Causes and SymptomsRespiratory diseases (Magill’s Medical Guide, Sixth Edition)
The inflammation associated with bronchitis may be localized or diffuse, acute or chronic, and it is usually caused by infections or physical agents. In its infectious form, acute bronchitis is part of a general, acute upper respiratory infection, sometimes brought on by the common cold. It can also develop from a viral infection of the nasopharynx, throat, or tracheobronchial tree. Acute bronchitis is most prevalent in winter. Factors contributing to the onset of the disease include exposure, chilling, malnutrition, fatigue, or rickets. The inflammation may be serious in debilitated patients and those with chronic pulmonary disease, and the real danger rests in the development of pneumonia. Certain physical and chemical irritants can bring on acute bronchitis. Such agents as mineral and vegetable dusts, strong acid fumes, volatile organic compounds, and tobacco smoke can trigger an attack.
The disease causes thickening of the bronchi and a loss of elasticity in the bronchial tree. Changes in the mucous membranes occur, leukocytes infiltrate the submucosa, and a sticky, mucopurulent exudate is formed. The normally sterile bronchi are invaded by bacteria and cellular debris. A barking cough is often present, and this serves as an essential mechanism for eliminating bronchial secretions.
Chronic bronchitis is characterized by swollen mucous membranes, tenacious exudate, and spasms in the...
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Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
Acute bronchitis is treated with bed rest and medication to counteract the symptoms of inflammation. The room air should be kept warm and humid. Steam inhalation and cough syrup sometimes give relief from the severe, painful cough.
All surveys have demonstrated a high incidence of bronchitis in cigarette smokers when compared with nonsmokers, thus providing a good reason for the cessation of smoking.
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
American Lung Association. http://www.lungusa.org. Includes detailed information and recent research findings, a guide to local events and programs, and a section to share personal stories, among other features.
Goldman, Lee, and Dennis Ausiello, eds. Cecil Textbook of Medicine. 23d ed. Philadelphia: Saunders/Elsevier, 2007. A comprehensive textbook covering the diagnosis and treatment of diseases.
Niederman, Michael S., George A. Sarosi, and Jeffrey Glassroth. Respiratory Infections. 2d ed. Philadelphia: Lippincott Williams & Wilkins, 2001. Text that covers a range of respiratory problems, including bronchitis.
Shayevitz, Myra, and Berton R. Shayevitz. Living Well with Chronic Asthma, Bronchitis, and Emphysema. Yonkers, N.Y.: Consumer Reports Books, 1991. A book written to help those suffering from chronic lung disease. Provides an agenda for living with the disease.
Smolley, Laurence A., and Debra Fulghum Bruce. Breathe Right Now: A Comprehensive Guide to Understanding and Treating the Most Common Breathing Disorders. New York: W. W. Norton, 1998. Realizing that often breathing disorders may be linked to other medical problems or behavior (such as smoking), Smolley and Bruce provide perspective on the physiology of the respiratory system and the factors that can trigger its malfunction.
West, John B. Pulmonary Pathophysiology: The...
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Bronchitis (Encyclopedia of Medicine)
Bronchitis is an inflammation of the air passages between the nose and the lungs, including the windpipe or trachea and the larger air tubes of the lung that bring air in from the trachea (bronchi). Bronchitis can either be of brief duration (acute) or have a long course (chronic). Acute bronchitis is usually caused by a viral infection, but can also be caused by a bacterial infection and can heal without complications. Chronic bronchitis is a sign of serious lung disease that may be slowed but cannot be cured.
Although acute and chronic bronchitis are both inflammations of the air passages, their causes and treatments are different. Acute bronchitis is most prevalent in winter. It usually follows a viral infection, such as a cold or the flu, and can be accompanied by a secondary bacterial infection. Acute bronchitis resolves within two weeks, although the cough may persist longer. Acute bronchitis, like any upper airway inflammatory process, can increase a person's likelihood of developing pneumonia.
Anyone can get acute bronchitis, but infants, young children, and the elderly are more likely to get the disease because people in these age groups generally have weaker immune systems. Smokers and people with heart or other lung diseases are also at higher risk of developing...
