Chronic cough, expectoration and wheezing in winter and spring

Introduction According to cough, cough or wheezing, the onset of disease lasts for 3 months, for 2 consecutive years or more, and can exclude other cardiopulmonary diseases (such as tuberculosis, pneumoconiosis, asthma, bronchiectasis, lung cancer, abscess, chronic nasopharyngeal disease, heart disease, cardiac dysfunction, etc.) . Bacterial pneumonia is mainly caused by pneumococci, and viral pneumonia is mainly caused by adenovirus. Infants and young children have poor defense function and immature lung development. Therefore, the incidence rate is the highest within 2 years old, and it is most common in the upper respiratory tract infection and acute infectious diseases.

Cause

(1) The virus has viral bronchopneumonia caused by canine distemper virus, canine adenovirus type I and type II, canine parainfluenza virus, herpes virus, reovirus, cat upper respiratory syndrome virus and the like.

(2) The bacteria have Chlamydia psittaci. Bacterial bronchopneumonia caused by Mycobacterium tuberculosis, Pasteurella, Streptococcus, Staphylococcus, Escherichia coli, Nocardia, Actinomycetes, B. bronchiseptica, Klebsiella pneumoniae, etc.

(3) The fungus has fungal bronchitis caused by cryptococcus, histoplasma, aspergillus, candida, and the like.

(4) The parasite has parasitic bronchopneumonia caused by aerated capillary nematodes, toxoplasma, cat worm, aphids and hookworm larvae.

(5) Foreign body pneumonitis or allergic bronchitis caused by foreign body, vomit, inhalation of irritating substances or certain allergic reactions.

(6) Some purulent diseases, such as metritis, mastitis, etc., the bacteria can enter the lungs through the blood and cause disease. Diagnostic points There are nose drops, cough and bronchial rales at the beginning of the disease. The body temperature rises above 4 °C and is a relaxation heat. Increased breathing, rhythm changes, paroxysmal cough. As the disease progresses, the alveolar breath sounds in the lung lesions are weakened, the surrounding breath sounds are enhanced, and there are wet or dry rales. Diseased animals also exhibit systemic symptoms such as depression, lethargy, anorexia or waste. Blood tests, leukocytosis, increased proportion of neutrophils, and left shift of the nucleus. Allergic bronchitis, eosinophilia. In addition to eosinophilia, parasitic bronchopneumonia can detect eggs in the feces. X-ray film examination, increased lung texture at the beginning of the disease or partial light and uniform shadows. In the middle of the disease, the lungs undergo a real change, showing a large uniform and dense shadow. In the late stage, the lung shadow density decreases and becomes brighter, and some of the shadows appear scattered in the form of sheets or strips.

an examination

Related inspection

Chest CT examination mammography

Chronic cough, wheezing and wheezing in winter and spring are rapid or delayed, and most have mild upper respiratory tract infections before onset. However, the cause of the disease is judged based on the specific clinical manifestations. In addition to detailed medical history, symptoms and physical examination (pulmonary auscultation, percussion), blood routine examination is necessary. Other laboratory tests are performed selectively according to the condition, such as sputum bacterial culture tests, as well as X-ray, electrocardiogram, CT and other tests to assist in the establishment of the diagnosis.

Differential diagnosis

(A) acute bronchitis, systemic symptoms are light, generally no obvious dyspnea and hypoxia symptoms, the lungs smell and the wet rhythm, more often not fixed, with cough and change.

(B) Acute miliary tuberculosis, miliary tuberculosis can also show high fever, shortness of breath, cough, purpura and other symptoms similar to pneumonia, but the lungs are often not obvious. According to the history of tuberculosis exposure, tuberculin test positive and X-ray examination, the lungs are miliary shadows can be identified.

(C) bronchial foreign body, a history of foreign body inhalation, sudden cough, and combined with chest X-ray examination can be distinguished, if necessary, fiberoptic bronchoscopy.

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