Bronchitis

Description

Bronchitis is an inflammation of the lower airways. The areas affected are the branches of the windpipe (trachea): the bronchial tubes and their smaller branches, the bronchioles. Often the trachea itself is affected (tracheobronchitis). If bronchitis occurs for more than three months at a time in two consecutive years, this is termed chronic bronchitis.

Symptoms

The main symptom is a violent, in the beginning mostly dry cough. Often the chest hurts. When bronchitis develops, the bronchial mucosa produces increased secretions that are coughed up as expectorate. The result is a productive cough with mucus (phlegm). General cold symptoms such as dullness, head and body aches, runny nose or sore throat and possibly also fever may exist.

Causes and Risks

Viruses are in most cases the cause of acute bronchitis. In adults, the most common triggers to consider are influenza (flu), parainfluenza, rhinoviruses or adenoviruses. In children, the common triggers are respiratory syncytial virus (RS), adenovirus, coxsackie and echo viruses.

Bacteria, much less often than viruses, can also cause acute bronchitis. Bacterial bronchitis occurs mostly in cases of a weakened immune system or pre-existing damage to the lungs, for example from cigarette smoke or air pollutants. In adults, the main triggering germs are streptococci, haemophilus influenzae or moraxella catarrhalis. In children and infants they are often haemophilus influenzae, mycoplasma or chlamydia.

Very rarely, fungi also cause bronchitis. The most common fungal bronchitis is so-called "thrush bronchitis," caused by the yeast fungus candida albicans.

Examination and Diagnosis

Usually the doctor already has the first indications of the presence of acute bronchitis from the patient's medical history and the typical symptoms present. Physical examination can confirm obstruction of the airway. As a rule, the ears, sinuses, oropharynx and lymph nodes on the neck are also examined.

Blood tests can determine the inflammation markers such ​​as CRP (C-reactive protein), BSG (blood sedimentation rate) and the number of white blood cells (leukocytes). These values ​​are often elevated.

An X-ray or CT (computed tomography) recording is arranged if the presence of pneumonia is suspected.

In order to confirm a possible shift of the bronchi (due to obstruction), pulmonary function tests (spirometry) can be conducted.

Additionally, attention must be paid in case of repeated acute bronchitis to a possible transition to a chronic disease course, or that for example an immune deficiency may be present.

Treatment

If acute bronchitis is triggered by viruses, a causal therapy is usually not possible. Instead the treatment aims to relieve the symptoms. As long as the cough is dry, antitussive agents (cough suppressants) may dampen the urge to cough. If the cough fades but you need to cough up mucus, expectorant medicines can help. A combination of cough suppressants  and expectorants is usually not helpful, since they each have opposite effects.

An antibiotic can only help if acute bronchitis is caused by bacteria.

It is important to drink plenty of fluids, as this helps to liquefy the secretions. In addition, inhaling with a saline solution for example may be helpful.

Course and Prognosis

Acute bronchitis usually heals within 7 to 14 days. However, in some cases the cough may persist for a longer period.

Miscellaneous/Other Comments

Complications of acute bronchitis are above all pneumonia or secondary bacterial infection.