Acute bronchitis is an inflammation of the large bronchi (medium-sized airways) in the lungs that

is usually caused by viruses or bacteria and may last several days or weeks.

Bronchiolitis is a term that describes inflammation of the smaller bronchi referred to as

bronchioles. In infants, this is usually caused by respiratory syncytial viruses (RSV), and affects the
small bronchi and bronchioles more than the large. In adults, other viruses as well as some bacteria
can cause bronchiolitis and often manifest as a persistent cough at times productive of small plugs
of mucus.

*Characteristic symptoms include cough, sputum (phlegm) production, and shortness of breath and
wheezing related to the obstruction of the inflamed airways. Diagnosis is by clinical examination
and sometimes microbiological examination of the phlegm. Treatment for acute bronchitis is
typically symptomatic. As viruses cause most cases of acute bronchitis, antibiotics should not be
used unless microscopic examination of Gram stained sputum reveals large numbers of bacteria.*

*Acute bronchitis can be caused by contagious pathogens. In about half of instances of acute
bronchitis a bacterial or viral pathogen is identified. Typical viruses include respiratory syncytial
virus, rhinovirus, influenza, and others:
• Damage caused by irritation of the airways leads to inflammation and leads to neutrophils
infiltrating the lung tissue.
• Mucosal hypersecretion is promoted by a substance released by neutrophils.
• Further obstruction to the airways is caused by more goblet cells in the small airways. This
is typical of chronic bronchitis.
• Although infection is not the reason or cause of chronic bronchitis it is seen to aid in
sustaining the bronchitis.

Signs and symptoms

Bronchitis may be indicated by an expectorating cough, shortness of breath (dyspnea) and
wheezing. Occasionally chest pains, fever, and fatigue or malaise may also occur. Additionally,
bronchitis caused by Adenoviridae may cause systemic and gastrointestinal symptoms as well.
However the coughs due to bronchitis can continue for up to three weeks or more even after all
other symptoms have subsided.

Diagnosis
A physical examination will often reveal decreased intensity of breath sounds, wheezing, rhonchi
and prolonged expiration. Most doctors rely on the presence of a persistent dry or wet cough as.
evidence of bronchitis.
A variety of tests may be performed in patients presenting with cough and shortness of breath:
• A chest X-ray that reveals hyperinflation; collapse and consolidation of lung areas would
support a diagnosis of pneumonia. Some conditions that predispose to bronchitis may be
indicated by chest radiography.
• A sputum sample showing neutrophil granulocytes (inflammatory white blood cells) and
culture showing that has pathogenic microorganisms such as Streptococcus spp.
• A blood test would indicate inflammation (as indicated by a raised white blood cell count
and elevated C-reactive protein).
Treatment
Antibiotics
Only about 5-10% of bronchitis cases are caused by a bacterial infection. Most cases of bronchitis
are caused by a viral infection and are "self-limited" and resolve themselves in a few weeks. Acute
bronchitis should not be treated with antibiotics unless microscopic examination of the sputum
reveals large numbers of bacteria. Treating non-bacterial illnesses with antibiotics leads to the
promotion of antibiotic-resistant bacteria, which increase morbidity and mortality.

Smoking cessation
Many physicians recommend that to help the bronchial tree heal faster and not make bronchitis
worse, smokers should quit smoking completely to allow their lungs to recover from the layer of tar
that builds up over time.

Antihistamines
Using over-the-counter antihistamines may be harmful in the self-treatment of bronchitis.
An effect of antihistamines is to thicken mucus secretions. Expelling infected mucus via coughing
can be beneficial in recovering from bronchitis. Expulsion of the mucus may be hindered if it is
thickened. Antihistamines can help bacteria to persist[citation needed] and multiply in the lungs by
increasing its residence time in a warm, moist environment of thickened mucus.
Using antihistamines along with an expectorant cough syrup may be doubly harmful encouraging
the production of mucus and then thickening that which is produced. Using an expectorant cough
syrup alone might be useful in flushing bacteria from the lungs. Using an antihistamine along with
it works against the intention of using the expectorant.
Prognosis
Acute bronchitis usually lasts a few days or weeks. It may accompany or closely follow a cold or
the flu, or may occur on its own. Bronchitis usually begins with a dry cough, including waking the
sufferer at night. After a few days it progresses to a wetter or productive cough, which may be
accompanied by fever, fatigue, and headache. The fever, fatigue, and malaise may last only a few
days; but the wet cough may last up to several weeks.
Should the cough last longer than a month, some doctors may issue a referral to an
otorhinolaryngologist (ear, nose and throat doctor) to see if a condition other than bronchitis is
causing the irritation. It is possible that having irritated bronchial tubes for as long as a few months
may inspire asthmatic conditions in some patients.
In addition, if one starts coughing mucus tinged with blood, one should see a doctor. In rare cases,
doctors may conduct tests to see if the cause is a serious condition such as tuberculosis or lung
cancer.