Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Acute bronchitis describes an infection and inflammation of the breathing
tubes leading to cough and occasional wheezing.
Treatment is supportive keeping fever under control and the patient well
Wheezing is often treated with inhaled albuterol, either by puffer (HFA) or
Steroid medication may be used short term to help decrease the inflammation
within the bronchial tubes.
Patients with underlying lung diseases such as asthma or
COPD may be at
greater risk of developing acute bronchitis.
Antibiotics are not commonly prescribed for acute bronchitis but may be
prescribed if specifically indicated.
What is acute bronchitis?
Air is pulled into the lungs when we breathe, initially passing through the mouth,
nose, and larynx (voicebox) into the trachea and continues en route to each lung
via either the right or left bronchi (the bronchial tree
- bronchi, bronchioles, and alveoli). Bronchi are formed as the lower part of the
trachea divides into two tubes that lead to the lungs. As the bronchi get farther away
from the trachea, each bronchial tube divides and gets smaller (resembling an
inverted tree) to provide the air to lung tissue so that it can transfer oxygen
to the blood stream and remove carbon dioxide (the waste product of metabolism).
Bronchitis describes inflammation of
the bronchial tubes (inflammation = itis). The inflammation causes swelling of
the lining of these breathing tubes, narrowing the tubes and promoting secretion
of inflammatory fluid.
Acute bronchitis describes the inflammation of the bronchi usually caused by a viral infection, although bacteria and chemicals also may cause acute bronchitis.
Bronchiolitis is a term that describes inflammation of the smaller bronchi referred to as bronchioles. In infants, this is usually caused by respiratory syncytial viruses (RSV), and affects the small bronchi and bronchioles more than the large. In adults, other viruses as well as some bacteria can
cause bronchiolitis and often manifest as a persistent cough at times productive of small plugs of mucus.
Acute bronchitis is as mentioned above, is a cough that begins suddenly usually due to a viral infection involving the larger airways.
Colds (also known as
viral upper airway infections) often involve the throat (pharyngitis) and nasal passages, and at times the larynx (resulting in
a diminished hoarse voice, also known as laryngitis). Symptoms can include a runny nose, nasal stuffiness, and sore throat.
Croup usually occurs in infants and young children and involves the voice box and upper large airways (the trachea and large bronchi).
Chronic bronchitis for research purposes is defined as a
daily cough with sputum production for at least three months, two
years in a row. Chronic bronchitis is a diagnosis usually made based on clinical findings of a long term persistent cough usually associated with tobacco
abuse. From a pathologic standpoint, characteristic microscopic findings involving inflammatory cells in seen in airway tissue samples make the diagnosis.
When referring to pulmonary function testing, a decrease in the ratio of the volume of airflow at 1 second when compared to total airflow is less than 70%.
This confirms the presence of obstructive airways disease of which chronic bronchitis is one type. Certain findings can be seen on imaging studies (chest X-ray, and
CT or MRI of the lungs) to suggest the presence of chronic bronchitis;
usually this involves an appearance of thickened tubes.
Picture of the anatomy of the lungs
What causes acute bronchitis?
Acute bronchitis occurs most often due to a viral infection that causes the
inner lining of the bronchial tubes to become inflamed and undergo the changes
that occur with any inflammation in the body. Common viruses include the
rhinovirus, respiratory syncytial virus (RSV), and the
can also cause bronchitis
(a few examples include, Mycoplasma, Pneumococcus, Klebsiella, Haemophilus).
Inflammation of the bronchial tubes narrows the inside opening of the bronchial tubes. Narrowing of the bronchial tubes result in increased resistance, this increase makes it more difficult for air to move to and from the lungs. This can cause wheezing, coughing, and shortness of breath. The cough may consist of sputum due to the secretions from the inflamed cells that line the bronchi. By coughing, the body attempts to expel secretions that clog the bronchial tubes. If these secretions contain certain inflammatory cells, discoloration of the mucus may result often in a green or yellow color. Sometimes the severity of the inflammation may result in some bleeding.
As with any other infection, there may be associated:
the general sensation of feeling poorly or malaise.