Bronchitis, Acute

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

To view the entire topic, please or .

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

-- The first section of this topic is shown below --

Basics

  • Acute bronchitis is a common clinical condition characterized by an acute onset but persistent cough, with or without sputum production. It is typically self-limited, resolving within 1 to 3 weeks. Symptoms result from inflammation of the lower respiratory tract and are most frequently due to viral infection.
  • Treatment is focused on patient education and supportive care. Antibiotics are not needed for the great majority of patients with acute bronchitis but are greatly overused for this condition. Reducing antibiotic use for acute bronchitis is a national and international health care priority.

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 chronic obstructive pulmonary disease (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 respiratory syncytial virus (RSV) may be fatal.
  • Antitussive medication not indicated in patients age <6 years (2)

Epidemiology

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

Incidence
It accounts for approximately 10% of ambulatory care visits in the United States or 100 million visits per year. The incidence of acute bronchitis is highest in late fall and winter when transmission of respiratory viruses peaks (2),(3),(4).

Etiology and Pathophysiology

  • Viruses are the most commonly identified pathogens in patients with acute bronchitis (about 60%). The most common viral causes of acute bronchitis include (2):
    • Influenza A and B
    • Parainfluenza
    • Coronavirus types 1 to 3
    • Rhinoviruses
    • RSV
    • Human metapneumovirus
  • Bacteria are detected in 1–10% of cases of acute bronchitis.
  • Atypical bacteria, such as Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Bordetella pertussis, are rare causes of acute bronchitis.
  • Approximately 10% of patients presenting with a cough lasting at least 2 weeks have evidence of B. pertussis 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

-- To view the remaining sections of this topic, please or --

Basics

  • Acute bronchitis is a common clinical condition characterized by an acute onset but persistent cough, with or without sputum production. It is typically self-limited, resolving within 1 to 3 weeks. Symptoms result from inflammation of the lower respiratory tract and are most frequently due to viral infection.
  • Treatment is focused on patient education and supportive care. Antibiotics are not needed for the great majority of patients with acute bronchitis but are greatly overused for this condition. Reducing antibiotic use for acute bronchitis is a national and international health care priority.

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 chronic obstructive pulmonary disease (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 respiratory syncytial virus (RSV) may be fatal.
  • Antitussive medication not indicated in patients age <6 years (2)

Epidemiology

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

Incidence
It accounts for approximately 10% of ambulatory care visits in the United States or 100 million visits per year. The incidence of acute bronchitis is highest in late fall and winter when transmission of respiratory viruses peaks (2),(3),(4).

Etiology and Pathophysiology

  • Viruses are the most commonly identified pathogens in patients with acute bronchitis (about 60%). The most common viral causes of acute bronchitis include (2):
    • Influenza A and B
    • Parainfluenza
    • Coronavirus types 1 to 3
    • Rhinoviruses
    • RSV
    • Human metapneumovirus
  • Bacteria are detected in 1–10% of cases of acute bronchitis.
  • Atypical bacteria, such as Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Bordetella pertussis, are rare causes of acute bronchitis.
  • Approximately 10% of patients presenting with a cough lasting at least 2 weeks have evidence of B. pertussis 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

There's more to see -- the rest of this entry is available only to subscribers.