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Acute bronchitis

Definition
  • Inflammation of the bronchial tubes in the lungs, usually caused by infections.
Etiology
  • Most commonly viral (e.g., influenza, rhinovirus, RSV).
  • Bacterial causes include Mycoplasma pneumoniae, Bordetella pertussis, and Chlamydia pneumoniae.
  • Exacerbation by smoking, environmental pollutants, and underlying lung disease.
Clinical Presentation
  • Productive or dry cough lasting 1-3 weeks.
  • Substernal chest discomfort.
  • Wheezing and shortness of breath.
  • Fever (usually low-grade) and malaise.
  • No signs of consolidation on examination (differentiates from pneumonia).
Investigations
  • Mostly clinical diagnosis; investigations not routinely needed.
  • Chest X-ray if pneumonia is suspected: to exclude consolidation.
  • Pertussis PCR/swab if whooping cough is suspected.
Management
  • Symptomatic treatment:
    • Paracetamol or ibuprofen for fever and pain.
    • Cough suppressants like dextromethorphan.
  • Most cases are viral, so antibiotics not routinely recommended unless bacterial cause suspected.
  • Advise smoking cessation if relevant.
  • Encourage adequate hydration and rest.
Complications
  • Pneumonia.
  • Chronic bronchitis in smokers.
Prognosis
  • Generally self-limiting with full recovery within 2-3 weeks.

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