Bronchitis Health Article

Definition

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.

Description

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.

Demographics

Acute bronchitis is one of the more common illnesses affecting preschool and school-age children. It is more commonly diagnosed among children under age five than any other age group. It occurs more often in young males. It can occur anytime but is more frequent during the winter months. In otherwise healthy children complications are few.

Causes and symptoms

Acute bronchitis usually begins with the symptoms of a cold, such as a runny nose, sneezing, and dry cough. However, the cough soon becomes deep and painful. Coughing brings up a greenish yellow phlegm or sputum. These symptoms may be accompanied by a fever of up to 102°F (38.8°C). Wheezing after coughing is common.

In uncomplicated acute bronchitis, the fever and most other symptoms, except the cough, disappear after three to five days. Coughing may continue for several weeks. Acute bronchitis is often complicated by a bacterial infection, in which case the fever and a general feeling of illness persist. To be cured, the bacterial infection should be treated with antibiotics. A cough that does not go away may be a sign of another problem such as asthma or pneumonia.

Physical findings of acute bronchitis vary with the age of the child, and the stage of the disease, but may include the following:

• runny nose
• dry, hacking unproductive cough that may change to a loose cough with increased mucus
• sore throat
• back and other muscle pains
• chills and low grade fever
• headache and general malaise (feeling unwell)

Diagnosis

Initial diagnosis of bronchitis is based on observing the child's symptoms and health history. The physician will listen to the child's chest with a stethoscope for specific sounds that indicate lung inflammation, such as moist rales and crackling, and wheezing, that indicate airway narrowing. Moist rales is a bubbling sound heard with a stethoscope that is caused by fluid secretion in the bronchial tubes.

A sputum culture may be performed, particularly if the sputum is green or has blood in it, to determine whether a bacterial infection is present and to identify the disease-causing organism so that an appropriate antibiotic can be selected. Normally, the patient will be asked to cough deeply then spit the material that comes up from the lungs (sputum) into a cup. This sample is then grown in the laboratory to determine which organisms are present. The results are available in two to three days.

Occasionally, in diagnosing a chronic lung disorder, the sample of sputum is collected using a procedure called a bronchoscopy. In this procedure, the patient is given a local anesthetic, and a tube is passed into the airways to collect a sputum sample.

To better determine what type of obstructive lung disease a patient has, the doctor may do a chest x ray and order blood tests. Other tests may be used to measure how effectively oxygen and carbon dioxide are exchanged in the lungs.