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Bronchitis, Acute

Bronchitis, Acute is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Inflammation of trachea, bronchi, and bronchioles resulting from a respiratory tract infection or chemical irritant (1)
  • Cough, the predominant symptom, may last as long as 3 weeks (2,3).
  • Generally self-limited, with complete healing and full return of function (2)
  • Most infections are viral if no underlying cardiopulmonary disease is present (2).
  • Synonym(s): tracheobronchitis

Geriatric Considerations
Can be serious, particularly if part of influenza, with underlying COPD or CHF (3)

Pediatric Considerations
  • Usually occurs in association with other conditions of upper and lower respiratory tract (trachea usually involved)
  • If repeated attacks occur, child should be evaluated for anomalies of the respiratory tract, immune deficiencies, or for asthma.
  • Acute bronchitis caused by RSV may be fatal.
  • Antitussive medication not indicated in patients age <6 years (2)

Epidemiology

  • Predominant age: all ages
  • Predominant gender: male = female

Incidence
  • ~5% of adults per year
  • Common cause of infection in children

Prevalence
Results in 10 to 12 million office visits per year

Etiology and Pathophysiology

  • Viral infections such as adenovirus, influenza A and B, parainfluenza virus, coxsackievirus, RSV, rhinovirus, coronavirus (types 1 to 3), herpes simplex virus, metapneumovirus (2)
  • Bacterial infections, such as Chlamydia pneumoniae, Mycoplasma, Bordetella pertussis, Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Mycobacterium tuberculosis (2)
  • Secondary bacterial infection as part of an acute upper respiratory infection
  • Possible fungal infections
  • Chemical irritants
  • Acute bronchitis causes an injury to the epithelial surfaces, resulting in an increase in mucus production and thickening of the bronchiole wall (1).

Genetics
No known genetic pattern

Risk Factors

  • Infants
  • Elderly
  • Air pollutants
  • Smoking
  • Secondhand smoke
  • Environmental changes
  • Chronic bronchopulmonary diseases
  • Chronic sinusitis
  • Tracheostomy or endobronchial intubation
  • Bronchopulmonary allergy
  • Hypertrophied tonsils and adenoids in children
  • Immunosuppression
    • Immunoglobulin deficiency
    • HIV infection
    • Alcoholism
  • Gastroesophageal reflux disease (GERD)

General Prevention

  • Avoid smoking and secondhand smoke.
  • Control underlying risk factors (i.e., asthma, sinusitis, and reflux).
  • Avoid exposure, especially daycare.
  • Pneumovax, influenza immunization

Commonly Associated Conditions

  • Allergic rhinitis
  • Sinusitis
  • Pharyngitis
  • Epiglottitis (rare but can be rapidly fatal)
  • Coryza
  • Croup
  • Influenza
  • Pneumonia
  • Asthma
  • COPD/emphysema
  • GERD

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Citation

Stephens, Mark B., et al., editors. "Bronchitis, Acute." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute.
Bronchitis, Acute. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute. Accessed April 25, 2019.
Bronchitis, Acute. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute
Bronchitis, Acute [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 25]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bronchitis, Acute ID - 116095 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116095/all/Bronchitis__Acute PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -