P01.002 Acute bronchitis

Acute bronchitis is an inflammation of the bronchi in the lungs, typically caused by viral infections, leading to cough and other respiratory symptoms.

Etiology

Viral Causes (most common):
- Influenza
- Respiratory syncytial virus (RSV)
- Rhinovirus
- Coronavirus
- Adenovirus
Bacterial Causes (less common):
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
- Bordetella pertussis

Clinical Features

Symptom	Description
Cough	Persistent, can be dry or productive
Sputum Production	May be clear, yellow, or green
Wheezing	Whistling sound during breathing
Shortness of Breath	Especially with exertion
Chest Discomfort	Often described as tightness or burning
Fever and Malaise	Low-grade fever, fatigue
Pharyngitis or Rhinitis	Commonly accompanies bronchitis

Diagnosis

Clinical History and Physical Examination
- Cough lasting more than five days
- Wheezing or rhonchi heard on auscultation
Investigations (typically not required unless suspecting complications or alternative diagnoses):
- Chest X-ray: To rule out pneumonia
- Sputum culture: Rarely indicated
- Pulmonary function tests: If underlying chronic lung disease is suspected

Management

Treatment Modality	Details
Symptomatic Treatment	Rest, hydration, and use of humidifiers
Analgesics/Antipyretics	Paracetamol or ibuprofen for fever and discomfort
Antitussives (if required)	Codeine or dextromethorphan for bothersome cough
Bronchodilators (if wheezing)	Salbutamol inhaler
Antibiotics	Generally not recommended unless bacterial infection is suspected
Patient Education	Avoidance of smoking and irritants, hand hygiene

Complications

Pneumonia
Chronic bronchitis (if recurrent)
Worsening of underlying chronic pulmonary conditions (e.g., asthma, COPD)

Points to Remember

Acute bronchitis is mostly viral; antibiotics are rarely needed.
Focus on symptomatic relief and patient education.
Ensure patients with chronic lung conditions are monitored closely.
Consider alternative diagnoses if symptoms persist or worsen after three weeks.

Comparison: Acute Bronchitis vs. Pneumonia

Feature	Acute Bronchitis	Pneumonia
Cough	Persistent, productive or non-productive	Productive with purulent sputum
Fever	Low-grade or absent	High-grade
Auscultation	Wheezing, rhonchi	Crackles, decreased breath sounds
Chest X-ray	Usually normal	Consolidation present
General Condition	Mild to moderate discomfort	More severe illness, systemic symptoms

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