Acute bronchitis

Question 1

What characterises acute bronchitis?

Answer 1

Inflammation of the trachea + major bronchi
a/w oedematous large airways + production of sputum

Question 2

What is the leading cause and usual course of acute bronchitis?

Answer 2

Viral infection
Usually resolves before 3w
80% occurs in Autumn or Winter

Question 3

Give 4 presenting features of acute bronchitis

Answer 3

Cough: may or may not be productive
Sore throat
Rhinorrhoea
Wheeze

Question 4

3 Features of acute bronchitis on examination

Answer 4

Majority normal chest exam
Low grade fever
Wheeze

Question 5

How can acute bronchitis be differentiated from pneumonia based on the history?

Answer 5

Sputum, wheeze + breathlessness may be absent in acute bronchitis whereas at least 1 tends to present in pneumonia

Question 6

How can acute bronchitis be differentiated from pneumonia based on the examination?

Answer 6

Acute bronchitis: No other focal chest signs other than wheeze

Pneumonia: may have dullness to percussion, crepitations, bronchial breathing.
Systemic features (malaise, myalgia, fever) tend to be present

Question 7

How is acute bronchitis diagnosed?

Answer 7

Clinical dx
If CRP testing avialable, may be used to guide whether Abx indicated

Question 8

Describe management of acute bronchitis

Answer 8

Analgesia
Good fluid intake
Consider abx

Question 9

In which patients with acute bronchitis should antibiotics be considered?

Answer 9

Systemically very unwell
Pre-existing co-morbidities
CRP 20-100 (delayed prescription)
CRP >100 (immediate)

Question 10

What is the first line antibiotic used in acute bronchitis?

Answer 10

Doxycycline 200mg 1st day, 100mg for 4 days
Amoxicillin in children/ pregnancy