bronchitis - Symptoms, Diagnosis, Pathophysiology, Treatment, Prognosis, Prevention, History

Inflammation of the airways (bronchi). Acute bronchitis is a serious disease in infants, usually caused by viruses such as influenza which produce intense inflammation of the respiratory tract that may lead to asphyxia. Chronic bronchitis affects adults who smoke cigarettes. Excessive bronchial mucous secretion follows, inducing a chronic cough productive of sputum.

For information about the bronchial condition called asthma see Allergic asthma

Bronchitis
Classifications and external resources

ICD-10	J20-J21
ICD-9	490-491

Bronchitis is an obstructive pulmonary disorder characterized by inflammation of the bronchi of the lungs. Like many disorders, bronchitis can be acute (short-term), or chronic (long-lasting). Chronic bronchitis is defined clinically as a persistent cough that produces sputum matter that is coughed up from the respiratory tract, for at least three months in two consecutive years.

Chronic bronchitis is predominantly caused by smoking, and has also been linked to pneumoconiosis, excessive alcohol consumption and exposure to cold and draught.

Symptoms

An expectorating cough (the colour of the mucus does not signify whether the infection is viral or bacterial) Dyspnea (Shortness of breath) Fatigue and/or malaise Mild fever Mild chest pains Vibration in chest when breathing coldness

Diagnosis

A physical examination will often reveal decreased intensity of breath sounds (rhonchi) and extended expiration.

A variety of lab test results may suggest chronic bronchitis, namely:

a chest x-ray that reveals hyperinflation and increased bronchovascular markings a pulmonary function test that shows an increase in the lung's residual volume and a decreased vital capacity arterial blood gases that show a decreased level of oxygen in the blood and an increased level of carbon dioxide a sputum culture that has pathogenic microorganisms and/or neutrophils in it

Some of these findings may also be seen in acute bronchitis.

Pathophysiology

Acute bronchitis often follows a cold or infection.

Chronic bronchitis, however, is most likely due to environmental irritation of the bronchial tubes and is often caused by smoking. The initiating event in developing chronic bronchitis is chronic irritation due to inhalation of certain substances (especially cigarette smoke). As bronchitis persists to become chronic bronchitis, a substantial increase in the number of goblet cells in the small airways is seen. A Reid index larger than 0.4 is indicative of chronic bronchitis.

The role of infection in the pathogenesis of chronic bronchitis is secondary.

Treatment

In most cases, acute bronchitis is caused by viruses, not bacteria and it will go away on its own after a few days without antibiotics.

To treat acute bronchitis that appears to be caused by a bacterial infection, or as a precaution, antibiotics may be given.

To help the bronchial tree heal faster and not make bronchitis worse, smokers should cut down on the number of cigarettes they smoke (or quit altogether if possible), or at least try not to smoke in their house.

Prognosis

Acute bronchitis usually lasts approximately 10 or 11 days.

Should the cough last longer than a month, some doctors may issue a referral to an ENT Doctor to see if a cause other than bronchitis is causing the irritation.

The prognosis for patients with severe chronic bronchitis varies, but recovery is harder for those patients with additional severe illnesses (lung diseases or heart conditions). Pulmonary hypertension, cor pulmonale, and chronic respiratory failure are possible complications from chronic bronchitis.

Prevention

The best way to avoid acute bronchitis is to wash your hands frequently and thoroughly, to get lots of rest, and to drink lots of fluids. Acute bronchitis is most commonly caused by viruses or bacteria, which spread via coughing droplets in the air and/or from touching contaminated surfaces.

Chronic bronchitis is often preventable. Smokers in the early stages of chronic bronchitis can change and improve the course of the disease by quitting smoking.

History

Bronchitis was originally named and described by Charles Bedham in 1808.