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Bronchitis is inflammation of the bronchi (large and medium-sized airways) in the lungs that causes coughing.[1] Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain.[1] Bronchitis can be acute or chronic.[1]

Acute bronchitis usually has a cough that lasts around three weeks,[4] and is also known as a chest cold.[5] In more than 90% of cases the cause is a viral infection.[4] These viruses may be spread through the air when people cough or by direct contact.[6] A small number of cases are caused by a bacterial infection such as Mycoplasma pneumoniae or Bordetella pertussis.[4] Risk factors include exposure to tobacco smoke, dust, and other air pollution.[6] Treatment of acute bronchitis typically involves rest, paracetamol (acetaminophen), and nonsteroidal anti-inflammatory drugs (NSAIDs) to help with the fever.[7][8]

Chronic bronchitis is defined as a productive cough – one that produces sputum – that lasts for three months or more per year for at least two years.[9][10] Many people with chronic bronchitis have chronic obstructive pulmonary disease (COPD).[11] Tobacco smoking is the most common cause, with a number of other factors such as air pollution and genetics playing a smaller role.[12] Treatments include quitting smoking, vaccinations, rehabilitation, and often inhaled bronchodilators and steroids.[13] Some people may benefit from long-term oxygen therapy.[13]

Acute bronchitis is one of the most common diseases.[7][14] About 5% of adults are affected and about 6% of children have at least one episode a year.[2][15] Acute bronchitis is the most common type of bronchitis.[5] In the United States, in 2018, 9.3 million people were diagnosed with chronic bronchitis.[16][17]

Acute bronchitis

Bronchitis

Acute bronchitis, also known as a chest cold, is short term inflammation of the bronchi of the lungs.[4][6] The most common symptom is a cough, that may or may not produce sputum.Acute bronchitis usually has a cough that lasts around three weeks,[4] and is also known as a chest cold.[5] In more than 90% of cases the cause is a viral infection.[4] These viruses may be spread through the air when people cough or by direct contact.[6] A small number of cases are caused by a bacterial infection such as Mycoplasma pneumoniae or Bordetella pertussis.[4] Risk factors include exposure to tobacco smoke, dust, and other air pollution.[6] Treatment of acute bronchitis typically involves rest, paracetamol (acetaminophen), and nonsteroidal anti-inflammatory drugs (NSAIDs) to help with the fever.[7][8]

Chronic bronchitis is defined as a productive cough – one that produces sputum – that lasts for three months or more per year for at least two years.[9][10] Many people with chronic bronchitis have chronic obstructive pulmonary disease (COPD).[11] Tobacco smoking is the most common cause, with a number of other factors such as air pollution and genetics playing a smaller role.[12] Treatments include quitting smoking, vaccinations, rehabilitation, and often inhaled bronchodilators and steroids.[13] Some people may benefit from long-term oxygen therapy.[13]

Acute bronchitis is one of the most common diseases.[7][14] About 5% of adults are affected and about 6% of children have at least one episode a year.[2][15] Acute bronchitis is the most common type of bronchitis.[5] In the United States, in 2018, 9.3 million people were diagnosed with chronic bronchitis.[16][17]

Acute bronchitis, also known as a chest cold, is short term inflammation of the bronchi of the lungs.[4][6] The most common symptom is a cough, that may or may not produce sputum.[4][18] Other symptoms may include coughing up mucus, wheezing, shortness of breath, fever, and chest discomfort.[6] Fever when present is mild.[19] The infection may last from a few to ten days.[6] The cough may persist for several weeks afterwards, with the total duration of symptoms usually around three weeks.[4][6] Symptoms may last for up to six weeks.[7]

Cause

In more than 90% of cases, the cause is a viral infection.[4] These viruses may spread through the air when people cough or by direct contact.[6] Risk factors include exposure to tobacco smoke, dust, and other air pollutants.[6] A small number of cases are due to bacteria such as Mycoplasma pneumoniae or Bordetella pertussis.[4]

Diagnosis

Diagnosis is typically based on a person's signs and symptoms.[19] The color of the sputum does not indicate if the infection is viral or bacterial.[4] Determining the underlying organism is usually not required.[4] Other causes of similar symptoms include asthma, pneumonia, bronchiolitis, bronchiectasis, and COPD.[2][4] A chest X-ray may be useful to detect pneumonia.[4]

Another common sign of bronchitis is a cough which lasts ten days to three weeks. If the cough lasts for longer than a month, it may become chronic bronchitis. In addition, a fever may be present. Acute bronchitis is normally caused by a viral infection. Typically, these infections are rhinovirus, parainfluenza, or influenza. No specific testing is normally needed in order to diagnose acute bronchitis.[19]

Treatmentviral infection.[4] These viruses may spread through the air when people cough or by direct contact.[6] Risk factors include exposure to tobacco smoke, dust, and other air pollutants.[6] A small number of cases are due to bacteria such as Mycoplasma pneumoniae or Bordetella pertussis.[4]

Diagnosis<

Diagnosis is typically based on a person's signs and symptoms.[19] The color of the sputum does not indicate if the infection is viral or bacterial.[4] Determining the underlying organism is usually not required.[4] Other causes of similar symptoms include asthma, pneumonia, bronchiolitis, bronchiectasis, and COPD.[2][4] A chest X-ray may be useful to detect pneumonia.[4]

Another common sign of bronchitis is a cough which lasts ten days to three weeks. If the cough lasts for longer than a month, it may become chronic bronchitis. In addition, a fever may be present. Acute bronchitis is normally caused by a viral infection. Typically, these infections are rhinovirus, parainfluenza, or influenza. No specific testing is normally needed in order to diagnose acute bronchitis.[19]

