bronchitis%20-%20uncomplicated%20acute
BRONCHITIS - UNCOMPLICATED ACUTE
Uncomplicated acute bronchitis is a self-limiting infection of the trachea and bronchi that usually lasts for 1 to 3 weeks. A healthy patient experiences sudden onset of cough, with or without sputum production.
It is an inflammatory response to infections of the bronchial epithelium of the large airways of the lungs that begins with mucosal injury, epithelial cell damage and release of proinflammatory mediators.
There is transient airflow obstruction and bronchial hyperresponsiveness.
Purulence can result from either bacterial or viral infection.

Definition

Uncomplicated Acute Bronchitis

  • A self-limiting acute respiratory tract infection (RTI) characterized by the sudden onset of cough, with or without sputum production, in an otherwise healthy individual
    • Diagnosis is based on clinical findings

Pathogenesis

  • An inflammatory response to infections of the bronchial epithelium of the large airways of the lungs
    • Begins with mucosal injury, epithelial cell damage and release of proinflammatory mediators
    • Transient airflow obstruction and bronchial hyperresponsiveness
  • Purulence can result from either bacterial or viral infection

Etiology

Viral

  • The most common cause (90% of cases) of bronchial inflammation in otherwise healthy adults presenting with acute bronchitis
    • Influenza A and B, parainfluenza 3 and respiratory syncytial virus produce primarily lower respiratory tract disease
    • Corona virus, adenovirus and rhinoviruses more commonly produce upper respiratory tract symptoms

Non-viral

  • Mycoplasma pneumoniae, Chlamydia pneumoniae, Bordetella pertussis (5-10% of cases)
  • Environmental cough triggers (eg dust, dander, toxic fume inhalation)

Signs and Symptoms

Lower Respiratory Tract Infection

  •  Cough and/or increase in sputum production
  •  Breathlessness/wheeze
  • Sweats and/or sore throat
  • Increase in temperature


Uncomplicated Acute Bronchitis Typical Clinical Presentation

  • Predominant symptom: Cough that is usually productive that persists <3 weeks
    • The cough generally lasts 7-10 days but occasionally persists for >1 month
    • Influenza (flu) virus typically causes a nonproductive cough
    • If cough has been >3 weeks, consider investigation of other diagnoses (eg tuberculosis in endemic areas)
  • Sputum may be clear, white, yellow, green or even tinged with blood
    • Green/yellow (purulent) sputum production is indicative of an inflammatory reaction and it can result from either viral or bacterial infection
  • Cough may be accompanied by clinical features that suggest an acute respiratory tract infection (eg sore throat, rhinorrhea, hoarseness)
  • Patient may also present with retrosternal chest pain on coughing, dyspnea, wheezing, fever, fatigue or night cough

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