Acute bronchitis

When acute bronchitis is an inflammation of the newly created greater branched respiratory tract - the bronchi - referred to as cough, mucus production, fever and other systemic symptoms. If - as is often the case - the trachea is affected, it is called an acute tracheobronchitis.

Summary

The diagnosis of acute bronchitis is one of the most frequently asked diagnoses in general practice, although with respect to the definition and pathophysiology often consist ambiguities. It would be better in most cases the diagnosis: acute respiratory infection, since as a rule not only the bronchi, but also other parts of the respiratory tract are affected.

Epidemiology

One reason for the frequent diagnosis is the unreflective summary of various diseases under this term. As clear disease-specific symptoms, as well as pioneering laboratory parameters are missing, each cough is often referred to in infections of the upper respiratory tract, allergic syndromes or even a sinusitis as bronchitis; it is one of the most common consultation events in a general medical practice.

In a study could already be shown that patients with acute bronchitis one on the 6.5 - fold increased incidence of disease ( prevalence) of had a history of bronchial asthma and had a nine- fold increased risk, the diagnosis of bronchial asthma in the sequence to get. This is an indication of both diseases underlying hypersensitivity of the airways ( bronchial hyperreactivity ). May play an untreated chlamydial infection of the airways an important role in the transformation of acute bronchitis in bronchial asthma.

Etiology

The data situation, in what percentage of cases a viral, bacterial, or fungal infection of the bronchi is present or non-infectious causes are to be guilty is poor, especially when one considers the frequency and the economic importance of this disease.

The coding of diseases in the German health care system in the DRG system distinguishes several different pathogen- related forms of acute bronchitis. The diagnosis is remunerated better with pathogen detection. It would therefore be expected that can be increasingly better information about the individual causative agent of acute bronchitis make. The corresponding data are rarely published and reviewed critically.

Signs and Symptoms

Cough and obstructive symptoms such as the often existing stridor caused by the inflammation of the bronchial mucosa with caused thereby swelling and mucus production.

The cough is usually dry at first, because the swelling of the mucous membranes due to the infection- induced increase in blood flow ( Gr. hyperemia) the production of mucus is preceded by the formation of which the cough becomes productive. The ejection - called in medical terminology as sputum - is tough or thin. In viral infection it is usually clear to grayish, while colored rather greenish-yellow with a bacterial infection, but this can only be tendential clues to the underlying etiology.

In obstructive bronchitis ( formerly spastic bronchitis ), the cramping muscle contraction of the bronchial tubes rattling and wheezing, especially during exhalation, create, and make it difficult to cough up sputum.

The assessed by spirometry lung function shows similar values ​​as for mild bronchial asthma in about 60 percent of patients. As this case of recurring acute bronchitis, which were caused by chlamydia, may possibly develop, patients should undergo after the acute symptoms of control.

Diagnosis

The physical examination may confirm the obstruction of the airways, but more important is the history: a nocturnal cough may be the only symptom of acute bronchitis. Routinely performed tests of sputum bring either no results or are not cost effective. In the 25 percent of cases, suffering from more than four weeks persistent cough, but a Keuchhustenserologie and other further investigations should be made to rule out something more serious diseases such as lung or systemic diseases. At groundbreaking research would be blood values ​​, to name a chest X-ray and ultrasound examinations.

Differential Diagnosis

• Common cold
• Flu
• Whooping cough
• Bronchial asthma, bronchial
• Reflux oesophagitis
• Exposure to toxic or allergenic substances
• Pneumonia
• Heart failure
• Bronchial
• Dysphagia with aspiration
• Pulmonary aspergillosis and aspergilloma

Therapy

Antibiotics

The administration of an antibiotic is indicated only in cases of suspected bacterial infection in a purely viral infection is not. Often, however, it comes as a result of a weakening of the immune system (in addition to the existing viral infection ) to a stubborn and dangerous part of bacterial infection.

Cough Medicine

The gift of the silent cough agent can be counterproductive, since the produced sputum should be coughed up. For complaints about a disturbed night's sleep of heart failure must be considered, both of which significantly increases can cause symptoms while lying on one or reflux esophagitis. Otherwise, no available data on the appropriate use of cough or expectoration facilitating breastfeeding means ( expectorants ) are available.

Bronchospasmolytics

The previous studies, expanding the benefits of the bronchial substances occupy ( bronchodilators ), this is not necessarily a.

Course of the disease

Acute bronchitis usually heals without treatment after several days or sometimes weeks without complications from. The symptoms usually keep on for no longer than ten days. In rare cases, the cough persist for several months, in which case a whooping cough, bronchial asthma or cardiac and tumor formation or chronic pneumonia should be considered.

Prevention

• Not smoking