Acute Bronchitis in Adults Diagnosis

  • Diagnosis

    Acute bronchitis is a short-term respiratory illness that usually lasts less than 15 days. With bronchitis, air passages in the lungs become irritated, swell, and produce mucus.

    Acute bronchitis is one of the top 10 reasons people in the United States seek medical care. Bronchitis is diagnosed based upon physical signs and symptoms, and by ruling out more serious illnesses (such as pneumonia). Cough is the main symptom of bronchitis. Bronchitis may also be called a lower respiratory infection, or “chest cold.” It occurs most often during the winter months, and may follow a head cold, the flu, or another illness.

    Acute bronchitis is usually caused by a viral infection Figure 01[Table 4].

    About 90% of infectious bronchitis cases (bronchitis caused by a germ) are viral. Viruses may be spread in the air when someone coughs or sneezes and another person inhales the germs. A person may also be exposed to viruses by shaking hands with an infected person, or touching something contaminated by an infected person.

    Bacteria, yeast, and fungi may also cause bronchitis. However, since a virus usually causes bronchitis, antibiotics often will not be helpful in treating the illness. This is because antibiotics are only effective against bacteria [Table 4].

    Click to enlarge: Normal Lungs

    Figure 01. Normal Lungs

    Bronchitis can occur due to exposure to chemicals or irritants that are inhaled. This is referred to as occupational or environmental bronchitis.

    You can avoid some bronchitis-causing irritants by refraining from smoking tobacco or other substances. If you work around dust or fumes, read and know the safety precautions recommended in the Material Safety Data Sheet(s) of the products or substances.

    A persistent cough is the primary symptom of bronchitis.

    With bronchitis, the cough may be dry or productive (mucus-producing). If your mucus is colored, it does not necessarily mean that you need antibiotics, as is often falsely believed. Your mucus may be clear, green, yellow, or white, or have streaks of blood in it. The cough from bronchitis can last for a month or longer.

    With bronchitis, you may or may not have a mild fever, chest pain, or a sore throat. You may wheeze when you breathe, and have mild shortness of breath Table 01.

    As with a cold, you may feel achy and tired in addition to having your other symptoms. A high or persistent fever may mean you have pneumonia or the flu. Any severe trouble breathing requires immediate medical attention.

    The chest pain of bronchitis, if present, may worsen when you cough or take a deep breath. It is felt directly under the breastbone, and may feel like a burning pain Table 01.

    Table 1.  Symptoms of Acute Bronchitis

    Persistent cough White, yellow, or green mucus that may appear 1 to 2 days after cough begins Feeling tired and achy Possible fever and chills Mild shortness of breath Soreness and tightness in the upper chest, which gets worse when you cough

    Acute bronchitis tends to strike more often during the winter months, when viral infections are more prevalent.

    It is important to wash your hands frequently, especially after shaking hands or touching common objects such as doorknobs. Also, avoid touching your eyes and nose. Try to stay away from people who have a cold or the flu, and insist that those around you cover their mouths when they cough.

    Repeated episodes of acute bronchitis can increase your risk of developing chronic bronchitis. Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD), which can be a serious illness.

    People who have repeated episodes of acute bronchitis have an increased risk of developing the chronic form of the disease. In the United States, about 5% of the population, or about 14 million people, have chronic bronchitis, making it the seventh-ranking chronic condition in the country. The disease affects people of all ages, but is most common in women and in people over the age of 45.

    Recurrent viral respiratory tract infections during infancy or early childhood can also lead to chronic bronchitis. There may be a higher risk of developing chronic bronchitis if a parent or sibling has had the disease.

    Smoking cigarettes or other tobacco products increases your risk for bronchitis.

    Inhaling smoke temporarily paralyzes the tiny, hair like cells called cilia that line the airways. These cilia are important because they help to keep germs and irritants out of the lungs. The more you smoke, the more damage you do to the cilia.

    Eventually, the cells may stop functioning altogether, putting you at constant risk for infection and bronchitis. If a person gets bronchitis often, it may lead to chronic bronchitis, which can be a serious health condition. Your clinician can inform you of a number of medications and programs available to help you quit smoking.

    Children of heavy smokers have an increased risk for developing bronchitis, as do people who are repeatedly exposed to the cigarette smoke of others.

    Prolonged exposure to air pollution or certain dusts found in industrial settings increases your risk for bronchitis.

    Bronchitis is more common in urban areas where air pollution is greater. In particular, exposure to emissions of sulfur dioxide (SO2), a chemical used in bleaching and as a refrigerant and preservative, has been shown to increase the risk of bronchitis. Workers exposed to either inorganic or organic dusts (such as coal miners, grain handlers, and metal molders) are also at an increased risk of developing chronic bronchitis, which can be a serious health condition.

    People with certain diseases are at a greater risk of becoming ill with acute bronchitis.

    People who have chronic lung or airway diseases (such as asthma), or whose lungs are congested due to heart failure, are more prone to developing acute bronchitis. Children with enlarged tonsils and adenoids are also more prone to bronchitis.

    There is no specific test that confirms a diagnosis of acute bronchitis. Your clinician will determine if you have bronchitis based on your symptoms.

    If your symptoms are severe, or if you have other health problems, your clinician may perform blood tests or a chest x-ray. This can help determine how your body is handling the illness and make sure you don't have pneumonia or another illness.

    Your clinician will need to examine you and listen to your lungs to make sure you have bronchitis and not something else. If your clinician hears wheezing in your lungs, you are more likely to have bronchitis.

