Acute Bronchitis

Question 1

Definition

Answer 1

Common and self limiting LRTI inflammation more frequent during the last autumn and winter months

Question 2

Risk factors

Answer 2

Viral or atypical bacteria exposure,
Cigarette smoking,
Household pollution exposure
History of bronchiectasis, CF, CHF and asthma

Question 3

Pathophysiology

Answer 3

Acute inflammation of bronchial airways and not in the lung parenchyma (pneumonia) due to viral (Rhinovirus) or bacterial infections (e.g. mycoplasma pneumoniae)
Inflammation of bronchi wall cause mucosal thickening

Question 4

Aetiology

Answer 4

Viral - rhinovirus
Bacterial - mycoplasma pneumoniae

Question 5

Signs and symptoms

Answer 5

MacFarlane Criteria
- Acute illness < 21 days
- Cough as the predominant symptom
- Atleast 1 other lower resp tract symptoms
= sputum production
= wheezing
= chest pain
= fever
= no other explanation

Question 6

Diagnosis

Answer 6

Clinical diagnosis
Pulmonary function test (obstruction)
CXR (rule out pneumonia)
CRP (>100 mg/L requires immeadiate ABx)
Procalcitonin (increased in bacterial infection)

Question 7

Treatment

Answer 7

<4 weeks; observation, paracetamol, SABA or antitussive (dextromethorphan)
>4 weeks; look for the other causes, salbutamol and if systemically unwell consider immediate or delayed Abx