Acute Bronchitis
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Acute inflammatory obstructive disease of the bronchi.
Causes
- Mostly viral
- In older children, can be caused by Mycoplasma pneumoniae
- Secondary Bacterial infection: Streptococcus pneumoniae, Haemophilus influenzae
Predisposing Factors
- Exposure to cold, dust, smoke
- Cigarette smoking
Clinical features
- Often starts with rhinopharyngitis, descend progressively to larynx, pharynx, tracheitis
- Irritating, productive cough sometimes with scanty mucoid, blood streaked sputum
- Chest tightness, sometimes with wheezing
- Fever may be present
- No tachypnoea or dyspnoea
- Secondary bacterial infection: fever > 38.5°C, dyspnoea, purulent expectorations
Differential diagnosis
- Bronchial asthma, emphysema
- Pneumonia, tuberculosis
Investigations
- Diagnosis based on clinical features
- Chest X-ray
Management
Treatment
- Most cases are viral and mild
- Paracetamol 1 g every 4-6 hours (max: 4 g daily)
- Child: 10 mg/kg (max: 500 mg) per dose
- Plenty of oral fluids
- Children: nasal irrigation with normal saline to clear the airway
- Local remedies for cough (honey, ginger, lemon)
If there is suspicion of bacterial infection, especially if patient is in general poor conditions (malnutrition, measles, rickets, severe anaemia, elderly, cardiac disease)
- Give Amoxicillin 500 mg every 8 hours
- Child: 40 mg/kg dispersible tablets every 12 hours
- Or Doxycycline 100 mg every 12 hours
- Child >8 years: 2 mg/kg per dose
Prevention
- Avoid predisposing factors above