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Acute BronchitisAka: Bronchitis, Chest Cold
- See Also
- Definition
- Infection of trachea, bronchi, or bronchioles
- Acute bronchitis is most often of viral etiology
- Chronic Bronchitis exacerbation is usually bacterial
- Etiology: Viral Causes (most common)
- Age under one year
- Respiratory Syncytial Virus (winter to spring)
- Parainfluenza Virus (fall)
- Coronavirus (winter to spring)
- Age one to 10 years
- Parainfluenza Virus (fall)
- Enterovirus (fall)
- Respiratory Syncytial Virus (winter to spring)
- Rhinovirus (fall)
- Age over 10 years
- Influenza virus (winter to spring)
- Respiratory Syncytial Virus (winter to spring)
- Adenovirus
- Age under one year
- Etiology: Other Causes
- Bacterial causes
- Streptococcus Pneumoniae (Pneumococcus)
- Haemophilus Influenzae
- Moraxella catarrhalis (Branhamella catarrhalis)
- Bordetella pertussis (and parapertussis)
- Atypical Bacterial causes
- Yeast or fungi
- Blastomyces dermatitidis
- Candida albicans (and tropicalis)
- Coccidioides immitis
- Cryptococcus neoformans
- Histoplasma capsulatum
- Environmental irritants (noninfectious triggers)
- Bacterial causes
- Symptoms
- Cough (onset within 2 days in 85% of acute bronchitis)
- Dyspnea
- Wheezing
- Chest Pain
- Hoarseness
- Constitutional symptoms
- Signs
- Diagnostics
- Sputum exam not indicated unless Pneumonia suspected
- Pulse oximetry may be indicated in severe illness
- Peak Flow values may be indicated in Asthma history
- C-Reactive Protein (CRP)
- Value <20 suggests bronchitis (instead of Pneumonia)
- Hopstaken (2003) Br J Gen Pract 53:358
- Radiology: Chest XRay Indications
- Pulmonary cause of cough suspected
- Serious comorbid condition
- Elderly patient
- Chronic Obstructive Lung Disease
- Immunocompromised patient
- Malignancy history
- Recent history of pulmonary process
- Differential Diagnosis
- Management: Symptomatic
- Supportive care for viral illness
- Inhaled Bronchodilator (e.g. Albuterol)
- May shorten bronchitis course to less than 1 week
- Hueston (1994) J Fam Pract 39:437
- Symptomatic relief of cough (especially nighttime)
- Cough suppression risks worsening bronchospasm
- See Cough Suppressant (Antitussive)
- Avoid Albuterol Syrup (Not helpful)
- Pelargonium sidoides (herbal product)
- Decreases overall symptoms compared with Placebo
- Return to work 2 days earlier compared with Placebo
- Matthys (2003) Phytomedicine 10:7
- Management: Specific Circumstances
- Treat suspected underlying cause of cough
- See Cough Management
- See Chronic Cough
- Persistent post-bronchitic cough
- Bronchodilators reduce symptom severity and duration
- Consider Inhaled Corticosteroid (e.g. Azmacort)
- Treat suspected underlying cause of cough
- Management: Antibiotics
- Most cases are viral and do not require antibiotics
- Most studies show minimal if any antibiotic benefit
- No benefit with Azithromycin
- Evans (2002) Lancet 359:1648
- Patients with cough under 1 week showed no benefit
- Most patients improve with or without antibiotics
- See Antibiotic Resistance for Patient Education
- Most studies show minimal if any antibiotic benefit
- Productive cough short duration (<1 week)
- Avoid antibiotics
- Treat symptomatically as above
- Productive cough longer than 1-2 weeks
- Evaluate for other causes of cough
- Pneumonia (consider Chest XRay)
- Acute Sinusitis
- Allergic Rhinitis
- Tuberculosis (consider PPD)
- Reassurance
- Observation is reasonable if otherwise healthy
- Bronchitis often lasts >2 weeks (see course below)
- Consider Inhaled Corticosteroid
- Antibiotic protocol (if used; controversial)
- Adult under age 50 years
- Macrolide antibiotic or
- Doxycycline
- Adult over age 50 years
- Chronic Obstructive Lung Disease
- Adult under age 50 years
- Evaluate for other causes of cough
- Most cases are viral and do not require antibiotics
- Precautions
- Course
- Resources: Patient Education
- Information from your Family Doctor
- References
Bronchitis (C0006277) | |
|---|---|
| Definition (NCI) | (bron-KYE-tis) Inflammation (swelling and reddening) of the bronchi. |
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 490 |
| English | Bronchitides, Bronchitis, Bronchitis unspecified, Recurrent wheezy bronchitis |
| Spanish | bronquitis, bronquitis no especificada |
| Credits | Derived from the NIH UMLS (Unified Medical Language System) |
Acute bronchitis (C0149514) | |
|---|---|
| Definition (CSP) | sudden inflammation of the tracheobronchial tree, which comprises the trachea, or windpipe, and the bronchi; typically associated with a viral upper respiratory tract infection, such as the common cold, and is usually mild; in patients with chronic lung or heart disease, acute bronchitis is more severe, and can become chronic and progress to pneumonia. |
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 466.0 |
| English | Acute bronchitis, BRONCHITIS ACUTE |
| Spanish | bronquitis aguda |
| Credits | Derived from the NIH UMLS (Unified Medical Language System) |
Lower respiratory tract infection (C0149725) | |
|---|---|
| Concepts | Disease or Syndrome (T047) |
| English | Chest cold, CHEST INFECTION, Infection of lower respiratory tract, Lower resp tract infection, Lower respiratory infection, Lower respiratory tract infection, Lower respiratory tract infections |
| Spanish | catarro bronquial, infección de vÃas respiratorias inferiores, infección del tórax, infección torácica, infeccion de vias respiratorias inferiores, infeccion del torax, infeccion toracica |
| Credits | Derived from the NIH UMLS (Unified Medical Language System) |
