oral fungal infections, rinse the mouth after inhaling corticosteroids.

Does asthmatic bronchitis require hospitalization?

It depends on the condition, but generally, hospitalization is not needed. If the patient has high fever, severe wheezing, or difficulty breathing and outpatient treatment is ineffective, timely hospitalization is necessary.

Can asthmatic bronchitis be cured completely?

It can be cured, but there is a possibility of recurrence, and it may develop into bronchial asthma in the future.

DIET & LIFESTYLE

What should patients with asthmatic bronchitis pay attention to in their diet?

Provide a high-calorie, high-protein, and high-vitamin diet, such as sufficient staple foods, dairy products, eggs, fish, meat, and fresh fruits and vegetables, to ensure adequate nutrient intake, enhance immunity, and promote recovery.

What should be noted in daily life after recovering from asthmatic bronchitis?

Avoid infections, strengthen physical fitness through reasonable and regular exercise, and avoid exposure to potential allergens.

Does asthmatic bronchitis require follow-up examinations? How is it reviewed?

Yes, follow medical advice to recheck hematological indicators and chest imaging. Generally, no further follow-up is needed after full recovery.

PREVENTION

Can wheezing bronchitis be prevented? How to prevent wheezing bronchitis?

Yes.

• Pay attention to keeping warm, especially during seasons with frequent climate changes like spring and autumn, to avoid catching cold;
• Avoid exposure to potential allergens, such as cold air, spring pollen, or hazy weather. Minimize outdoor activities during these conditions, and wear a mask when going out;
• Maintain regular physical exercise to strengthen the body.

How can patients with wheezing bronchitis prevent other diseases?

Early detection, early diagnosis, early treatment, follow medical advice for medication, undergo regular check-ups, and avoid recurrence.