Acute bronchitis

Definition

Acute bronchitis is an inflammation of the main airways to the lungs (the bronchi) that usually lasts for a brief period of time.

It is not the same as chronic bronchitis, which often persists for a longer period of time.

Alternative Names

Bronchitis - acute

Causes

Acute bronchitis is one of the most common medical conditions seen in a doctor's office. It is mainly caused by a virus that infects the respiratory system. There are many different respiratory viruses that can do this, including the rhinovirus, which causes the common cold.

You have a higher risk for getting bronchitis if you've had a recent illness or viral respiratory infection (which reduce your ability to fight off infections), or if you have chronic lung problems such as asthma, cystic fibrosis, or chronic obstructive pulmonary disease. You are also at higher risk for bronchitis if you smoke.

Symptoms

The classic symptoms of bronchitis may be like those of a cold. You may have a tickle in the back of your throat, which leads to a dry, irritating cough. As the infection gets worse, you may cough up thick, yellow mucus that may (rarely) be streaked with blood.

Sometimes the symptoms of bronchitis do not appear until the viral infection has gone away. Then another, bacterial infection causes the coughing symptoms of bronchitis.

The symptoms of bronchitis include:

• Cough
  • Stays steady or gets worse for 10 days - 2 weeks
  • Gets worse at night
  • Starts out dry and irritating, but becomes increasingly loose over time
  • Has mucus in it (younger kids usually can't cough this up; they swallow it)
  • Has blood in it (in rare cases); see a doctor if this happens
  • Lasts for less than 6-8 weeks
• Shortness of breath
• Wheezing
• "Rattle" sensation in chest
• General ill feeling (malaise)
• Slight fever
• Tickle feeling in back of throat that leads to soreness
• Chest pain, soreness, and tightness in the chest
• Poor sleep
• Chills (uncommon)

Whooping cough and sinusitis may cause bronchitis-like symptoms. See your health care provider for a correct diagnosis.

Exams and Tests

Your doctor can diagnose acute bronchitis by reviewing your current health and medical history. A physical exam and chest x-ray can help rule out pneumonia.

Treatment

In otherwise healthy people, antibiotics usually aren't helpful. That's because acute bronchitis is almost always caused by a virus, which will not respond to antibiotics. Antibiotics are is usually only needed if your doctor diagnoses you with whooping cough or pneumonia.

Medications called bronchodilators are used to open tight air passages in the lungs. Your doctor may prescribe this type of medicine if you are wheezing.

Decongestants may also help relieve symptoms of bronchitis. Medications that loosen mucus may also be prescribed, but how well they work remains uncertain.

Your doctor will tell you to:

• Drink more fluids to help thin mucus in the lungs
• Rest
• Soothe your airways by increasing humidity in the air (you can do this by using a cool mist humidifier)

Outlook (Prognosis)

Symptoms will usually go away within 7 - 14 days if you don't have chronic pulmonary disease. However, it may take much longer for the cough to go away in some people.

Possible Complications

Pneumonia is a possible complication. Some people also may have sinusitis

When to Contact a Medical Professional

Call your health care provider if you have symptoms of acute bronchitis.

Call your health care provider if you are being treated for acute bronchitis and:

• Your symptoms last longer than 2 weeks
• You develop breathlessness or wheezing
• You cough up blood

Prevention

Good handwashing is one of the best ways to avoid getting viruses and other respiratory infections.

Since flu viruses have been shown to be a major cause of bronchitis, getting a flu shot may also help prevent acute bronchitis.

Limit your exposure to cold, damp environments. When combined with air pollution or tobacco smoke, the cold and damp may make you more likely to get bronchitis.

Knutson D. Diagnosis and Management of Acute Bronchitis. Am Fam Physician. May 2002; 65(10): 2039-44.

Aagaard E. Management of Acute Bronchitis in Healthy Adults. Infect Dis Clin North Am. Dec 2004; 18(4): 919-37.

American Academy of Pediatrics. Cough Illness/Bronchitis. In: Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003:696.

Braman SS. Chronic Cough Due to Chronic Bronchitis: ACCP Evidence-Based Clinical Practice Guidelines. Chest. January 2006;129(1 Suppl):104S-115S.