Acute Bronchitis

Acute Bronchitis
Definition
Bronchitis is an acute inflammation of bronchi or trachea of the respiratory system/ lungs. Bonchitis may be either acute or chronic.

Incidence
Internationally, it is one of the top 5 reasons for childhood physician visits in the countries that track such data. In America, the frequency of visits made bronchitis just slightly less common than otitis media and slightly more common than asthma. However, in children, asthma is often underdiagnosed and is frequently misdiagnosed as chronic or recurrent bronchitis

Pathophysiology
Acute bronchitis leads to the hacking cough and phlegm production that often follows upper respiratory tract symptoms. This occurs because of the inflammatory response of the mucous membranes within the lungs’ bronchial passages. In bronchitis, there is a hypersecretion of mucus in the bronchi due to hypertrophy of submucosal mucus-producing glands and increased number of goblet cells. In most patients, this is strengthened by smoking. Mucocillary clearance is delayed cause of excess mucus production and loss of ciliated cells.

Aetiology
Bronchitis occurs most often during the cold and flu season, usually coupled with an upper respiratory infection.
• Several viruses cause bronchitis, including influenza A and B, commonly referred to as “the flu.”
• A number of bacteria are also known to cause bronchitis, such as Mycoplasma pneumoniae, which causes so-called walking pneumonia.
• Bronchitis also can occur when you inhale irritating fumes or dusts. Chemical solvents and smoke, including tobacco smoke, have been linked to acute bronchitis.
• People at increased risk both of getting bronchitis and of having more severe symptoms include the elderly, those with weakened immune systems, smokers, and anyone with repeated exposure to lung irritants.
• Bronchitis may also occur when acids from your stomach consistently back up into your food pipe (esophagus) and a few drops go into your upper airway, a condition known as gastroesophageal reflux disease (GERD).

Signs and symptoms
• Cough – In acute bronchitis, cough can linger for several weeks after bronchitis resolves.
• Production of mucus (sputum), either clear or white or yellowish-gray or green in color
• Shortness of breath, made worse by mild exertion
• Wheezing
• Fatigue
• Slight fever and chills
• Chest discomfort

Investigation
Doctors diagnose bronchitis generally on the basis of symptoms and a physical examination.
• If the doctor suspects the patient has pneumonia, a chest x-ray may be ordered.
• Examine nasopharyngeal secretions for Chlamydia species and for viral culture or antigens of respiratory syncytial, parainfluenza, and influenza viruses to guide appropriate antimicrobial selection.
• Doctors may measure the patient’s oxygen saturation (how well oxygen is reaching blood cells) using a sensor placed on a finger.
• Sometimes a doctor may order an examination and/or culture of a sample of phlegm coughed up to look for bacteria
• Bronchoalveolar lavage may reveal numerous monocytic or polymorphonuclear inflammatory cells.
• In children with chronic aspiration of gastric contents, lipids may be present within macrophages.

Differential Diagnosis
• Asthma
• Pneumonia, Bacterial
• Chronic Obstructive Pulmonary Disease and Emphysema
• Pneumonia, Mycoplasma
• Bronchiolitis
• Laryngotracheobronchitis
• Pertussis
• Tubercolosis

Management
Basically for acute bronchitis, the management target at controlling the symptoms and ensures that the patient feels better throughout the course disease.
• A cool mist vaporizer or humidifier can help decrease bronchial irritation.
• Drinking fluids is very important because fever causes the body to lose fluid faster. Lung secretions will be thinner and easier to clear when the patient is well hydrated
• Acetaminophen (Feverall, Panadol, Tylenol), aspirin, or ibuprofen (Motrin, Nuprin, Advil) will help with fever and muscle aches.
• Antibiotics and antivirals can be prescribed to relieve the infection but it has not proven any considerable benefit.

Prognosis
• Acute bronchitis usually completely heals, with excellent prognosis.
• Patients with chronic bronchitis and established diagnoses of asthma, structural airway disease, or immunodeficiency need careful periodic monitoring to minimize further lung damage and progression to chronic irreversible lung disease.

=) not sure if it is but oh well xD was doing this during practical lolx xD