Acute bronchitis

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Bronchitis is an inflammation of the bronchi (medium-size airways) in the lungs. Acute bronchitis is usually caused by viruses or bacteria and may last several days or weeks.[1]

Symptoms include cough and sputum (phlegm) production and sometimes symptoms related to the obstruction of the airways by the inflamed airways and the phlegm, such as shortness of breath and wheezing. Diagnosis is by clinical examination and sometimes microbiological examination of the phlegm. Treatment may be with antibiotics (if a bacterial infection is suspected), bronchodilators (to relieve breathlessness) and other treatments.

Cause/Etiology

In about half of instances of acute bronchitis a bacterial or viral pathogen is identified. [2] Typical viruses include respiratory syncytial virus, rhinovirus, influenza, and others.[3]

13% to 32% of adolescents and adults with a cough lasting six days or more may have B. pertussis.[4][5]

Signs and symptoms

Bronchitis may be indicated by an expectorating cough, shortness of breath (dyspnea) and wheezing. Occasionally chest pains, fever, and fatigue or malaise may also occur. Bronchitis caused by Adenoviridae may causes systemic and gastroentestinal symptoms.[6]

Diagnosis

A physical examination may be normal or may reveal wheezing or rhonchi, and if airway obstruction is present, may reveal decreased intensity of breath sounds and prolonged expiration.

A polymerase chain reaction blood assay may diagnose B. pertussis.[7]

Treatment

Antibiotics

A meta-analysis found that antibiotics may reduce symptoms by one-half day.[8] A second meta-analysis suggested that antibiotics may prevent pneumonia in elderly patients.[9]

Bronchodilators

Smoking cessation

References

  1. Wenzel RP, Fowler AA (2006). "Clinical practice. Acute bronchitis". N. Engl. J. Med. 355 (20): 2125–30. DOI:10.1056/NEJMcp061493. PMID 17108344. Research Blogging.
  2. Macfarlane J, Holmes W, Gard P, et al (2001). "Prospective study of the incidence, aetiology and outcome of adult lower respiratory tract illness in the community". Thorax 56 (2): 109–14. PMID 11209098[e]
  3. Freymuth F, Vabret A, Gouarin S, et al (2004). "[Epidemiology and diagnosis of respiratory syncitial virus in adults]" (in French). Revue des maladies respiratoires 21 (1): 35–42. PMID 15260036[e]
  4. Hewlett EL, Edwards KM (2005). "Clinical practice. Pertussis--not just for kids". N. Engl. J. Med. 352 (12): 1215–22. DOI:10.1056/NEJMcp041025. PMID 15788498. Research Blogging.
  5. Cornia PB, Lipsky BA, Saint S, Gonzales R (2007). "Clinical problem-solving. Nothing to cough at--a 73-year-old man presented to the emergency department with a 4-day history of nonproductive cough that worsened at night". N. Engl. J. Med. 357 (14): 1432–7. DOI:10.1056/NEJMcps062357. PMID 17914045. Research Blogging.
  6. Civilian Outbreak of Adenovirus Acute Respiratory Disease -- South Dakota, 1997. Retrieved on 2007-10-08.
  7. Crowcroft NS, Pebody RG (2006). "Recent developments in pertussis". Lancet 367 (9526): 1926–36. DOI:10.1016/S0140-6736(06)68848-X. PMID 16765762. Research Blogging.
  8. Bent S, Saint S, Vittinghoff E, Grady D (1999). "Antibiotics in acute bronchitis: a meta-analysis". Am. J. Med. 107 (1): 62–7. PMID 10403354[e]
  9. Petersen I, Johnson AM, Islam A, Duckworth G, Livermore DM, Hayward AC (2007). "Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database". DOI:10.1136/bmj.39345.405243.BE. PMID 17947744. Research Blogging.