BRONCHITIS Flashcards
What is bronchitis?
a lower respiratory tract infection which causes inflammation in the bronchial airways
Characterised by a cough resulting from acute inflammation of the trachea and large airways but with no evidence of pneumonia
What are the differences between acute and chronic bronchitis?
Acute - typically caused by RTI
Chronic - typically associated with COPD
What are the features of acute bronchitis?
Productive/dry cough
Low grade fever
Sore throat
Rhinorrhoea
Wheeze
How long does bronchitis usually last?
Usually resolves within 3 weeks but 25% of patients will have a cough after this time
How do you differentiate between acute bronchitis and pneumonia?
History: Sputum, wheeze, breathlessness may be absent in acute bronchitis whereas at least one tends to be present in pneumonia.
Examination: No other focal chest signs (dullness to percussion, crepitations, bronchial breathing) in acute bronchitis other than wheeze. Moreover, systemic features (malaise, myalgia, and fever) may be absent in acute bronchitis, whereas they tend to be present in pneumonia.
CXR normal in acute bronchitis and abnormal in pneumonia
How is bronchitis investigated?
Typically a clinical diagnosis but CRP testing may be used
How do you manage acute bronchitis?
Analgesia - NSAIDs, self care, good fluid intake
Stop smoking
Advise pt to seek medical help if symptoms worsen rapidly, dont improve after 3-4 weeks or become systemically unwell
Consider antibiotic therapy if systemically unwell or at risk of complications, if CRP >100mg/L
Who should recieve antibiotics in acute bronchitis?
are systemically very unwell
have pre-existing co-morbidities
have a CRP of 20-100mg/L (offer delayed prescription) or a CRP >100mg/L (offer antibiotics immediately)
What antibiotics are recommended for acute bronchitis?
Doxycycline
What typically causes acute bronchitis?
Viral infection - rhinovirus, enterovirus, influenza A and B, parainfluenza, coronavirus, RSV, adenovirus
Bacteria are rarer - streptococcus pneumoniae, haemophilus influenza, moraxella catarrhalis
When does acute bronchitis typically occur?
During autumn or winter
Whats the prognosis of acute bronchitis?
Usually a mild, self-limiting illness
Cough usually lasts 2-3 weeks but 25% will have a cough that persists for 6 months
Pneumonia may occur as a complication of acute bronchitis
What self care treatments can you advise for pt with acute bronchitis?
Honey.
Pelargonium (a herbal medicine).
Over-the-counter cough medicines containing guaifenesin (an expectorant).
Over-the-counter cough medicines containing cough suppressants (except codeine) if the person does not have a persistent cough or excessive secretions.
