Acute bronchitis

Acute bronchitis is inflammation of the bronchial tubes in the lungs, usually caused by infections.

• 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.

• 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).

• 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.

• 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.

Generally self-limiting with full recovery within 2-3 weeks.

• Pneumonia.
• Chronic bronchitis in smokers.

• Acute bronchitis is commonly caused by viral infection and is generally self-limiting.
• Clinical features include a cough (occurring for 1-3 weeks), chest pain, wheezing and general malaise, with absence of consolidation on examination.
• Management is supportive with symptomatic treatment and antibiotics are often not required.