Acute bronchitis

Acute bronchitis is an inflammation of the upper respiratory tract, usually after acute respiratory infections. Usually it is a viral infection, although sometimes a bacterial infection; pathogens are rarely detected. The most frequent symptoms of acute bronchitis are cough with or without phlegm and / or fever. Patients with COPD can also have hemoptysis, burning pain in the chest and hypoxemia.

Diagnosis is clinical and is an exception method. Supportive treatment of acute bronchitis; antibiotics are necessary only for patients with signs of bacterial infection (no more than 10% of all cases of acute bronchitis). An excellent prognosis in patients without lung disease, but in patients with COPD can result in acute respiratory failure.

[1], [2]

Causes of acute bronchitis

Acute bronchitis is often a component of ARVI caused by:

• rhinovirus,
• parainfluenza,
• influenza A or influenza B viruses,
• respiratory syncytial virus,
• coronavirus,
• respiratory adenoviruses.

Less frequent pathogens are Mycoplasma pneumoniae, Bordetella pertussis and Chlamydia pneumoniae. The risk group includes smoking patients and patients with COPD and other diseases that worsen bronchial clearance mechanisms, such as cystic fibrosis or conditions leading to bronchiectasis.

[3], [4], [5], [6], [7], [8]

Symptoms of acute bronchitis

Symptoms of acute bronchitis - an unproductive or minimal, but productive cough, accompanied by symptoms of acute respiratory viral infection or arising after ARI. Subjective sensation of shortness of breath is a consequence of chest pain when breathing, and not hypoxia, except for patients with underlying pulmonary disease. Symptoms are often absent, but can include scattered rales and whistles.

Sputum can be clean, purulent or with veins of blood. The characteristics of sputum do not correspond to a specific etiology (i.e., viral or bacterial).

Diagnosis of acute bronchitis

The diagnosis of "acute bronchitis" is based on symptoms. Radiography of the chest is required only if fever, dyspnea or other symptoms of acute bronchitis and make you suspect pneumonia. Gram staining and bacteriological analysis of sputum are not advisable.

[9], [10], [11]

Treatment of acute bronchitis

Acute bronchitis in healthy people is the main reason for the abuse of antibiotics. Almost all patients require only symptomatic treatment of acute bronchitis, such as paracetamol and hydration. Antitussives should be used only to relieve sleep. Patients with wheezing can be relieved by the use of inhaled beta-agonists (eg, salbutamol) or anticholinergic drugs (eg ipratropium bromide), but not more than 7 days. Oral   antibiotics    (for example, 7 days amoxicillin 500 mg 3 times a day, orally doxycycline 100 mg twice daily or trimethoprim-sulfamethoxazole 160/800 mg orally 2 times a day) are believed to be useful for patients with COPD or other serious pulmonary diseases in the presence of at least two of the following signs: severe cough, severe shortness of breath, increased quantity and purulent sputum character.

What is the prognosis of acute bronchitis?

Acute bronchitis has a favorable prognosis. Cough is allowed within 2 weeks in 75% of patients. Patients with persistent cough should undergo a chest x-ray and pertussis diagnosis (paroxysmal cough) and non-infectious causes, such as postnatal drainage, allergic rhinitis and a cough variant of bronchial asthma. In some patients, inhalation glucocorticoids administered for several days are effective if cough persists due to respiratory tract irritation.