A Simple Guide to Bronchitis

A Simple Guide to Bronchitis
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What is Bronchitis?
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Bronchitis is an acute disease which causes inflammation and infection of the trachea, bronchi and bronchioles of the lungs.

The mucous membranes of the bronchi of the lungs becomes inflamed from bacterial or viral infection or irritated by fumes and dust in the air resulting in swelling of the bronchial mucosa with excess mucous discharge causing narrowing of the air passages.

Because of the congestion of the brochi there is difficulty in breathing and insufficient oxygen to the body thus posing a danger to the patient's life .

What are the causes of Bronchitis?
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Bacterial Infections:
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1.Gram positive bacteria such as Streptococcus Bronchitise and Staphphylococcus may be serious and fatal in some cases.

2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas, Mycobacteria(including tuberculosis), Legionaire's Disease,chlamydia

Viral infections:
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Influenza, arbovirus, Severe Acute Respiratory Syndrome(SARS) virus, coxsackie virus

Fungal infections:
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Cryptococcus neoformans

Non-infectious:
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1.chemicals such as fumes can damage the lungs and cause Bronchitis

2.Othostatic Bronchitis occurs in people who are bedridden and are unable to get rid of the fluids accumulated in their lungs

3.Aspiration Bronchitis occurs with saliva or fluids in the throat become sucked into the windpipe and the lungs.
This occurs in comatose patients and people having seizures or stroke.

What are Signs and symptoms of Bronchitis?
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Symptoms:

1.cold or runny nose is usually the first symptom

2.Fever may be present

3.cough initially dry, followed by productive purulent sputum which can yellow, green or bloody

4.Breathlessness due to airway obstruction

5.chest pain especially the sides of the chest due to coughing and fever

6.Myalgia (bodyaches) and headache which may be related to the fever

Signs:

1.Moist sounds and wheezing on auscultation with sthetoscope due to narrowing of the airways(bronchi)

2.rhonchi or wheezing sounds due to narrowing of the airways from pressure in the congested lungs

3.Reduced breath sounds - air movement is reduced in the lungs

4.Hyporesonance on percussion of the lungs

5.Cyanosis(blue color) of the lips and fingers if not enough oxygen is entering.

This will considered as a medical emergency.

Children and babies with Bronchitis may not have signs of a chest infection.
They are however quite ill, with fever and lethargy.

How is the diagnosis of Bronchitis made?
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1.Symptoms and signs of fever, breathless and productive cough

2.blood tests (complete blood count, ESR and blood culture)

3.Sputum culture to determine the type of micro-organism

4.Chest X-rays to establish site and character of the bronchial infection

5.CT or MRI of the lungs may be done if required especailly if there is suspicion of lung cancer.

What are the complications of Bronchitis?
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1.Pneumonia

2.adult respiratory distress syndrome

3.Emphysema

What is the treatment of Bronchitis?
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1.Rest, fluids and oxygen

2.Bronchidilators such as aminophylline, ventolin, bricanyl

3.Antibiotics depending on the organism found:

a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus

b.cephalosporins, gentamycin for pseudomonas

c.Tetracycline or erythromycin for mycoplasma and chlamydia

d.Erythromycin and rifampicin for Legionaire's disease.

3.Antivirals such as Tamiflu for Influeza infection
Acyclovir may be given for herpes virus infection

4.High dosages of antifungals may be given for Fungal Bronchitis for a prolonged period of time

5.corticosteroids is useful to reduce complications

6.Humidifiers and steam inhalations

5.cough mixtures and mucolytic agents such as bisolvon

What is the prognosis of Bronchitis ?
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This depends on the severity and type of infection.

Most cases if treated early and correctly recovered completely with return of normal lung function.

In elderly and debilitated patients, breathing can be a problem and recurrence can occur.


What are the Preventive measures taken for Bronchitis ?
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1.Avoid smoking and dusty environment.

2.Healthy lifestyle with balanced diet and exercise.

3.Vaccination against the influenza virus may help.