Acute bronchitis

Lung anatomy

Bronchitis and Normal Condition in Tertiary Bronchus

Respiratory system

Acute bronchitis

Definition:

An inflammation of the main air passages to the lungs (the bronchi).

Causes, incidence, and risk factors:

Bronchitis generally follows a viral respiratory infection and typically appears just as the symptoms of the initial infection are waning.

The viral infection, which may be caused by any number of respiratory viruses including the rhinoviruses which cause the common cold, produces bronchial inflammation which sets the stage for bronchitis and, in some cases, a secondary bacterial infection.

Early symptoms may include a tickle deep in the throat just above the sternal notch which progresses into an irritating dry cough.

As the infection progresses, the cough may become productive with thick yellow sputum (purulent sputum) which is very rarely blood streaked. Associated symptoms may include fever, malaise, chest pain, and shortness of breath.

When affected, infants generally develop other respiratory complications, such as bronchiolitis or pneumonia, while older children and adolescents develop typical adult symptoms of bronchitis.

Risk factors include recent illnesses that have lowered resistance to infection, a preceding viral respiratory infection, smoking, or chronic pulmonary problems. The incidence is approximately 4 out of 100 people.

Symptoms:

Cough
- May produce pus-like sputum or mucous-like sputum
- May have episodes of coughing up blood (blood streaked sputum)
- Lasting for less than 6 weeks
Shortness of breath
May cause the individual to awaken at night (paroxysmal nocturnal dyspnea)
Wheezing
Rales
Rattle in chest
General ill feeling (malaise)
Slight fever
Sore throat
Chest pain, soreness, and constricted feeling in the chest
Chills (uncommon)

Signs and tests:

A physical examination confirms the symptoms, and is important to help rule out the presence of pneumonia.

Tests performed may include:

A chest X-ray to determine if pneumonia has developed
A sputum culture to determine if the inflammation is caused by bacteria

Treatment:

The goal of treatment is to relieve the symptoms with medications and supportive measures.

Medications which open constricted air passages in the lungs (bronchodilators), such as albuterol, may be prescribed. In otherwise healthy people, antibiotics are rarely needed.

Decongestants (such as pseudoephedrine) may also help alleviate the symptoms of bronchitis. Medications that liquefy mucus secretions (mucolytics, like guaifenesin) may also be prescribed.

Supportive measures include rest, increased humidity (using a cool mist humidifier) to soothe air passages, and increased fluid intake to maintain hydration and to thin mucous lung secretions.

Expectations (prognosis):

Symptoms usually abate within 7 to 10 days in the absence of prior chronic pulmonary disease. Complete resolution of cough may take longer in some patients.

Complications:

Pneumonia is a possible complication.

Calling your health care provider:

Call your health care provider if symptoms suggestive of bronchitis occur.

Call your health care provider if you are being treated for acute bronchitis and breathlessness develops, or if you cough up blood.

Prevention:

Good handwashing is one of the best ways to avoid exposure to viruses and other respiratory infections. Minimize exposure to cold, damp environments which, combined with air pollution, may make people more susceptible to bronchitis.

Review Date: 5/9/2002
Reviewed By: Thomas A. Owens, M.D., Departments of Internal Medicine and Pediatrics, Duke University Medical Center, Durham, NC. Review provided by VeriMed Healthcare Network.

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