Acute Bronchitis

Question 1

What is acute bronchitis?

Answer 1

Defined as self-limiting LRTI and refers to infections causing inflamm in bronchial airways

Question 2

Pathophysiology of acute bronchitis?

Answer 2

Acute inflamm of bronchial wall→ increased mucus prod + bronchial oedema→ productive cough (LRTI hallmark).

Infection may clear in several days but repair of bronchial wall may take several weeks→ will continue to cough.

Question 3

Aetiology of acute bronchitis?

Answer 3

Viral>bacterial

Most common viruses= coronavirus, rhinovirus, respiratory syncytial virus, adenovirus, etc

Question 4

Risk factors of bronchitis? (3)

Answer 4

Viral/ bacterial infection exposure
Smoking
Chronic lung conditions (COPD, CF)

Question 5

Signs and symptoms of acute bronchitis?

Answer 5

Acute illness of <21 days (NB: cough may linger)

Cough (often non-productive/ mildly productive?)

At least 1 other LRTI symptom: sputum production, wheezing, chest pain

No alternative explanation for the symptoms

NB: (Not part of Macfarlane criteria) dyspnoea; mild fever

Question 6

Investigations for acute bronchitis?

Answer 6

Clinical diagnosis (history and examination)

Consider:
- Pulmonary function test- evaluate for asthma
- CXR- Rule out pneumonia; should be normal
- Sputum culture (not norm needed)

Question 7

Management for acute bronchitis?

Answer 7

Conservative: regular paracetamol, ibuprofen, hydration

If wheeze: salbutamol; antitussive for disruptive cough; ICS if persistent severe cough