Cardiovascular

There may be chest tightness involved depending on the severity. Although acute bronchitis is usually self-limiting with frequent bouts can lead to chronic bronchitis and possibly COPD and heart failure.

Musculoskeletal

The main symptom in this category would be muscle aches due to the chills and fever, and chest discomfort from the coughing.

Respiratory

Production of sputum that is usually white and clear, but can also be yellowish-grey or green in color, occurs. Occasionally, but rarely, it can be streaked with blood. There may also be shortness of breath due to the inflammation of the bronchial tubes and not being able to get enough air flow to the lungs. Tachypnea may be present. Productive cough of more than 5 days duration may already be suggestive of bronchitis [5].

Systemic

Sometimes there can be a slight fever and chills, as in flu like symptoms. If the acute bronchitis is from a bacterial infection, it possibly, but rarely can get into the blood stream and cause bacteremia.

• Fever

  Mild fever may be present, but high or prolonged fever is unusual and suggests influenza or pneumonia. On resolution, cough is the last symptom to subside and often takes 2 to 3 wk or even longer to do so. [merckmanuals.com]

  Call your provider if you: Have a cough on most days, or have a cough that keeps returning Are coughing up blood Have a high fever or shaking chills Have a low-grade fever for 3 or more days Have thick, yellow-green mucus, especially if it has a bad smell [nlm.nih.gov]

• Fatigue

  Sinus congestion Chest congestion Shortness of breath Wheezing Fatigue Body aches or chills Chest discomfort from coughing Here's a snapshot of the symptoms that distinguish acute bronchitis from chronic bronchitis, followed by more detailed information [verywell.com]

  […] production, cough, and symptoms of airway obstruction Clinical presentation patients with acute bronchitis or upper respiratory tract infection (URI) have considerable overlap in symptoms and signs symptoms may include cough (productive or nonproductive) fatigue [clinicaladvisor.com]

  Some symptoms of acute bronchitis are: Chest discomfort Cough that produces mucus -- the mucus may be clear or yellow-green Fatigue Fever -- usually low-grade Shortness of breath that gets worse with activity Wheezing, in people with asthma Even after [nlm.nih.gov]

• Collapse

  CB is caused by overproduction and hypersecretion of mucus by goblet cells, which leads to worsening airflow obstruction by luminal obstruction of small airways, epithelial remodeling, and alteration of airway surface tension predisposing to collapse. [doi.org]

  Cough is a very violent action that results in dynamic collapse of the airways. This collapse results in the walls of the airways banging against one another. [emedicinehealth.com]

  Inspiratory wheezing also occurs in hypersensitivity pneumonitis.[6] Wheezes heard at the end of both expiratory and inspiratory phases usually signify the periodic opening of deflated alveoli, as occurs in some diseases that lead to collapse of parts [en.wikipedia.org]

  Dyspnea (shortness of breath 20 ) that may be severe ✓ Respiratory failure ✓ Pneumonia ✓ Cor pulmonale (enlargement and weakness of the right heart ventricle due to lung disease) ✓ Pneumothorax (collection of air or gas in the lungs resulting in lung collapse [articles.mercola.com]

  J20.9 Bronchorrhea J98.09 ICD-10-CM Diagnosis Code J98.09 Other diseases of bronchus, not elsewhere classified 2016 2017 2018 2019 Billable/Specific Code Applicable To Broncholithiasis Calcification of bronchus Stenosis of bronchus Tracheobronchial collapse [icd10data.com]

• Constitutional Symptom

  Symptoms of bronchitis include the following: Cough (the most commonly observed symptom) Sputum production (clear, yellow, green, or even blood-tinged) Fever (relatively unusual; in conjunction with cough, suggestive of influenza or pneumonia) Nausea, [emedicine.medscape.com]

• Cough

  Those taking ibuprofen had 9 days of frequent coughing vs. 11 for antibiotics and placebo, and also fewer total days of cough, but this wasn't statistically significant. [pulmccm.org]

  In the combined data of trials in adults, there was a trend towards improvements regarding cough, productive cough and night cough as well as in daily cough severity scores in participants randomised to the beta2‐agonists. [doi.org]

  Cough resolves within 2 wk in 75% of patients. Patients with persistent cough should undergo a chest x-ray. [merckmanuals.com]

  This is indicated by the relationship between acute bronchitis and bronchial asthma. 3 Clinical presentation The first symptom of acute bronchitis is often a nonproductive cough (dry cough), which can be painful at high intensities. [flexikon.doccheck.com]

  Participants given antibiotics were less likely to have a cough (four studies with 275 participants, RR 0.64, 95% CI 0.49 to 0.85; NNTB 6); have a night cough (four studies with 538 participants, RR 0.67, 95% CI 0.54 to 0.83; NNTB 7) and a shorter mean [epubs.rcsi.ie]

• Sputum

  These observations suggest that sputum might be useful to monitor an inflammatory/immune response of the airway in acute infections. [ncbi.nlm.nih.gov]