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Bronchitis (Encyclopedia of Children's Health)
Bronchitis is an inflammation of the air passages between the nose and the lungs, including the windpipe or trachea and the larger air tubes of the lung that bring air in from the trachea (bronchi). Bronchitis can either be of brief duration (acute) or have a long course (chronic). Acute bronchitis is usually caused by a viral infection but can also be caused by a bacterial infection and can heal without complications. Chronic bronchitis is a sign of serious lung disease that may be slowed but cannot be cured. This form is found almost exclusively in adult smokers. Bronchitis in children is often misdiagnosed as asthma.
Acute bronchitis is most prevalent in winter. It is most often caused by a viral infection and may be accompanied by a secondary bacterial infection. Acute bronchitis resolves within two weeks, although the cough may persist longer. Acute bronchitis, like any upper airway inflammatory process, can increase a child's likelihood of developing pneumonia.
Acute bronchitis is one of the more common illnesses affecting preschool and school-age children. It is more commonly diagnosed among...
(The entire section is 1477 words.)
Bronchitis (Encyclopedia of Alternative Medicine)
Bronchitis is an inflammation of the air passages between the nose and the lungs, including the windpipe, or trachea, and the larger air tubes called bronchi that bring air into the lungs from the trachea. When bronchitis is mild and brief in duration, it is called acute. Chronic bronchitis is recurrent, has a prolonged course, and is often a sign of a serious underlying lung disease.
Bronchitis is an inflammation of the breathing airways accompanied by coughing and spitting up of phlegm. It can be caused by exposure to a cold or the flu, infection, or irritants. Although the symptoms of acute and chronic bronchitis are similar, their causes and treatments are different. Acute bronchitis is most common in winter. It usually follows an upper respiratory infection, and may be accompanied by a secondary bacterial infection. Acute bronchitis usually resolves within two weeks, although the cough may persist longer. Like any upper airway inflammatory process, acute bronchitis can increase a person's likelihood of developing pneumonia.
Anyone can get acute bronchitis, but infants, young children, and the elderly are more likely to come down with the disease. Smokers and people with heart or lung diseases are at a higher risk of...
(The entire section is 1854 words.)
Bronchitis (Encyclopedia of Public Health)
The term "bronchitis" refers to the inflammation of medium-sized and large airways in the lung (bronchi). Bronchitis is distinguished from bronchiolitis (inflammation of small airways that lack cartilage and mucus-secreting glands in their walls) and from bronchiectasis (permanent dilation and destruction of bronchi associated with chronic cough productive of purulent sputum). Although bronchial asthma is a chronic inflammatory airway disease, it is not considered under the heading of bronchitis.
Acute bronchitis is usually an infectious disease caused by viruses (influenza A and B, parainfluenza, the common cold viruses [rhinovirus and coronavirus], adenovirus, and respiratory syncytial virus). Infrequently, acute bronchitis is caused by inhalation of toxic gases and products of combustion or by aspiration of foreign material. Acute infectious bronchitis is a self-limited illness characterized by cough, sputum production, and, in most cases, symptoms of an upper respiratory tract infection (sore throat, and nose and sinus congestion). Inflammation of the trachea usually occurs together with inflammation of the bronchi, so the term "tracheobronchitis" is sometimes used. The majority of cases occur during the winter. In most cases, symptoms clear spontaneously within one week. In about 10 percent of cases, acute bronchitis can be traced to infection by nonviral agents including Mycoplasma pneumoniae, Chlamydia pneumoniae, and Bordetella pertussis. Diagnostic tests to determine the specific organism responsible for acute bronchitis are impractical, so therapy is usually empiric.
Treatment of acute bronchitis consists of symptomatic relief with cough suppressant medication (antitussives), pain relief with nonsteroidal anti-inflammatory drugs, and decongestants if nasal and sinus congestion is present. Antibiotics against bacterial organisms are not indicated in the treatment of acute bronchitis. If acute bronchitis occurs during a community outbreak of influenza A or B infection, influenza is likely and may be managed with new antiviral drugs that shorten the duration of illness. This therapy is effective, however, only if begun within two days of the onset of symptoms. Expense and limitation of the symptomatic benefit to one to two days render such antiviral therapy controversial.
