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Bronchitis - acute

Acute bronchitis is swelling and inflammation in the main passages that carry air to the lungs. The swelling narrows the airways, which makes it harder to breathe. Another symptom of bronchitis is a cough. Acute means the symptoms have been present only for a short time.

Bronchitis is the inflammation of the bronchi, the main air passages to the lungs, it generally follows a viral respiratory infection. Symptoms include; coughing, shortness of breath, wheezing and fatigue.

Causes

When acute bronchitis occurs, it almost always comes after having a cold or flu-like illness. The bronchitis infection is caused by a virus. At first, it affects your nose, sinuses, and throat. Then it spreads to the airways that lead to your lungs.

Bronchitis is an inflammation of the bronchial tubes, the part of the respiratory system that leads into the lungs. Acute bronchitis has a sudden onset and usually appears after a respiratory infection, such as a cold, and can be caused by either a virus or bacteria. The infection inflames the bronchial tubes, which causes symptoms such as fever, cough, sore throat, wheezing, and the production of thick yellow mucus. If acute bronchitis occurs because of a bacterial infection antibiotics are given for the treatment. Otherwise if the infection is viral medications can only be given to alleviate the symptoms. Although acute bronchitis is relatively common, some people are more prone to it than others.

Sometimes, bacteria also infect your airways. This is called a secondary infection.

Chronic bronchitis is a long-term condition. To be diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least 3 months.

Chronic bronchitis is most frequently caused by long term irritation of the bronchial tubes. Bronchitis is considered "chronic" if symptoms continue for three months or longer. Bronchitis caused by allergies can also be classified as chronic bronchitis.  Chronic bronchitis is caused most often by exposure to airborne pollutants such as cigarette smoke, excessive dust in the air, or chemicals. The bronchial lining becomes inflamed and the constant exposure to such pollutants begins to cause damage in the bronchioles (the smaller airways in the lungs). Symptoms of chronic bronchitis include shortness of breath or wheezing, chest pain, and chronic productive cough.

Symptoms

Some symptoms of acute bronchitis are:

  • Chest discomfort
  • Cough that produces mucus -- the mucus may be clear or yellow-green
  • Fatigue
  • Fever -- usually low-grade
  • Shortness of breath that gets worse with activity
  • Wheezing, in people with asthma

Even after acute bronchitis has cleared, you may have a dry, nagging cough that lasts for 1 to 4 weeks.

Sometimes it can be hard to know you have pneumonia or bronchitis. If you have pneumonia, you are more likely to have a high fever and chills, feel sicker, or be more short of breath.

 

Exams and Tests

Your health care provider will listen to the breathing sounds in your lungs with a stethoscope. Your breathing may sound abnormal or rough.

When air is inhaled through the nose or mouth, it travels down the trachea to the bronchus, where it first enters the lung. From the bronchus, air goes through the bronchi, into the even smaller bronchioles and lastly into the alveoli.

Tests may include:

  • Chest x-ray, if your health care provider suspects pneumonia
  • Pulse oximetry, a painless test that helps determine the amount of oxygen in your blood by using a device placed on the end of your finger

Treatment

Most people DO NOT need antibiotics for acute bronchitis. The infection will almost always go away on its own within 1 week. Doing these things may help you feel better:

  • Drink plenty of fluids.
  • If you have asthma or another chronic lung condition, use your inhaler.
  • Get plenty of rest.
  • Take aspirin or acetaminophen (Tylenol and other brands) if you have a fever. Do not give aspirin to children.
  • Use a humidifier or steam in the bathroom.

Certain medicines that you can buy without a prescription can help break up or loosen mucus. Look for the word "guaifenesin" on the label. Ask the pharmacist if you need help finding it.

If your symptoms do not improve or if you are wheezing, your doctor may prescribe an inhaler to open your airways.

If your doctor thinks you also have bacteria in your airways, he or she may prescribe antibiotics. This medicine will only get rid of bacteria, not viruses. A bacterial infection is more common if you also have a chronic lung disease like COPD.

Sometimes, bacteria may infect the airways along with the virus. If your doctor thinks this has happened, you may be prescribed antibiotics. Sometimes, corticosteroid medicine is also needed to reduce inflammation in the lungs.

Other tips include:

  • Do not smoke.
  • Avoid secondhand smoke and air pollution.
  • Wash your hands (and your children's hands) often to avoid spreading viruses and other germs.

Outlook (Prognosis)

Except for the cough, symptoms usually go away in 7 to 10 days if you do not have a lung disorder.

When to Contact a Medical Professional

Call your doctor if you:

  • Have a cough on most days, or have a cough that keeps returning
  • Are coughing up blood
  • Have a high fever or shaking chills
  • Have a low-grade fever for 3 or more days
  • Have thick, yellow-green mucus, especially if it has a bad smell
  • Feel short of breath or have chest pain
  • Have a chronic illness, like heart or lung disease

References

Davids S, Schapira RM. Respiratory diseases, acute bronchitis. In: Bope ET, Kellerman RD, eds.Conn's Current Therapy 2014

Ferri FF. Acute bronchitis. In: Ferri FF, ed.Ferri's Clinical Advisor 2013

Update Date 4/26/2014

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