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16-September-2008 16:15:15 - bronchitis Bronchitis Classification and external resources ICD-10 J20.-J21. ICD-9 466 MeSH D001991 Bronchitis is an inflammation of the large bronchi medium-size airways in the lungs. It can progress to pneumonia. Acute bronchitis is usually caused by viruses or bacteria and may last several days or weeks.1 Acute bronchitis is characterized by cough and sputum phlegm production and symptoms related to the obstruction of the airways by the inflamed airways and the phlegm, such as shortness of breath and wheezing. Diagnosis is by clinical examination and sometimes microbiological examination of the phlegm. Treatment may be with antibiotics if a bacterial infection is suspected, bronchodilators to relieve breathlessness and other treatments. Contents 1 Cause/Etiology 2 Signs and symptoms 3 Diagnosis 4 Treatment 4.1 Antibiotics 4.2 Smoking cessation 4.3 Antihistamines 5 Prognosis 6 Prevention 7 References 8 See also 9 External links Cause/Etiology Acute bronchitis can be caused by contagious pathogens. In about half of instances of acute bronchitis a bacterial or viral pathogen is identified. Typical viruses include respiratory syncytial virus, rhinovirus, influenza, and others. Acute bronchitis can also result from breathing irritating fumes, such as those of tobacco smoke or polluted air. Signs and symptoms Bronchitis may be indicated by an expectorating cough, shortness of breath dyspnea and wheezing. Occasionally chest pains, fever, and fatigue or malaise may also occur. Additionally, Bronchitis caused by Adenoviridae may cause systemic and gastrointestinal symptoms as well. However the coughs due to bronchitis can continue for up to three weeks or more even after all other symptoms have subsided. Diagnosis A physical examination will often reveal decreased intensity of breath sounds, wheezing, rhonchi and prolonged expiration. Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis. A variety of tests may be performed in patients presenting with cough and shortness of breath: A chest X-ray that reveals hyperinflation; collapse and consolidation of lung areas would support a diagnosis of pneumonia. Some conditions that predispose to bronchitis may be indicated by chest radiography. A sputum sample showing neutrophil granulocytes inflammatory white blood cells and culture showing that has pathogenic microorganisms such as Streptococcus spp. A blood test would indicate inflammation as indicated by a raised white blood cell count and elevated C-reactive protein. Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation. Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present. Mucosal hypersecretion is promoted by a substance released by neutrophils. Further obstruction to the airways is caused by more goblet cells in the small airways. This is typical of chronic bronchitis. Although infection is not the reason or cause of chronic bronchitis it is seen to aid in sustaining the bronchitis. Treatment Antibiotics In most cases, acute bronchitis is caused by viruses, not bacteria, and will go away on its own without antibiotics. To treat acute bronchitis that appears to be caused by a bacterial infection, or as a precaution, antibiotics may be given. Also, a meta-analysis found that antibiotics may reduce symptoms by one-half day. Smoking cessation For more details on this topic, see Smoking cessation. To help the bronchial tree heal faster and not make bronchitis worse, smokers should quit smoking completely to allow their lungs to recover from the layer of tar that builds up over time. Antihistamines Using over-the-counter antihistamines may be harmful in the self-treatment of bronchitis. An effect of antihistamines is to thicken mucus secretions. Expelling infected mucus via coughing can be beneficial in recovering from bronchitis. Expulsion of the mucus may be hindered if it is thickened. Antihistamines can help bacteria to persistcitation needed and multiply in the lungs by increasing its residence time in a warm, moist environment of thickened mucus. Using antihistamines along with an expectorant cough syrup may be doubly harmful encouraging the production of mucus and then thickening that which is produced. Using an expectorant cough syrup alone might be useful in flushing bacteria from the lungs. Using an antihistamine along with it works against the intention of using the expectorant. Prognosis Acute bronchitis usually lasts a few days. 2 It may accompany or closely follow a cold or