Acute Bronchitis

Acute Bronchitis is a very common diagnosis especially at the height of cough and cold season. It consists of an abrupt onset of lower respiratory tract infection and is distinguished from a cold because of a few unique characteristics. It is a lower respiratory tract infection as opposed to a ?head cold.? It produces a cough that persists rather than dissipates throughout the course of the illness. Annually, 5 % of the general population in the United States develops acute bronchitis. It is most common in the fall and winter months.

In the lungs, the process is that the illness secondarily causes inflammation and spasm of the bronchial airways (tubes going into the lungs). The cough can be productive of sputum, chest pain occurs on occasion, and wheezing is also a possibility. There may be significant mucus production or it could be mostly dry. There is often bronchospasm which is when the walls of the tubes going to the lungs have spasm thereby narrowing the caliber of the tube and making it more difficult to breathe freely. ?Usually the cough is worse at night and with exercise. Cold air and talking can also trigger the cough spasms. Cough can last greater than 2 weeks in 50 % of patients and greater than 4 weeks in 25 %.

Other causes of prolonged cough include post nasal drip, pneumonia, and asthma.

Acute bronchitis is usually caused by viruses that cause head colds.? Some of them include coronavirus, rhinovirus, respiratory syncytial virus, and adenovirus. In the past it was felt that acute bronchitis was a bacterial infection and therefore antibiotics were used. After many studies showed no improvement with antibiotic use and other studies confirmed that bacteria were not in the airways during a bronchial infection the standard of practice is to no longer treat acute bronchitis with antibiotics.

Treatments are aimed at symptom reduction since most bronchitis is caused by viruses for which there is no treatment. Cough suppressants can be helpful as the cough can be worse at night and prevent sleep. Over the counter cough suppressants are limited in their efficacy. Honey is shown to be equally effective to many of the over the counter cough medications. If symptoms are more severe, occasional bronchodilators are needed.? These are prescription inhalers typically used for asthma. If symptoms have progressed and inflammation of the airways is now the main culprit causing the cough, steroid inhalers or even oral steroids may be necessary for treatment. Sometimes running a humidifier at night may be helpful as humidified air may be easier to breathe.

Complications from acute bronchitis are rare. Occasionally pneumonia can develop. This usually presents with fever, shortness of breath, and a change in the pattern of coughing. Often a chest x-ray is used to help make the distinction between bronchitis and pneumonia.

In summary, acute bronchitis is mostly a viral infection that leads to a prolonged cough. Occasionally people develop asthma like reactions which contribute to the prolonged cough. This does not necessarily mean the patient has developed asthma but the treatments are similar.