A few patients with acute bronchitis suffer from persistent cough beyond seven to ten days, requiring management with inhaled bronchodilators such as albuterol. Persistent cough along with sore throat (pharyngitis) may suggest infection from Mycoplasma pneumoniae or Chlamydia pneumoniae, prompting treatment with an antibiotic (doxycycline, erythromycin, clarithromycin, or azithromycin). A persistent, violent, barking cough may be a clue to infection from Bordetella pertussis. This fairly common problem may respond to a one- or two-week course of antibiotic treatment with erythromycin. A cough that persists for more than three weeks is termed "chronic cough." Occasionally chronic cough follows an episode of acute bronchitis. More likely, however, chronic cough is caused by some type of under-lying chronic lung disease, bronchial asthma, postnasal drip, or gastroesophageal reflux disease.
It is important to distinguish acute bronchitis from pneumonia. Patients with pneumonia usually have fever, chills, and a more severe illness than is seen with acute bronchitis, and the chest X-ray reveals a shadow (lung infiltrate) that is lacking in acute bronchitis. Acute bronchitis should also be distinguished from an attack of bronchial asthma and from acute exacerbation of chronic obstructive pulmonary disease (COPD).
Chronic bronchitis is characterized by chronic or recurrent excess bronchial mucus secretion. About 12.5 million Americans are thought to suffer from chronic bronchitis, and the morbidity, mortality, and economic impact of this condition (and of emphysema) are immense. Chronic bronchial inflammation results in a persistent cough, which by definition occurs most days for at least three months of the year for at least two successive years. The cough is typically productive of varying amounts and appearance of phlegm (sputum). Other diseases that are associated with excessive mucus secretion, such as chronic sinusitis with post-nasal drip, asthma, lung cancer, tuberculosis, and bronchiectasis, must not be confused with chronic bronchitis. Patients with "simple chronic bronchitis" lack airflow obstruction on pulmonary function tests (spirometry), whereas those with "chronic obstructive bronchitis" have reduced air-flow rates. Both types of chronic bronchitis are closely linked to cigarette smoking.
Chronic obstructive bronchitis is one of two types of COPD, the other being emphysema. Some, but not all, patients with simple chronic bronchitis progress to the chronic obstructive form. Most patients with chronic obstructive bronchitis also have emphysema. Chronic asthmatic bronchitis is an overlap condition with features of both chronic bronchitis and bronchial asthma. Industrial bronchitis is a type of chronic bronchitis associated with occupational exposure to dusts.
Patients with chronic obstructive bronchitis usually have a daily cough, sputum production, shortness of breath (dyspnea), and sometimes wheezing. These symptoms typically appear in the age range from forty-five to sixty and gradually progress, particularly if cigarette smoking continues. In advanced cases, chronic respiratory failure may occur. Acute exacerbations of chronic bronchitis are intermittent episodes of increasing cough with discolored sputum, shortness of breath, and wheezing that typically occur one or two times each year. Viral or bacterial infection is a common cause of these episodes.
Medical management of chronic bronchitis includes general measures such as patient education, smoking cessation, improved nutrition, exercise, and immunization against infection by influenza virus and Streptococcus pneumoniae. Complete elimination of cigarette smoking is essential and has been proven to slow the rate of decline in pulmonary function that occurs over time. Patients with chronic obstructive bronchitis are treated with bronchodilator drugs such as inhaled ipratropium bromide and albuterol and occasionally with oral theophylline. Supplemental oxygen is prescribed for patients with low arterial blood-oxygen levels (hypoxemia), and antibiotics are often given for significant acute exacerbations. Other management strategies that are recommended for emphysema are also appropriate for chronic obstructive bronchitis because of the over-lap of these two conditions.
JOHN L. STAUFFER
(SEE ALSO: Acute Respiratory Diseases; Asthma; Influenza)
American Thoracic Society (1995). "Standards for the Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease." American Journal of Respiratory and Critical Care Medicine 152(5):S77S120.
Anthonisen, N. R.; Manfreda, J.; Warren, C. P. W.; Hershfield, E. S.; Harding, G. K. M.; and Nelson, N. A. (1987). "Antibiotic Therapy of Acute Exacerbations of Chronic Obstructive Pulmonary Disease." Annals of Internal Medicine 106(2):19604.
Sethi, S. (2000). "Infectious Etiology of Acute Exacerbations of Chronic Bronchitis." Chest 117(5):380S85S.
Snow, V.; Mottur-Pilson, C.; and Gonzales, R. (2001). "Principles of Appropriate Antibiotic Use for Treatment of Acute Bronchitis in Adults." Annals of Internal Medicine 134:51820.