Acute Bronchitis Flashcards
what is bronchitis
self-limiting lower respiratory tract infection causing inflammation of the bronchi
difference between common cold and bronchitis
common cold is a viral, upper respiratory tract infection
difference between pneumonia and bronchitis
Bronchitis refers specifically to infections causing inflammation in the bronchial airways, whereas pneumonia denotes infection in the lung parenchyma resulting in consolidation of the affected segment or lobe
Macfarlane definition criteria of bronchitis
(a) an acute illness of <21 days;
(b) cough as the predominant symptom;
(c) at least 1 other lower respiratory tract symptom, such as sputum production, wheezing, chest pain;
(d) no alternative explanation for the symptoms
cause of bronchitis
viral infections in the lower respiratory tract
pathophysiology
The symptoms of acute bronchitis are due to acute inflammation of the bronchial wall, which causes increased mucus production together with oedema of the bronchus. This leads to the productive cough that is the hallmark of a lower respiratory tract infection. While the infection may clear in several days, repair of the bronchial wall may take several weeks. During the period of repair, patients will continue to cough. Pulmonary function studies of patients with acute bronchitis demonstrate bronchial obstruction similar to that in asthma. As the symptoms of acute bronchitis abate, pulmonary function returns to normal.
what is post bronchitis syndrome
Half of all patients with acute bronchitis continue to cough for >2 weeks.[7] In a quarter of patients, cough may last for >1 month. This is termed post-bronchitis syndrome. This period probably reflects ongoing repair to the bronchial walls after the clearance of the acute infection.
epidemiology
one of most common conditions encountered in clinic. most common around autumn/winter
risk factors
smoking, polluted household/working area
presenting symptoms
cough for >30 days, productive cough, no other explanation, no Hx of chronic respiratory condition, fever
uncommon; wheeze
do you always need investigations
to diagnose bronchitis, a cough >30 days and it being productive is key. investigations rule out other causes.
investigations to consider with bronchitis
pulmonary function tests - Not recommended in patients with acute bronchitis but can be helpful in evaluating for asthma
chest X-ray - pneumonia
C-reactive protein - if after clinical assessment a diagnosis of pneumonia has not been made, and antibiotic therapy is being considered to help guide therapy.
why aren’t antibiotics really used for patients with bronchitis
bronchitis is the result of viral infections
treatment of bronchitis if cough lasts LESS than 4 weeks (acute)
antipyretics, antitussive and short acting beta agonist bronchodilator and CONSIDER immediate or delayed antibiotics
what’s an antitussive
cough suppressing medications
