Acute Bronchitis
- causes and risk factors
- signs, symptoms, and diagnosis
- pathophysiology
- treatments
- consequences and course
- the patient
- health care team
- community involvement
- resources and references
Acute bronchitis is an infection of the tracheobronchial tree, causing inflammation, bronchial edema, and mucus formation.
Causes and Risk Factors
Up to 80% of cases of bronchitis are viral, with the most common pathogens being rhinovirus, coronavirus, adenovirus, influenza, parainfluenza, and RSV.
The remaining 20% of cases are bacterial/mycoplasmal, commonly M. pneumoniae, C. pneumoniae, and S. pneumoniae.
Signs, Symptoms, and Diagnosis
Acute bronchitis is typically a clinical diagnosis.
- history
- physical exam
- lab investigations
- diagnostic imaging
- differential diagnosis
History
Bacterial infections tend to give higher fever, excessive amounts of purulent sputum production, and may be associated with concomitant COPD.
Not all purulent sputum is bacterial, however.
Physical Exam
Lab Investigations
While sputum cultures/gram stains can be done, they are not normally informative.
Diagnostic Imaging
Differential Diagnosis
- URTI
- asthma
- acute exacerbation of chronic bronchitis
- sinusitis/post-nasal drip
- pneumonia
- bronchiolitis
- pertussis
- environmental/occupational exposures
- reflux esophagitis
- congestive heart failure
- bronchogenic carcinoma
- aspiration
- cyctic fibrosis
Pathophysiology
Treatments
Primary prevention
Primary prevention includes frequent handwashing, smoking cessation, and avoidance of irritant exposure.
Symptom relief
Rest, fluids, humidity, analgesics, and antitussives can be used for symptom relief.
Bronchidilators (ie albuterol) can also improve suffering.
Medications
As most cases of bronchitis are viral, antibiotics are not likely helpful. However, they should be prescribed in the elderly, in people with comorbidities, if pneumonia is suspected, or the patient is toxic.
Antibiotics have no benefit in children.
Consequences and Course
The Patient
Health Care Team
Community Involvement
Resources and References