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- 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
Can be serious, particularly if part of influenza, with underlying COPD or CHF (3)
- 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)
- Predominant age: all ages
- Predominant gender: male = female
- ~5% of adults per year
- Common cause of infection in children
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).
No known genetic pattern
- Air pollutants
- Secondhand smoke
- Environmental changes
- Chronic bronchopulmonary diseases
- Chronic sinusitis
- Tracheostomy or endobronchial intubation
- Bronchopulmonary allergy
- Hypertrophied tonsils and adenoids in children
- Immunoglobulin deficiency
- HIV infection
- Gastroesophageal reflux disease (GERD)
- 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
- Epiglottitis (rare but can be rapidly fatal)