Acute bronchitis

Acute bronchitis, also known as a chest cold, is short-term

Acute bronchitis is one of the most common diseases.[3]^[13] About 5% of adults are affected and about 6% of children have at least one episode a year.^[7][8] It occurs more often in the winter.^[7] More than 10 million people in the United States visit a doctor each year for this condition with approximately 70% receiving antibiotics, most of which are not needed.^[3] There are efforts to decrease the use of antibiotics in acute bronchitis.^[13]

Signs and symptoms

The primary symptom is cough with sputum that may be purulent. The illness may also cause shortness of breath or wheezing. Upper respiratory tract infections (URTI's) often precede acute bronchitis, with overlapping symptoms including headache, nasal congestion, sore throat. About a third of patients will experience a fever, but fevers due to acute bronchitis rarely rise above 100 °F (37.8 °C) or last for longer than a few days.^[14] As fever and other systemic symptoms are less common in acute bronchitis than in pneumonia, their presence raises suspicion for the latter,^[15][16] especially high or persistent fevers.^[14]

Cause

Acute bronchitis can be caused by contagious

• Damage caused by irritation of the airways leads to inflammation and leads to neutrophils infiltrating the lung tissue.
• Mucosal hypersecretion is promoted by a substance released by
  neutrophils
  .
• Further obstruction to the airways is caused by more
  goblet cells in the small airways. This is typical of chronic bronchitis
  .
• Although infection is not the reason or cause of chronic bronchitis, it is seen to aid in sustaining the bronchitis.

A

Although there is no universally-accepted clinical definition for acute bronchitis, there is a proposed set of practical criteria (Macfarlane, 2001[19]) that include:

• An acute illness of less than three weeks.
• Cough as the predominant symptom.
• At least one other lower respiratory tract symptom, such as sputum production, wheezing, chest pain.
• No alternative explanation for the symptoms.

A variety of tests may be performed in people presenting with cough and shortness of breath:^[20]

• A
  chest X-ray is useful to exclude pneumonia which is more common in those with a fever, fast heart rate, fast respiratory rate, or who are old.^[7]
• A sputum sample showing
  neutrophil granulocytes (inflammatory white blood cells) and culture showing that has pathogenic microorganisms such as Streptococcus species
  .
• A blood test would indicate inflammation (as indicated by a raised white blood cell count and elevated C-reactive protein).

Decreased breath sounds,

Most cases are self-limited and resolve themselves in a few weeks. Pain medications may help with symptoms.^[23] Other recommendations may include rest and keeping well hydrated.^[24]

Antibiotics

Evidence does not support the general use of antibiotics in acute bronchitis.^[12] A systematic review found antibiotics reduced cough by an average of 12 hours (out of a total average of about 14–28 days). Antibiotics caused more side effects such as nausea and diarrhoea, and also may promote antibiotic-resistant bacteria. It is possible they are useful in susceptible groups such as the frail and elderly but there was not enough research information to determine this.^[25]

Calling acute bronchitis with benign-sounding labels such as chest cold or viral infections may reduce antibiotic usage by improving patients satisfaction when antibiotics are not prescribed.^[26]

Smoking cessation

To help the bronchial tree heal faster and not make bronchitis worse, smokers should quit smoking completely.^[27]

Alternative therapeutic approaches

Salbutamol is not effective in children with an acute cough who do not have restricted airways.^[28] There is weak evidence that salbutamol may be useful in adults with wheezing due to a restricted airway; however, it may result in nervousness, shakiness or a tremor.^[1][28]

Prognosis

Acute bronchitis usually lasts a few days or weeks.^[29] It may accompany or closely follow a cold or the flu, or may occur on its own. Bronchitis usually begins with a dry cough, including waking the patient at night. After a few days, it progresses to a wetter or productive cough, which may be accompanied by fever, fatigue, and headache. The fever, fatigue, and malaise may last only a few days, but the wet cough may last up to several weeks.^[30]

Epidemiology

Acute bronchitis is one of the most common diseases.^[3][13] About 5% of adults are affected and about 6% of children have at least one episode a year.^[7][8] It occurs more often in the winter.^[7]

In infants under one year of age, acute bronchitis was the most common reason for admission to the hospital after an emergency department visit in the US in 2011.^[31]

References

External links

Wikisource has the text of the 1911 Encyclopædia Britannica article "Bronchitis".

• Acute Bronchitis FamilyDoctor.org (American Academy of Family Physicians)
• "Acute Bronchitis". MedlinePlus. U.S. National Library of Medicine.