Bronchitis

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Questions to Ask Your Pulmonary Care Team
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Signs and Symptoms

The first sign of bronchitis is usually a persistent dry cough (associated with an upper respiratory infection). Eventually, coughing brings up sputum from the lungs that may be thin, clear, and white. As infection progresses, the sputum becomes thick and yellow, green, or brown. A thick, pus-filled discharge suggests a bacterial infection.

Other symptoms include the following:

• Burning pain, wheezing, and crackling in the chest
• Painful and difficult breathing
• Malaise
• Low-grade fever (101ºF–102ºF)

Insomnia can develop with persistent nighttime coughing. Symptoms usually last 3 to 7 days; a dry cough commonly persists several weeks after the infection resolves.

Complications
Left untreated, acute bronchitis can occasionally progress to pneumonia and chronic bronchitis, particularly in people with suppressed immune systems or lung disease. Chronic bronchitis is associated with long-term constriction of airways, bacterial infection, and other diseases, including asthma, emphysema, and chronic obstructive pulmonary disease (COPD).

Diagnosis

Diagnosis is made by the health care provider taking a careful history of symptoms and performing a physical examination. A stethoscope is used to listen to the lungs. If symptoms are prolonged or severe, a chest x-ray may be performed to check for a more serious condition.

Treatment

Viral bronchitis usually resolves without treatment. Increasing fluid intake helps reduce congestion and is necessary when fever is present. Rest is also helpful, and fever and back and muscle pain may be treated with acetaminophen (Tylenol®). Over-the-counter cough suppressants and expectorants and steamy showers can temporarily relieve symptoms by thinning mucus and opening airways, allowing for easier expulsion of mucus.

Bacterial bronchitis is treated with antibiotics, such as tetracycline, erythromycin, and amoxicillin (in children), depending on the causative bacteria. Side effects of these medications are usually mild and include nausea, vomiting, diarrhea, and abdominal pain.

Gemiflaoxacin mesylate (FACTIVE®) has been approved by the Food and Drug Administration (FDA) to treat drug-resistant bacterial bronchitis. This antibiotic medication, which is taken orally in tablet form, is administered once daily for 5 days. Side effects include diarrhea, rash, and nausea.

Rest is beneficial until exertion is easier. Afterwards, moderate cardiorespiratory exercise may help the lungs regain normal function and expel mucus.

Prevention

Good hygiene can reduce the spread of viral infection. Immunizations against influenza and pertussis can reduce the risk for bacterial bronchitis. Avoiding cigarettes, second-hand smoke, and heavy fumes can hasten recovery, because the lungs' task of filtering pollutants is made easier.

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