Acute bronchitis

What is acute bronchitis according to the summary?

A lower respiratory tract infection (LRTI) characterized by inflammation of the bronchi. Summary 1

What type of infection most commonly precedes acute bronchitis?

Acute bronchitis often follows an upper respiratory tract infection (URTI). Summary 2

What is the most common cause (>90%) of acute bronchitis?

The cause is viral in more than 90% of cases. Summary / Etiology 3

What are the typical symptoms of acute bronchitis mentioned in the summary?

Cough (often productive, may persist 2-3 weeks, associated with chest pain), runny nose, headache, and malaise. Summary / Clinical 4

How is the diagnosis of acute bronchitis typically made according to the summary?

Diagnosis is made on the basis of clinical symptoms and auscultation findings; further diagnostic testing is not routinely necessary. Summary / Diagnosis 5

What are important differential diagnoses to consider when evaluating suspected acute bronchitis?

Important differentials include asthma, acute exacerbation of COPD (AECOPD), and pneumonia. Summary / Diff Dx 6

What is the mainstay of management for acute bronchitis according to the summary?

Management consists of adequate hydration and symptomatic relief. Summary / Treatment 7

Is antibiotic treatment generally indicated for acute bronchitis?

No, treatment with antibiotics is not generally indicated. Summary / Treatment 8

Name three common viruses that cause acute bronchitis.

Influenza A and B, Parainfluenza, Adenovirus, RSV, Rhinovirus, or Coronavirus. (Any 3) Etiology 9

What is the main symptom of acute bronchitis?

Cough, which may occur in bouts with or without sputum production. Clinical Features 10

How long does the cough associated with acute bronchitis typically last?

The cough typically resolves within 2-3 weeks. Clinical Features 11

What symptoms of a preceding URTI might accompany acute bronchitis?

Runny nose and sore throat. Clinical Features 12

What systemic or generalized symptoms can occur with acute bronchitis?

Headache, malaise, myalgias, chest pain, mild dyspnea, or low-grade fever (uncommon after first few days). Clinical Features 13

What are possible findings on lung auscultation in acute bronchitis?

Auscultation may be clear, or show rhonchi or wheezing. Fine crackles are rare. Clinical Features 14

How is acute bronchitis typically diagnosed?

Acute bronchitis is a clinical diagnosis based on typical clinical features and auscultation findings. Diagnosis 15

When are diagnostic studies generally required for suspected acute bronchitis?

Usually only required to rule out alternative diagnoses (like pneumonia) or evaluate for complications, especially in high-risk patients or those with atypical findings. Diagnosis 16

What patients with suspected acute bronchitis might warrant a chest x-ray to evaluate for pneumonia?

Patients with abnormal examination findings (e.g., focal crackles, signs of consolidation) or atypical clinical presentation (e.g., high fever, hypoxia, confusion). Diagnosis 17

What are typical chest x-ray findings in uncomplicated acute bronchitis?

Chest x-ray is often normal or may show nonspecific findings like peribronchial thickening. Diagnosis 18

In otherwise healthy patients with typical acute bronchitis symptoms and normal vitals, is diagnostic testing needed?

No, in otherwise healthy patients with typical findings and normal vital signs, acute bronchitis does not require diagnostic testing. Diagnosis 19

What is the general approach to treating acute bronchitis?

Treatment is focused on the relief of symptoms as the condition is generally self-limiting. Treatment 20

What supportive management is recommended for acute bronchitis?

Recommend rest, adequate hydration, and avoidance of lung irritants (e.g., smoke). Treatment 21

When should a patient with acute bronchitis be reevaluated?

Reevaluate if typical symptoms worsen (fever, dyspnea, cough), new worrisome symptoms appear (hemoptysis), or cough persists > 3 weeks. Treatment 22

What medications can be used for symptomatic relief of pain/fever in acute bronchitis?

Analgesics such as NSAIDs or acetaminophen. Treatment 23

Are antitussives, expectorants, bronchodilators, steroids, or antihistamines routinely recommended for acute bronchitis?

No, these symptom relievers are not routinely recommended as they have no proven efficacy in uncomplicated acute bronchitis. Treatment 24

When might antibiotics be considered for a patient presenting with acute bronchitis symptoms?

Only consider antibiotics in patients with suspected bacterial complications (e.g., pneumonia) or an alternate bacterial diagnosis (e.g., pertussis, AECOPD). Treatment 25

What are potential complications of acute bronchitis?

Respiratory failure, secondary bacterial infections (especially pneumonia), or protracted bacterial bronchitis. Complications 26

What is protracted bacterial bronchitis?

A chronic bacterial infection causing a productive cough lasting > 4 weeks that resolves within 2-4 weeks of antibiotic treatment, with no alternate diagnosis. Complications 27

What factors increase the risk for complications from acute bronchitis?

Advanced age, immunocompromise, and preexisting lung conditions. Prognosis 28