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dr. Bintang Y. M. Sinaga Sp.

Levels of competence

Standar Kompetensi Dokter , Konsil Kedokteran Indonesia, 2006



Infection of the lower respiratory

Generally follows an upper
respiratory tract infection
From viral or bacterial infection
Airways become inflamed; irritated
Mucus production
(CDC, Centre for Deseases Control and Prevention))

Acute bronchitis usually comes on quickly and gets better after several weeks.

Bronchoscopic examination

What causes acute bronchitis?

Acute bronchitis occurs most often due to a viral
infection that causes the inner lining of the bronchial
tubes to become inflamed and undergo the changes
that occur with any inflammation in the body.
Common viruses include the rhinovirus, respiratory
syncytial virus (RSV), influenza and the parainfluenza
Bacteria in rare cases can also cause bronchitis (a
few examples include, Mycoplasma, Pneumococcus,
Klebsiella, Haemophilus.
Chemical irritants for example, tobacco smoke,
gastric reflux, solvents can

There are two types of bronchitis:

Acute bronchitis is caused in most cases over 90% by a
viral infection and may begin after develop a cold or
sore throat. Bronchitis usually begins with a dry cough.
After a few days it progresses to a productive cough,
which may be accompanied by fever, fatigue, and
headache. The cough may last up to several weeks. If
not treated acute bronchitis can progress to pneumonia.
Chronic bronchitis is caused in most cases by exposure
to tobacco smoke or other irritants. As a result, the
airways produce lots of mucus. Inflammation and extra
mucus reduce air flow and cause severe coughing and
spitting up of phlegm. Phlegm production and
inflammation over many years may lead to permanent
lung damage and cause disability or even death.

Signs and Symptoms of Bronchitis

Cough that produces mucus (may
be without mucus the first few days)
Soreness in the chest
Mild headache
Mild body aches
Low-grade fever (less than 40C)
Watery eyes
Sore throat

Mild dyspnea
Pleuritic chest pain (possible)
Cough with clear to purulent sputum
Diffuse rhonchi and crackles

Chest x-ray -rule out pneumonia

Films show no evidence of lung


Reduce brochospasm
Promote sputum expectoration

2. Oral antibiotics if needed

3. Symptom management for fever
and cough

Chest physiotheraphy to mobilize

Hydration to liquefy secretions


Encourage mobilization of secretion

Coughing exercises
Deep breathing exercises

2. Adequate fluid intake

To liquefy secretions
Prevent dehydration caused by
fever and tachypnea

3. Encourage rest
4. Avoid bronchial irritants
5. Eat nutritious foods to facilitate
6. Instruct patient to comply taking
7. Caution the patient on using OTCs

Complications of acute bronchitis

Acute bronchitis usually resolves spontaneously
(about 2-3 weeks) with supportive care. If wheezing
and shortness of breath occurs the patient should
seek medical care.
In patients who have underlying lung conditions, the
inflammation can cause lung tissue to function
Pneumonia or infection of the lung tissue itself may

Acute Bronchitis at a Glance

Acute bronchitis describes an infection and inflammation of the
breathing tubes leading to cough and occasional wheezing.
Treatment is supportive keeping fever under control and the
patient well hydrated.
Wheezing is often treated with inhaled short acting
bronchodilator, either by puffer (HFA) or nebulizer.
Steroid medication may be used short term to help decrease the
inflammation within the bronchial tubes.
Patients with underlying lung diseases such as asthma or COPD
may be at greater risk of developing acute bronchitis.
Antibiotics are not commonly prescribed for acute bronchitis but
may be prescribed if specifically indicated.

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