Text IX. Acute Bronchitis

Acute bronchitis is an acute inflammation of the tracheobronchial tree, generally self-limiting and with eventual complete healing and return of function. Though commonly mild, bronchitis may be serious in debilitated patients and in patients with chronic pulmonary or cardiac disease. Pneumonia is a critical complication.

Etiology. Acute infectious bronchitis, most prevalent in winter, may develop following the common cold or other viral infection of the nasopharynx, throat, or tracheobronchial tree, often with secondary bacterial infection. Exposure to air pollutants and possibly chilling, fatigue and malnutrition are predisposing or contributory factors.

Acute irritative bronchitis may be caused by mineral and vegetable ducts of various kinds; fumes from strong acids; or tobacco smoke.

Symptoms and Signs. Preliminary symptoms are coryza, malaise, chills, slight fever, back and muscle pain, and sore throat. Onset of cough usually signals onset of bronchitis. The cough is initially dry and non-productive, but small amounts of sputum are raised after a few hours or days. The sputum later becomes more abundant and mucoid or mucopurulent. Frankly purulent sputum suggests bacterial infection. In severe uncomplicated cases fever to 38.3 or 38.9ºC (101 or 102ºF) may be present for up to 3 to 5 days. Persistent fever suggests complicating pneumonia.

Treatment. General: rest is indicated until fever subsides. Fluids (up to 3000 or 4000 ml/day) are forced during the febrile course. An antipyretic analgesic such as aspirin relieves malaise and reduces fever.

Local: a cough mixture may be used if cough is troublesome and interferes with sleep.

Antibiotic: indicated when complicating factors or purulent sputum are present, or when high fever persists and the patient is more than mildly ill.

27. Revision questions:

1. What diseases are more common in the first two years of life? Why?

2. What is chronic lung disease?

3. What infants are more subjected to chronic lung disease?

4. What is the main symptom of croup?

5. What does the treatment of croup consist of?

6. What is common cold characterized by?

7. Is there any treatment for the common cold?

8. Is vitamin C helpful in control of cold or not?

9. What type of influenza can cause epidemic?

10. How does influenza spread?

11. When does acute bronchitis occur more often?

12. How should one treat acute bronchitis