Acute Bronchitis

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Introduction

  • An inflammation of the bronchial tubes.
  • Commonly caused by a variety of viruses, same as those that are responsible for common cold. Primary bacterial aetiology may also occur.
  • Acute bronchitis can last from a few days to 10 days but the associated cough may last for several weeks after the infection has cleared up.
  • Bronchitis lasting up to 90 days is still usually classified as acute bronchitis.

Clinical features

  • Cough
  • Sputum production
  • Sputum may be clear, yellow or greenish
  • Wheezing
  • Muscle and backache
  • Low grade fever
  • Shortness of breath in severe cases
  • Chest pain especially while coughing

Differential diagnosis

  • Cough-variant asthma
  • Mycoplasma pneumonia
  • Chlamydia pneumonia
  • Bordetella pertussis

 Complications

  • Pneumonia
  • Acute respiratory failure
  • Repeated bouts of acute bronchitis over time may lead to COPD

Investigations

  • Chest x-ray
  • Sputum tests
  • (Quality sputum for culture and tests for evidence of allergy)
  • Pulmonary function tests

Drug treatment

  • Antibiotics
    • Amoxicillin 500 mg PO 8 hourly for 5 – 7 days
    • Macrolide g. erythromycin 500 mg 8 hourly 5 – 7 days
    • Co-trimoxazole 960mg 12 hourly 5 – 7 days

Notable adverse drug reactions, contraindications, and cautionCo-trimoxazole

  • Nausea
  • Skin rashes
  • Rarely Stevens-Johnson syndrome with co-trimoxazole.