    Your clinician will evaluate your vital signs, and listen closely to your chest and back as you breathe. This helps your clinician make sure you do not have a more serious infection, such as pneumonia. Your clinician will also rule out other possible causes of your symptoms, such as asthma, heart disease, other lung diseases, tuberculosis, or an allergic reaction.

    Tests such as blood tests and chest x-rays are not usually done unless your clinician is trying to rule out other illnesses, such as pneumonia or heart failure.

    If you have other health problems, or if you are in a high risk group for serious lung infections, your clinician may run other tests. Conditions that may place you at higher risk for serious lung infections include recent pneumonia or tuberculosis, cancer, or problems with mobility or your immune system.

    If you get bronchitis-like symptoms a lot, it may mean you are developing a long-term respiratory problem, such as chronic bronchitis or asthma.

    A clinician should evaluate any cough that is difficult to shake or that comes back frequently.

    Pneumococcal and influenza vaccines may reduce your risk of becoming ill with infections that can cause bronchitis.

    You can help prevent episodes of bronchitis by reducing your risk of getting pneumonia, influenza, and other respiratory illnesses. Ask your doctor whether you should be vaccinated against pneumococcal and seasonal influenza viruses. Both vaccines are usually recommended for people who are over the age of 65, have a chronic illness, or have a weakened immune system.

    The pneumococcal vaccine protects against many strains of pneumococcal bacteria, a bacteria that causes a serious form of pneumonia as well as other illnesses. People who receive the vaccine after age 65 only need it once. Those who receive it before age 65 may need a repeat vaccine after 5 years. The influenza vaccine must be taken yearly, as it offers protection against only the current year's strains of influenza viruses.

    Smoking increases your chance of developing bronchitis. If you already smoke, quit.

    The more you smoke, the more damage you do to your lungs. Smoking puts you at greater risk for respiratory illnesses. Smoking can also make recovery from illness take longer.

    If you get bronchitis often, it may lead to chronic bronchitis, which can be a serious health condition. Your clinician can inform you of a number of medications and programs available to help you quit smoking.

    Children of heavy smokers have an increased risk for developing bronchitis, as do people who are repeatedly exposed to the cigarette smoke of others.

    Limit your exposure to pollutants and airborne irritants.

    If you live in a polluted area, limit your exposure to irritants by staying indoors as much as possible on days when pollutant levels are high. Also, limit your exposure to indoor pollutants by using fewer aerosol deodorants, insecticides, and hair sprays.

    If you have bronchitis, cover your mouth when coughing, and wash your hands frequently to prevent spreading your illness to others.

    Caregivers and family members of people with bronchitis should also wash their hands often to prevent the infection from spreading.

    Take care of yourself by getting plenty of rest and eating right. Drink at least six to eight glasses of water daily.

    Fluids help to keep mucous membranes hydrated and able to expel infectious organisms, irritants, and other debris from the respiratory tract more efficiently.

    Good nutrition boosts your immune system and helps your body fight off infection. Eat foods rich in the antioxidant vitamins C, E, and beta-carotene, such as dark green vegetables (broccoli, kale), and orange or yellow-colored fruits and vegetables (winter squash, oranges, apricots).

  • Prevention and Screening

    Pneumococcal and influenza vaccines may reduce your risk of becoming ill with infections that can cause bronchitis.

    You can help prevent episodes of bronchitis by reducing your risk of getting pneumonia, influenza, and other respiratory illnesses. Ask your doctor whether you should be vaccinated against pneumococcal and seasonal influenza viruses. Both vaccines are usually recommended for people who are over the age of 65, have a chronic illness, or have a weakened immune system.

    The pneumococcal vaccine protects against many strains of pneumococcal bacteria, a bacteria that causes a serious form of pneumonia as well as other illnesses. People who receive the vaccine after age 65 only need it once. Those who receive it before age 65 may need a repeat vaccine after 5 years. The influenza vaccine must be taken yearly, as it offers protection against only the current year's strains of influenza viruses.

    Smoking increases your chance of developing bronchitis. If you already smoke, quit.

    The more you smoke, the more damage you do to your lungs. Smoking puts you at greater risk for respiratory illnesses. Smoking can also make recovery from illness take longer.

    If you get bronchitis often, it may lead to chronic bronchitis, which can be a serious health condition. Your clinician can inform you of a number of medications and programs available to help you quit smoking.

    Children of heavy smokers have an increased risk for developing bronchitis, as do people who are repeatedly exposed to the cigarette smoke of others.

    Limit your exposure to pollutants and airborne irritants.

    If you live in a polluted area, limit your exposure to irritants by staying indoors as much as possible on days when pollutant levels are high. Also, limit your exposure to indoor pollutants by using fewer aerosol deodorants, insecticides, and hair sprays.

    If you have bronchitis, cover your mouth when coughing, and wash your hands frequently to prevent spreading your illness to others.

    Caregivers and family members of people with bronchitis should also wash their hands often to prevent the infection from spreading.

    Take care of yourself by getting plenty of rest and eating right. Drink at least six to eight glasses of water daily.

    Fluids help to keep mucous membranes hydrated and able to expel infectious organisms, irritants, and other debris from the respiratory tract more efficiently.

    Good nutrition boosts your immune system and helps your body fight off infection. Eat foods rich in the antioxidant vitamins C, E, and beta-carotene, such as dark green vegetables (broccoli, kale), and orange or yellow-colored fruits and vegetables (winter squash, oranges, apricots).

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