One form of prevention is to avoid smoking and other lung irritants.[20] Frequent hand washing may also be protective.[20] Treatment for acute bronchitis usually involves rest, paracetamol (acetaminophen), and NSAIDs to help with the fever.[7][8] Cough medicine has little support for its use, and is not recommended in children under the age of six.[4][21] There is tentative evidence that salbutamol may be useful in treating wheezing; however, it may result in nervousness and tremors.[4][22] Antibiotics should generally not be used.[18] An exception is when acute bronchitis is due to pertussis.[4] Tentative evidence supports honey and pelargonium to help with symptoms.[4] Getting plenty of rest and drinking enough fluids are often recommended as well.[23] Chinese medicinal herbs are of unclear effect.[24]

EpidemiologyAcute bronchitis is one of the most common diseases.[7][14] About 5% of adults are affected, and about 6% of children have at least one episode a year.[2][15] It occurs more often in the winter.[2] More than 10 million people in the US visit a doctor each year for this condition, with about 70% receiving antibiotics which are mostly not needed.[7] There are efforts to decrease the use of antibiotics in acute bronchitis.[14] Acute bronchitis is the most common type of bronchitis.[5]

Chronic bronchitis

The condition

The condition of bronchitis has been recognised for many centuries, in several different cultures including the Ancient Greek, Chinese, and Indian, with the presence of excess phlegm and cough noted in recognition of the same condition.[64]

In Britain in 1808, a physician Charles Badham was the first person to describe the condition and name the acute form as acute bronchitis. This was written of in a book entitled Inflammatory conditions o

In Britain in 1808, a physician Charles Badham was the first person to describe the condition and name the acute form as acute bronchitis. This was written of in a book entitled Inflammatory conditions of the bronchia. In this book Badham distinguished three forms of bronchitis including acute and chronic. A second edition of this book was renamed An Essay on Bronchitis and published in 1814.[64] Bradham used the term catarrh to refer to the cardinal symptoms of chronic cough and mucus hypersecretion of chronic bronchitis, and described chronic bronchitis as a disabling disorder.[65]

In 1901 an article was published on the treatment of chronic bronchitis in the elderly. The symptoms described have remained unchanged. The cause was thought to be brought on by dampness, cold weather, and foggy conditions, and treatments were aimed towards various cough mixtures, respiratory stimulants, and tonics. It was noted that something other than the weather was thought to be at play.[66] Exacerbations of the condition were also described at this time. Another physician Harry Campbell was referred to who had written in the British Medical Journal a week before. Campbell had suggested that the cause of chronic bronchitis was due to toxic substances, and recommended pure air, simple food, and exercise to remove them from the body.[66]

A joint research programme was undertaken in Chicago and London from 1951 to 1953 in which the clinical features of one thousand cases of chronic bronchitis were detailed. The findings were published in the Lancet in 1953.[67] It was stated that since its introduction by Badham, chronic bronchitis had become an increasingly popular diagnosis. The study had looked at various associations such as the weather, conditions at home, and at work, age of onset, childhood illnesses, smoking habits, and breathlessness. It was concluded that chronic bronchitis invariably led to emphysema, particularly when the bronchitis had persisted for a long time.[67]

In 1957 it was noted that at the time there were many investigations being carried out into chronic bronchitis and emphysema in general, and among industrial workers exposed to dust.[68] Excerpts were published dating from 1864 in which Charles Parsons had noted the occurring consequence of the development of emphysema from bronchitis. This was seen to be not always applicable. His findings were in association with his studies on chronic bronchitis among pottery workers.[68]

A CIBA (now Novartis) meeting in 1959, and a meeting of the American Thoracic Society in 1962, defined chronic bronchitis as a component of COPD, in the terms that have not changed.[65][69]

Eosinophilic bronchitis is a chronic dry cough, defined by the presence of an increased number of a type of white blood cell known as eosinophils. It has a normal finding on X-ray and has no airflow limitation.[70]

Protracted bacterial bronchitis

Protracted bacterial bronchitis in children, is defined as a chronic productive cough with a positive Protracted bacterial bronchitis in children, is defined as a chronic productive cough with a positive bronchoalveolar lavage that resolves with antibiotics.[71][72] Protracted bacterial bronchitis is usually caused by Streptococcus pneumoniae, non-typable Haemophilus influenzae, or Moraxella catarrhalis.[72] Protracted bacterial bronchitis (lasting more than 4 weeks) in children may be helped by antibiotics.[73]

Plastic bronchitis

Plastic bronchitis is a rarely found condition in which thickened secretions plug the bronchi.[74][75] The plugs are rubbery or plastic-feeling (thus the name). The light-colored plugs take the branching shape of the bronchi that they fill, and are known as bronchial casts.[74] When these casts are coughed up, they are firmer in texture from typical phlegm or the short, softer mucus plugs seen in some people with asthma.[74] However, some people with asthma have larger, firmer, more complex plugs. These differ from the casts seen in people whose plastic bronchitis is associated with congenital heart disease or lymphatic vessel abnormalities mainly because eosinophils and Charcot–Leyden crystals are present in the asthma-associated casts but not in the others.[74]

Casts obstruct the airflow, and can result in the overinflation of the opposite lung. Plastic bronchitis usually occurs in children. Some cases may result from abnormalities in the lymphatic vessels. Advanced cases may show imaging similarities to lymphatic vessels. Advanced cases may show imaging similarities to bronchiectasis.[75]

Aspergillus bronchitis is one of the Aspergillosis spectrum of diseases, in which the bronchi are specifically subject to a fungal infection. This differs from the other pulmonary aspergillosis conditions, in that it need not affect just the immunocompromised.[76][77]

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