Bronchitis

Bronchitis is a lower respiratory tract infection which occurs as a result of chronic irritation of the bronchial mucosa leaving it inflamed and narrowed by excess mucus secretion. It mainly develops as a result of prolonged exposure to irritants that may be smokes, dust or pathogens. Bronchitis mainly occurs as either acute or chronic.

Bronchitis Drugs

Bronchitis Symptoms

Symptomatically bronchitis may mimic other COPDs. Therefore, it is important to get a clear picture of the patient’s job description and social history so as to determine whether there is chronic chemical exposure or a long history of smoking. A previous history of upper respiratory tract infection might also be useful. Productive cough with clear, yellowish-green or blood tinged sputum

  • Fever
  • Dyspnea
  • Cyanosis
  • Sore throat
  • Running nose
  • Headache
  • Nausea and vomiting
  • General malaise
  • Mayalgia
  • Sometimes diarrhea

Bronchitis Causes

Bronchitis is primarily caused by chronic irritation of bronchial mucosa which may be as result of disease-causing pathogen or environmental factors that you may be exposed to. The most common cause of bronchitis is smoking which destroys the ciliary and eventually renders alveolar macrophages inactive with end result being hyperplasia and hypertrophy of goblet cells. Other than this bronchitis may also follow upper respiratory tract infections that was poorly treated or was left untreated altogether. Some of the organisms that are implicated include: Bacteria

  • Mycoplasma gondii
  • Chlamydia pneumoniae
  • Streptococcus pneumoniae
  • Moraxella catarrhalis
  • Haemophilus influenzae
  • Bordetella pertussis

Viruses

Bronchitis Diagnosis

Bronchitis diagnosis mainly entails two very important aspects i.e. clinical assessment and laboratory and radiological investigations. First physical examination on your chest is done where the following are elicited:-

  • Lymphadenopathy
  • Rhinorrhea
  • Wheeze
  • Rhonchi
  • Use of accessory muscles during respiration
  • Inspiratory stridor
  • Coughing
  • Cyanosis
  • Finger and toe clubbing in case of extreme pulmonary insufficiency

Laboratory Investigations

  • Blood for full hemogram
  • Sputum for microscopy culture and sensitivity
  • Lung function tests including spirometry and blood gas analysis

Radiological Investigations

  • Chest x-ray

Bronchitis Treatment

Bronchitis is managed by quite a number of drugs. This is because you may be required to manage the patient symptomatically while treating the underlying cause. Below are the regimes used while managing bronchitis: Supportive Management

  • Ensure bed rest
  • Give Oxygen when patient has severe pulmonary insufficiency
  • Increase fluid intake to avoid dehydration
  • In case of COPD e.g. Asthma you may be required to use your inhaler taken when necessary. Steam inhalation may be effective in other conditions.
  • Analgesics e.g. Acetaminophen – 500 mg P.O every 8 hours for 3 days for children OR 1 gm P.O every 8 hours for Adults

Definitive management Antibiotics

  • Amoxil
  • Adults: 250-500mg P.O every 8 hours for 7-10 days
  • Children:
    • ?6 years: 250 mg P.O every 8 hours for 7-10 days
    • < 6 months: 5mls P.O every 8 hours for 7-10 days

Levofloxacin

  • Adults: 500 mg P.O/ IV every 24 hours for 1 week

Doxycyclin

  • Adults: 100 mg P.O/IV every 12 hours for 5-7 days