  In otherwise healthy people, green sputum is often present during viral infections. [pulmccm.org]

  Sputum Gram stain and culture usually have no role. [merckmanuals.com]

  At enrollment, sputum specimens were collected from all patients. Sputum amount was classified as scanty ( 50 cc/day), and sputum color was classified as white, yellow, brown, or green. [journals.plos.org]

  Description respiratory tract infection with wheezing or coughing (with or without sputum) Incidence/prevalence sixth most common diagnosis made during family physician visits Possible risk factors underlying predisposition to bronchial reactivity during [clinicaladvisor.com]

• Productive Cough

  The differences in presence of a productive cough at follow-up and MD of productive cough did not reach statistical significance.Antibiotic-treated patients were more likely to be unimproved according to clinician's global assessment (six studies with [epubs.rcsi.ie]

  There were no significant differences regarding the presence of night cough, productive cough, or activity limitations at follow up, or in the mean duration of activity limitations. [ncbi.nlm.nih.gov]

  Days of productive cough Comparison 6. [doi.org]

• Sore Throat

  Chest tightness or pain Persistent fatigue Swelling of ankles, feet, and (sometimes) legs Acute Bronchitis The typical progression of bronchitis symptoms starts with a runny nose, sore throat, productive cough and low-grade fever. [verywell.com]

  You should also call your doctor if your symptoms (sore throat, wheezing, coughing, chest congestion, body aches) last more than two weeks and/or if you experience any of the following symptoms: coughing or wheezing that worsens when you lie down or exercise [sharecare.com]

  throat, nasal congestion, runny nose) Past medical history (PMH) ask about history of asthma Social history (SH) ask about smoking or other toxic inhalant exposures Physical General physical may have low-grade fever practitioner interpretation of common [clinicaladvisor.com]

  The most common symptoms for acute bronchitis include cough, chest soreness, runny nose, feeling tired and achy, headache, chills, slight fever, and sore throat. [hopkinsmedicine.org]

  As an alternative to an over-the-counter cough medicine, try making your own mixture of honey and lemon, which can help soothe a sore throat and ease your cough. [nhs.uk]

• Acute Cough

  cough from acute bronchitis and the common cold. [pulmccm.org]

  There is also little evidence that the routine use of beta2-agonists is helpful for adults with acute cough. These agents may reduce symptoms, including cough, in patients with evidence of airflow obstruction. [ncbi.nlm.nih.gov]

• Constipation

  There were an abdominal fullness, weight loss, constipation, pencil-like stool with mucous and blood, low-grade fever, bone ache, and tea-color urine. [ncbi.nlm.nih.gov]

  If you are taking morphine, though, make sure you discuss with your healthcare provider common side effects, such as constipation, drowsiness, nausea and vomiting, and how to control these side effects. [chemocare.com]

  Anticholinergic side effects that may occur with tiotropium include dry mouth, constipation and tachycardia ( Tashkin 2008 ), as well as major cardiovascular events ( Singh 2009 ). [doi.org]

• Chest Pain

  Wheezing and chest pain were associated with higher ABSS values, whereas irrelevant clinical variables were not. [ncbi.nlm.nih.gov]

  Any time you have chest pain, you should call your doctor for advice. Chest pain can come from the heart as well as the lungs. [health.harvard.edu]

• Tachycardia

  Pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. [ncbi.nlm.nih.gov]

  […] lung examination useful but not diagnostic wheezing, rhonchi, prolonged expiratory phase or other obstructive signs may be present but not essential Making the diagnosis no clear diagnostic criteria have been established cough in the absence of fever, tachycardia [clinicaladvisor.com]

  […] nasal congestion and runny nose Physical exam pulmonary auscultation wheezes rhonchi Studies Making the diagnosis based on history and physical exam imaging is not necessary Differential Pneumonia differentiating factor a cough with fever, tachypnea, or tachycardia [medbullets.com]

  Multifocal atrial tachycardia, an arrhythmia that can accompany COPD, manifests as a tachyarrhythmia with polymorphic P waves and variable PR intervals. [msdmanuals.com]

  Also, round 2/3 of women experience shortness of breath as a part of a normal pregnancy.[8] Cardiac tamponade presents with dyspnea, tachycardia, elevated jugular venous pressure, and pulsus paradoxus.[20] The gold standard for diagnosis is ultrasound [en.wikipedia.org]

• Myalgia

  The history should focus on type and length of symptoms, paying particular attention to worrisome systemic symptoms (such as fevers, myalgia, dyspnea) more commonly seen in pneumonia. [journals.lww.com]

• Lethargy

  In occupational exposures, generally symptoms are restricted to the cough, without any other systemic symptoms such as fever, headaches, or lethargy. None; diagnosis should be made based on history of exposure to agents that can cause a cough. [online.epocrates.com]

• The first thing that the healthcare provider will be to ask questions regarding health history, such as smoking, second hand smoke or working in noxious inhalants.
• The healthcare provider will then listen to the lungs for air exchange and wheezing. They will listen for the presence of rhonchi, prolonged expiration and wheezing.
• The sputum can be tested for the presence of bacteria.
• Oxygen saturation percentage will be measured with a pulse oximeter.
• Chest x-ray may be done to rule out the presence of pneumonia.
• Blood tests may be performed.
• If necessary, pulmonary function tests and spirometry may be done, but these are performed when other diseases are suspected, such as COPD.

