The cause is almost always a viral infection. The pathogen is rarely identified.

Rhinovirus, coronavirus, influenza viruses, and adenovirus

Mycoplasma pneumoniaeChlamydia pneumoniae, and Bordetella pertussis may also cause bronchitis.

Secondary invasion with bacteria such as Haemophilus influenzae and Streptococcus pneumoniae.

It usually happens because of a virus or breathing in things that irritate the lungs such as tobacco smoke, fumes, dust and air pollution. Bacteria sometimes cause acute bronchitis.

Acute bronchitis is frequently a component of a URI caused by rhinovirusparainfluenzainfluenza A or B virusrespiratory syncytial virus, coronavirus, or human metapneumovirus. Less common causes may be Mycoplasma pneumoniaeBordetella pertussis, and Chlamydia pneumoniae. Less than 5% of cases are caused by bacteria.

Viruses spread through the air when people cough, or though physical contact (for example, on unwashed hands). Being exposed to tobacco smoke, air pollution, dusts, vapors, and fumes can also cause acute bronchitis.

Acute bronchitis is frequently a component of a URI caused by rhinovirusparainfluenzainfluenza A or B virusrespiratory syncytial virus, coronavirus, or human metapneumovirus. Less common causes may be Mycoplasma pneumoniaeBordetella pertussis, and Chlamydia pneumoniae. Less than 5% of cases are caused by bacteria, sometimes in outbreaks.

Acute bronchitis is inflammation of the tracheobronchial tree, commonly following a Upper Respiratory InfectionI, that occurs in patients without chronic lung disorders.

The most common symptom is cough, with or without fever, and possibly sputum production.

Diagnosis is based on clinical findings. Treatment is supportive; antibiotics are usually unnecessary. Prognosis is excellent.

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Bronchitis is an inflammation of the bronchial tubes.

Bronchitis

Acute bronchitis is the development of inflammation in bronchial tubes—the major airways into your lungs.

Acute bronchitis is a respiratory infection causing inflammation of the large airways without evidence of pneumonia.

The common cold is a viral infection of the upper respiratory tract, primarily affecting the nasal mucosa causing congestion, rhinorrhea, and sneezing. Influenza, or the flu, is a respiratory illness with fever, myalgias, cough, and fatigue.

The symptoms and signs of the common cold, influenza

and acute bronmchitis overlap, and their causative pathogens are often similar.

 

Specific acute respiratory tract infections

Infections of the upper respiratory tract also cause specific clinical conditions such as otitis media (see Chapter 242, “Ear Disorders”), pharyngitis and epiglottitis (see Chapter 246, “Neck and Upper Airway”), bronchiolitis (see Chapter 116, “Neonatal Emergencies and Common Neonatal Problems”), tracheitis (see Chapter 126, “Stridor and Drooling in Infants and Children”), and sinusitis (see Chapter 244, “Nose and Sinuses”).

 

 

 

 

 

Symptom relief (cough suppressants, expectorants).

 

Clinicians should not initiate antibiotics unless pneumonia is suspected.

The recommended treatment for acute bronchitis leans more towards palliative care, such as ibuprofen or acetaminophen for chills and fever, plenty of fluids and antitussives.

Acute bronchitis is self-limiting and resolves on its own, although the cough may continue for a few more weeks. Antibiotics usually are not recommended as typically it is caused by a viral infection [6].

Antibiotic therapy may be given to high risk patients like those with asthma, smokers and Chronic Obstructive Pulmonary Disease (COPD), coupling it with bronchodilators significantly reduces hospital stay [7].

[Studies further supports that using antibiotics in bronchitis cases can reduce hospital re-visits of patients from 76.8% to 27% in a 3 year period [8].?????]

Occasionally a short-term dose of steroids may help with the inflammation of the bronchial tubes. Oral anti-inflammatory agents has been used to control the inflammation in acute bronchitis [9].

 

Treatments include rest, fluids, and aspirin (for adults) or acetaminophen to treat fever. A humidifier or steam can also help. You may need inhaled medicine to open your airways if you are wheezing. Antibiotics won't help if the cause is viral. You may get antibiotics if the cause is bacterial.

Man persistently coughing. Side by side comparison of clean, healthy airways and narrowed airways with inflammation and mucus.

 

 

 

Complications of Injecting Drug Use

  • Local problems—Abscess (Figures 240-2 
    Image not available.

    A 32-year-old woman with type 1 diabetes developed large abscesses all over her body secondary to injection of cocaine and heroin. Her back shows the large scars remaining after the healing of these abscesses. (Courtesy of ­Richard P. Usatine, MD.)

    and 240-3; Abscess), cellulitis, septic thrombophlebitis, local induration, necrotizing fasciitis, gas gangrene, pyomyositis, mycotic aneurysm, compartmental syndromes, and foreign bodies (e.g., broken needle parts) in local areas.2
    • IDUs are at higher risk of getting methicillin-resistant Staphylococcus aureus(MRSA) skin infections that the patient may think are spider bites (Figure 240-4).
    • Some IDUs give up trying to inject into their veins and put the cocaine directly into the skin. This causes local skin necrosis that produces round atrophic scars (Figure 240-5).
  • IDUs are at risk for contracting systemic infections, including HIV and hepatitis B or hepatitis C.
    • Injecting drug users are at risk of endocarditis, osteomyelitis (Figures 240-6and 240-7), and an abscess of the epidural region. These infections can lead to long hospitalizations for intravenous antibiotics. The endocarditis that occurs in IDUs involves the right-sided heart valves (see Chapter 50, Bacterial Endocarditis).2 They are also at risk of septic emboli to the lungs, group A β-hemolytic streptococcal septicemia, septic arthritis, and candidal and other fungal infections.

 

Most cases of acute bronchitis get better within several days. But your cough can last for several weeks after the infection is gone.

Content 13

Content 11

 

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