the flu, or may occur on its own. Bronchitis usually begins with a dry cough, including waking the sufferer at night. After a few days it progresses to a wetter or productive cough, which may be accompanied by fever, fatigue, and headache. The fever, fatigue, and malaise may last only a few days; but the wet cough may last up to several weeks. Should the cough last longer than a month, some doctors may issue a referral to an otorhinolaryngologist ear, nose and throat doctor to see if a condition other than bronchitis is causing the irritation. It is possible that having irritated bronchial tubes for as long as a few months may inspire asthmatic conditions in some patients. In addition, if one starts coughing mucus tinged with blood, one should see a doctor. In rare cases, doctors may conduct tests to see if the cause is a serious condition such as tuberculosis or lung cancer. Acute bronchitis may lead to asthma or pneumonia.citation needed Prevention In 1985, University of Newcastle, Australia Professor Robert Clancy developed an oral vaccine for acute bronchitis. This vaccine was commercialised four years later References ^ Wenzel RP, Fowler AA 2006. Clinical practice. Acute bronchitis. N. Engl. J. Med. 355 20: 2125-30. doi:10.1056/NEJMcp061493. PMID 17108344. ^ Bronchitis, Mayo Foundation for Medical Education and Research, 2007-04-20, http://www.mayoclinic.com/health/bronchitis/DS00031/DSECTION=1. Retrieved on 30 May 2008 See also Chronic bronchitis External links Wikisource has the text of the 1911 Encyclopædia Britannica article Bronchitis. Online medical references: Bronchitis Lungs OnLine Acute Bronchitis FamilyDoctor.org American Academy of Family Physicians v d e Pathology of respiratory system J, 460-519, respiratory diseases Upper RT including URTIs, Common cold Head sinuses: Sinusitis nose: Rhinitis Vasomotor rhinitis, Atrophic rhinitis, Hay fever - Nasal polyp - Deviated septum tonsil: Tonsillitis - Adenoid hypertrophy - Peritonsillar abscess Neck pharynx: Pharyngitis Strep throat larynx: Laryngitis - Croup - Laryngospasm - vocal folds: Vocal fold nodule - epiglottis: Epiglottitis trachea: Tracheitis - Tracheal stenosis Lower RT/lung disease including LRTIs Pneumonia Viral - Bacterial/Atypical pneumonia Mycoplasma - Fungal pneumonia Pneumocystis pneumonia - Parasitic pneumonia - Bronchopneumonia - Chemical pneumonia Mendelson's syndrome Bronchial/ obstructive Acute: Bronchitis Acute, Chronic - Bronchiolitis Chronic: Emphysema - COPD - Asthma Status asthmaticus - Diffuse panbronchiolitis - Bronchiectasis Interstitial/ restrictive External agents/ occupational lung disease Pneumoconiosis Asbestosis, Baritosis, Bauxite fibrosis, Berylliosis, Caplan's syndrome, Chalicosis, Coalworker's pneumoconiosis, Siderosis, Silicosis, Byssinosis Hypersensitivity pneumonitis Bagassosis, Bird fancier's lung, Farmer's lung Other ARDS - Pulmonary edema - Löffler's syndrome/Eosinophilic pneumonia - Respiratory hypersensitivity Allergic bronchopulmonary aspergillosis Hamman-Rich syndrome - Idiopathic pulmonary fibrosis Obstructive or restrictive Atelectasis - Bronchiolitis obliterans Pleural cavity/mediastinum Suppuration Empyema - Lung abscess Pleural disease/pleural effusion Hemothorax - Pneumothorax - Hemopneumothorax - Hydrothorax - Pleurisy Mediastinal disease Mediastinal emphysema - Mediastinitis Other/general Respiratory failure - Influenza - SARS - Idiopathic pulmonary haemosiderosis see also congenital, neoplasia v d e Common cold Viruses Rhinovirus - Coronavirus - Human parainfluenza viruses - Human respiratory syncytial virus - Adenovirus - Enterovirus - Metapneumovirus Symptoms Pharyngitis - Rhinorrhea - Nasal congestion - Sneezing - Cough - Muscle aches - Fatigue - Malaise - Headache - Weakness - Loss of appetite Complications Acute bronchitis - Bronchiolitis - Croup - Pneumonia - Sinusitis - Otitis media - Strep throat Antiviral drugs Pleconaril experimental Retrieved from http://en..org/wiki/Acute_bronchitis Categories: Inflammations | Pulmonology | General practiceHidden categories: All articles with statements | Articles with statements since June 2008 | Articles with statements since October 2007 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية Català Dansk Deutsch Français Galego Bahasa Indonesia Ã?slenska Italiano Lëtzebuergesch Lietuvių Nederlands ‪Norsk bokmÃ¥l‬ ‪Norsk nynorsk‬ Polski Português РуÑ?Ñ?кий Shqip Suomi Svenska اردو ייִדיש 䏿–‡ This page was last modified on 14 August 2008, at 14:37
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