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.
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.
Transient airflow obstruction and bronchial hyperresponsiveness.
Purulence can result from either bacterial or viral infection.

Introduction

Signs & symptoms of lower respiratory tract infection:

  • Cough &/or increase in sputum production
  • Breathlessness/wheeze
  • Chest pain/aches
  • Sweats &/or sore throat
  • Increase in temperature

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 & release of proinflammatory mediators
    • Transient airflow obstruction & 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 & B, parainfluenza 3 & respiratory syncytial virus produce primarily lower respiratory tract disease
    • Corona virus, adenovirus & 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

Typical Clinical Presentation

Signs & Symptoms

  • Predominant symptom: Cough that is usually productive that persists <3 week
    • 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 week, 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 & 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

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Pearl Toh, 19 Jun 2016
Infants with persistent rhinitis have a higher abundance of Actinobacteria, especially Corynebacterium spp., in their nasal microbiome compared with healthy controls, according to a Singapore-based study presented at the European Academy of Allergy and Clinical Immunology (EAACI) Annual Congress 2016 held in Vienna, Austria.
29 Nov 2017
Lansoprazole, a widely available and commonly prescribed proton pump inhibitor (PPI), appears to reduce the incidence of tuberculosis disease, a recent study has found.
Gabriel Angelo Sembrano, 16 Sep 2014

“At present, there is a limited development of new antibiotics. There is also a fast development of resistance to antibiotics. There are pathogens no longer susceptible to all antibiotics, and many pathogens are no longer susceptible to most antibiotics,” said Dr. Andre Villanueva, chief of party of the USAID’s Innovations and Multisectoral Partnerships to Achieve Control of TB (IMPACT) Project at the recent Annual Convention of the Philippine Pharmacists’ Association in Davao City.

Audrey Abella, 06 Jan 2017
Persistent wheeze or childhood asthma may be reduced by fish oil supplementation, particularly n-3 long-chain polyunsaturated fatty acids (LCPUFAs), during pregnancy, a recent Danish study found.