The recommended treatment for acute bronchitis leans more towards palliative care, such as ibuprofen or acetaminophen for chills and fever, plenty of fluids and antitussives. Acute bronchitis is self-limiting and resolves on its own, although the cough may continue for a few more weeks. Antibiotics usually are not recommended as typically it is caused by a viral infection [6].

Antibiotic therapy may be given to high risk patients like those with asthma, smokers and Chronic Obstructive Pulmonary Disease (COPD), coupling it with bronchodilators significantly reduces hospital stay [7]. Studies further supports that using antibiotics in bronchitis cases can reduce hospital re-visits of patients from 76.8% to 27% in a 3 year period [8].

Occasionally a short-term dose of steroids may help with the inflammation of the bronchial tubes. Oral anti-inflammatory agents has been used to control the inflammation in acute bronchitis [9].

Acute bronchitis is almost always self limiting and clears up usually in 2 to 3 weeks without antibiotics. Some people, including infants, the elderly and those with pre-existing lung or cardiovascular diseases may be at higher risk of complications.

Although the main course of the acute bronchitis will subside quickly, the cough may continue for weeks after. If it lasts longer than a month, the physician may refer the patient to an otorhinolaryngologist, to see if something other than the bronchitis is causing the irritation to the lungs.

Complications

About one out of 20 people who experience acute bronchitis may develop a secondary infection which can become pneumonia.

Those that may be at risk for pneumonia are:

• Infants, babies and the elderly where there is diminished immunity and are more susceptible to a secondary infection.
• Patients with lung or heart conditions, these can include patients with COPD, heart failure patients and those with asthma.
• Diabetics may complicate to Acute Respiratory Distress Syndrome if bronchitis episodes remains too long [4].
• Smokers are more susceptible to develop chest infections, which can lead to a bacterial infection after having bronchitis.

Acute bronchitis most often caused by a viral infection. The most common viruses are Rhinovirus, Influenza A virus, Influenza B virus, Parainfluenza virus, Corona virus and Respiratory Syncytial Virus [1]. The acute form of bronchitis can also be the result of inhaling things that can irritate the bronchial tubes such as smoke and toxic fumes, including ammonia. Smoking is one of the major causes of acute bronchitis.

Sometimes acute bronchitis can be caused by bacteria, such as Streptococcus. This can happen after a viral infection, such as a cold or the flu, which does not get better. Acute bronchitis can last 3 to 10 days, but the cough can last several weeks after the infection is gone.

In the general population almost 5% will develop acute bronchitis in the US, the most occurrences happen during the fall and winter months. One of the top 5 reasons for children to see their Pediatrician is for lower respiratory infections, which include both acute and chronic bronchitis. Acute bronchitis is seen in males and females equally.

It is also seen in children under two years of age and then again between the ages of 9 and 15. Younger children exposed to second hand smoking and polycyclic aromatic hydrocarbons are more susceptible to develop bronchitis [2]. Elder patients are more prone to bronchitis because of their relatively low Forced Expiratory Volume (FEV), thus tend to accumulate more air and bacteria compared to the younger population [3].

Usually a viral infection, such as a cold or the flu, can turn into acute bronchitis, producing excess mucous and a cough lasting for several weeks in 50% of those affected, and 25% have the cough for a month or more.

An airway that is exposed to certain environmental agents, such as irritants or allergens, responds quickly to a cough and bronchospasm, followed by mucous production, edema and inflammation. This fact may explain why chronic bronchitis in children is actually asthma. The mucociliary clearance is a primary defense mechanism that helps protect the lungs from the damage caused by the inhalation of pollutants, pathogens and allergens.

There is no way to prevent acute bronchitis from occurring but steps can be taken to reduce the risks. Smoking or being in a smoking environment can be a big trigger for those who have had episodes if bronchitis or whose pulmonary status is already compromised.

Receiving an annual flu shot is also recommended. Children receiving pneumonia and flu vaccines controls protracted bacterial bronchitis and prevents recurrent coughing [10]. Avoiding the inhalation of noxious irritants, especially in enclosed areas.

Viruses, bacteria, and other agents can cause inflammation of the inner lining of the bronchial tubes, a condition which is referred to as acute bronchitis. Production of mucus causes one of the main symptoms - cough. Often acute bronchitis follows an upper respiratory infection.

Acute bronchitis is an inflammation of the bronchial tubes, the major airways into the lungs, which may be usually caused by bacteria and viruses.

Common signs and symptoms are:

• Cough
• Shortness of breath
• Wheezing
• Chest pain
• Fever
• Malaise

Most cases of bronchitis are caused by a viral infection and resolve themselves within a few days to weeks.

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