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Acute Bronchitis

What is acute bronchitis?

Air is pulled into the lungs when we breathe, initially passing through the mouth, nose, and larynx (voicebox) into the trachea and continues en route to each lung via either the right or left bronchi (the bronchial tree - bronchi, bronchioles, and alveoli).

Bronchitis describes inflammation of the bronchial tubes (inflammation = itis). The inflammation causes swelling of the lining of these breathing tubes, narrowing the tubes and promoting secretion of inflammatory fluid.

Acute bronchitis describes the inflammation of the bronchi that begins suddenly usually due to a viral infection involving the larger airways, although bacteria and chemicals also may cause acute bronchitis. Bronchiolitis is a term that describes inflammation of the smaller bronchi referred to as bronchioles.

Chronic bronchitis for research purposes is defined as a daily cough with sputum production for at least three months, two years in a row. Chronic bronchitis is a diagnosis usually made based on clinical findings of a long term persistent cough usually associated with tobacco abuse.

What causes acute bronchitis?

Acute bronchitis occurs most often due to a viral infection that causes the inner lining of the bronchial tubes to become inflamed and undergo the changes that occur with any inflammation in the body. Common viruses include the rhinovirus, respiratory syncytial virus (RSV), and the influenza virus.

Bacteria can also cause bronchitis (a few examples include, Mycoplasma, Pneumococcus, Klebsiella, Haemophilus).

Chemical irritants (for example, tobacco smoke, gastric reflux, solvents) can cause acute bronchitis.

What are the risk factors for acute bronchitis?

Bronchitis describes inflammation of the bronchial tubes. Smoking is a key risk factor for developing acute bronchitis.

People at risk for acute bronchitis include:
The elderly, infants, and young children
Persons with heart or lung disease
The following things can make bronchitis worse:
Air pollution
Certain occupations (such as coal mining, textile manufacturing, or grain handling)

What are the symptoms of acute bronchitis?

The symptoms of either type of bronchitis may include:
Chest discomfort
Cough that produces mucus; if it's yellow-green, you are more likely to have a bacterial infection
Fever -- usually low
Shortness of breath worsened by exertion or mild activity
Even after acute bronchitis has cleared, you may have a dry, nagging cough that lingers for several weeks.
Additional symptoms of chronic bronchitis include:
Ankle, feet, and leg swelling
Blue-colored lips from low levels of oxygen
Frequent respiratory infections (such as colds or the flu)

When should I seek medical care?

While a cough can be irritating and interfere with activities such as sleep, by itself, it needs little care. Drinking plenty of fluids to prevent dehydration, humidifying the air, and occasionally medication to suppress the cough are appropriate home care treatments.

However, medical care should be accessed immediately should shortness of breath occur. Fever, chills, wheezing, and signs of dehydration (lightheadedness, weakness, and rapid heart rate) are also reasons to seek medical care. Most coughs tend to subside after a few days. If the cough persists and mucus tends to be discolored, one should seek medical care.

What are the treatments for acute bronchitis?

Decreasing inflammation is the goal for treating acute bronchitis.
Albuterol inhalation, either with a hand held device (meter dosed inhaler, MDI) or nebulizer will help dilate the bronchial tubes.
Short-term steroid therapy will help minimize inflammation within the bronchial tubes. Topical inhaled steroids may also be of benefit with fewer potential side effects.
It is important to keep the patient comfortable by treating fever with acetaminophen or ibuprofen. Drinking plenty of fluid will keep the patient well hydrated and hydration keeps secretions into the bronchial tubes more liquid and easier to expel.
Antibiotics are not necessarily indicated for the treatment of acute bronchitis. Occasionally they may be prescribed should a bacterial infection be present in addition to the usual virus that causes acute bronchitis.
Cough suppression with cough drops or other liquid suppressants (for example, Vicks, Halls, and cough syrups that contain dextromethorphan) help to break this vicious cycle. In addition, if the person smokes, they should stop. If the acute bronchitis is being caused by inhaled smoke or chemicals, the patient should be removed from these irritant sources.

Can I treat acute bronchitis at home?

The treatment of acute bronchitis is geared toward prevention, control, and relief of symptoms (supportive care). In some cases, the following is all that is needed:
drink plenty of fluids to maintain proper hydration (avoiding dehydration and humidify air); and use of acetaminophen and ibuprofen to treat fever and decrease the inflammatory response.
For patients with underlying lung disease such as asthma or COPD, increased use of albuterol or similar inhaled medications may be indicated. However, the health care practitioner should be contacted when a patient considers altering their medication usage.

What are the complications of acute bronchitis?

Acute bronchitis usually resolves spontaneously (about 2-3 weeks) with supportive care. If wheezing and shortness of breath occurs the patient should seek medical care.
In patients who have underlying lung conditions, the inflammation can cause lung tissue to function improperly. Pneumonia or infection of the lung tissue itself may develop.