Bronchitis%20-%20uncomplicated%20acute Signs and Symptoms
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