Acute Bronchitis

Acute bronchitis is an inflammation of the tracheobronchial tree, which occurs usually after an infection of the upper respiratory tract in patients without chronic lung disease. The cause is almost always a viral infection. The pathogen is rarely recognized. Symptom is cough with or without fever and / or sputum. Diagnosis is based on clinical criteria. Treatment is supportive. Antibiotics are not usually necessary. The prognosis is excellent.

Acute bronchitis is a frequent accompaniment of infections of the upper respiratory tract caused by rhinoviruses, parainfluenza virus, influenza A or B viruses, RSV, coronavirus or HMPV. Rarer causes include Mycoplasma pneumoniae, Bordetella pertussis and Chlamydia pneumoniae. Less than 5% of cases are caused by bacteria, sometimes in outbreaks.

Acute bronchitis is an inflammation of the tracheobronchial tree, which occurs usually after an infection of the upper respiratory tract in patients without chronic lung disease. The cause is almost always a viral infection. The pathogen is rarely recognized. Symptom is cough with or without fever and / or sputum. Diagnosis is based on clinical criteria. Treatment is supportive. Antibiotics are not usually necessary. The prognosis is excellent. Acute bronchitis is a frequent accompaniment of infections of the upper respiratory tract caused by rhinoviruses, parainfluenza virus, influenza A or B viruses, RSV, coronavirus or HMPV. Rarer causes include Mycoplasma pneumoniae, Bordetella pertussis and Chlamydia pneumoniae. Less than 5% of cases are caused by bacteria, sometimes in outbreaks. Acute inflammation of the tracheobronchial tree in patients with underlying chronic bronchial diseases (eg. As COPD, bronchiectasis, cystic fibrosis) is considered an acute exacerbation of the disease and not as acute bronchitis. In these patients, the etiology, therapy and the result of those with acute bronchitis is different. (Chronic Obstructive Pulmonary Disease (COPD): treatment of acute exacerbation of COPD). Tips and risks Acute cough should be considered in patients with COPD, bronchiectasis or cystic fibrosis usually as an exacerbation of the disease and not as a simple acute bronchitis. Symptoms and complaints Typical symptoms are less productive or less productive cough with accompanying or preceding signs of infection of the upper respiratory tract, usually> 5 days. Subjective dyspnea is caused by chest pain or a feeling of tightness in breathing, not by hypoxia. The symptoms include occasional crackles and wheezing when breathing, however, are usually no symptoms present. The sputum may be clear, purulent or rarely contain blood. The Sputumbefund not allow any conclusions to a specific etiology (d. E. Viral vs. bacterial). Low-grade fever may be present, but high or prolonged fever is unusual and indicates an influenza or pneumonia. The decline of the disease is the last symptom cough. Until the cough subsides it often takes a few weeks or even longer. Diagnosis Clinical evaluation Sometimes chest X-ray to rule out other diseases. The diagnosis is made clinically. Tests are usually not necessary. However, patients who suffer from dyspnea, obtain a pulse oximetry to exclude hypoxemia. There is a chest x-ray if evidence of a serious illness or pneumonia point (z. B. ill appearance, change in mental Satus, high fever, tachypnea, hypoxemia, moist RG, signs of consolidation or pleural effusion). Elderly patients are the occasional exception, as they may have pneumonia without fever and auscultatory findings and instead have with clouding of consciousness and tachypnea. Gram stains or cultures of sputum are usually not indicated. Samples can be taken from the nose and throat and are tested for influenza and whooping cough, is suspected in this disease is. (. Eg in whooping cough persistent and paroxysmal coughing 10 to 14 days according to the disease, sometimes only with the characteristic wheezing and / or nausea, exposure to a confirmed case-pertussis: Diagnostics). In 75% of patients, the cough suspended after 2 weeks. Patients with persistent cough should be carried out a chest X-ray. Review of non-infectious causes, including postnasal drip and gastroesophageal reflux disease may be clinically performed normally. Differentiation of asthma with cough variant may require lung function tests. Treatment relief of symptoms (eg. As paracetamol, hydration, may antitussives) Inhaled ?-agonists or anticholinergics in wheezing The acute bronchitis in otherwise healthy patients is a major cause of the frequent use of antibiotics. Most patients require a purely symptomatic treatment, eg. As with paracetamol and plenty of liquid. Evidence supporting the effectiveness of the routine use of other symptomatic treatments, such as antitussives, mucolytics and bronchodilators, are weak. Antitussives should be considered only when sleep through coughing is severely impaired (therapy). Patients with wheezing can benefit over a few days of an inhaled ?2 agonists (such. As Salbutamol) or an anticholinergic (z. B. ipratropium). Oral antibiotics are not generally used, except in patients with pertussis or during known outbreaks of bacterial infection. There is a macrolide such as azithromycin 500 mg po 1 times, then 250 mg p.o. 1 times a day for 4 days or clarithromycin 500 mg po 2 times given daily for 14 days. Tips and risks Most cases of acute bronchitis in healthy patients should be treated without the use of antibiotics. Key points Acute bronchitis is viral in> 95% of cases, often part of an infection of the upper respiratory tract. The diagnosis of acute bronchitis is provided primarily by clinical evaluation; Chest x-ray and / or other tests should be used only in patients who have the manifestations of diseases. Most patients should only be treated to relieve symptoms.

Health Life Media Team

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