الأربعاء، 22 أغسطس 2012

Acute Bronchitis

Acute bronchitis is an infection of the bronchial (say: brawn-kee-ull) tree. The bronchial tree is made up of the tubes that carry air into your lungs. When these tubes get infected, they swell and mucus (thick fluid) forms inside them. This makes it hard for you to breathe.
Acute bronchitis is bronchitis that lasts a short time (several weeks or less), while chronic bronchitis is bronchitis that is long-lasting or recurring (and is usually caused by constant irritation of the bronchial tree, such as from smoking).




Acute Bronchitis - Cause

Acute bronchitis is usually caused by a virus. It is more common during the winter months and often develops after an upper respiratory illness such as influenza (flu) or a cold caused by a virus such as coronavirus, adenovirus, or a rhinovirus. Respiratory syncytial virus (RSV) may be a cause, especially in adults older than 65. About 10% of the time, acute bronchitis is caused by bacteria.1
Acute bronchitis can also be caused by exposure to smoke, chemicals, or air pollution, all of which can irritate the bronchial tubes. It can also develop from accidentally inhaling (aspirating) food or vomit.
See a picture of acute bronchitis camera.

How acute bronchitis is spread

Acute bronchitis is spread when an infected person coughs, sneezes, or talks and liquid droplets containing virus particles or bacteria are released into the air and onto objects. Then you may:
  • Breathe air that contains the virus particles or bacteria.
  • Touch an object that has been touched by an infected person and then touch your eyes, nose, or mouth without washing your hands.
 symptoms of acute bronchitis?

Inflammation of the bronchial tubes narrows the inside opening of the bronchial tubes. Narrowing of the bronchial tubes result in increased resistance, this increase makes it more difficult for air to move to and from the lungs. This can cause wheezing, coughing, and shortness of breath. The cough may consist of sputum due to the secretions from the inflamed cells that line the bronchi. By coughing, the body attempts to expel secretions that clog the bronchial tubes. If these secretions contain certain inflammatory cells, discoloration of the mucus may result often in a green or yellow color. Sometimes the severity of the inflammation may result in some bleeding.
As with any other infection, there may be associated fever, chills, aches, soreness and the general sensation of feeling poorly or malaise.

Physical examination

The health care practitioner may examine of the patient's upper airways to look for signs of ear, nose, or throat infection including redness of the tympanic membranes (ear drums), runny nose, and post nasal drip. Redness of the throat or swelling and pus on the tonsils can help distinguish common cold, tonsillitis, and acute bronchitis symptoms. The neck may be palpated or felt to check for swollen lymph nodes. Listening to the lungs may reveal decreased air entry and wheezing.
A chest X-ray may be considered by the health care practitioner if there is a concern that a pneumonia or infection of lung tissue is present.
Blood tests are usually not helpful; occasionally, cultures of sputum are done if a bacterial pathogen is suspected.
treatments for acute bronchitis

Decreasing inflammation is the goal for treating acute bronchitis.
Albuterol inhalation, either with a hand held device (meter dosed inhaler, MDI) or nebulizer will help dilate the bronchial tubes.
Short-term steroid therapy will help minimize inflammation within the bronchial tubes. Prednisone is a common prescription medication that enhances the anti-inflammatory effects of the steroids produced within the body by the adrenal glands. Topical inhaled steroids may also be of benefit with fewer potential side effects.
It is important to keep the patient comfortable by treating fever with acetaminophen or ibuprofen. Drinking plenty of fluid will keep the patient well hydrated and hydration keeps secretions into the bronchial tubes more liquid and easier to expel.
Antibiotics are not necessarily indicated for the treatment of acute bronchitis. Occasionally they may be prescribed should a bacterial infection be present in addition to the usual virus that causes acute bronchitis. However, most acute bronchitis is caused by viruses and no antibiotics are needed.
Although good hydration will help remove secretions into the bronchi, other treatments (for example, Mucinex, Robitussin and others that contain guaifenesin) can help clear secretions though this is often a highly variable finding.
Cough is a very violent action that results in dynamic collapse of the airways. This collapse results in the walls of the airways banging against one another. This action of cough can cause further inflammation and help perpetuate the problem by sustaining and increasing inflammation. Cough suppression with cough drops or other liquid suppressants (for example, Vicks 44, Halls, and cough syrups that contain dextromethorphan) help to break this vicious cycle. In addition, if the person smokes, they should stop. If the acute bronchitis is being caused by inhaled smoke or chemicals, the patient should be removed from these irritant sources.

The treatment of acute bronchitis is geared toward prevention, control, and relief of symptoms (supportive care). In some cases, the following is all that is needed:
  • drink plenty of fluids to maintain proper hydration (avoiding dehydration and humidify air); and
  • use of acetaminophen and ibuprofen to treat fever and decrease the inflammatory resposne.
The treatments section above covers those actions that can usually be done at home. However, people with medical conditions such as high blood pressure should be careful to choose those products approved for patients with high blood pressure because some cough/cold formulations may further increase a person's blood pressure to elevated or dangerous levels. People with diabetes should also choose cough and cold products that will not affect their blood glucose levels. If individuals are unsure which products are safe, they should contact their primary health care practitioner for advice.
For patients with underlying lung disease such as asthma or COPD, increased use of albuterol or similar inhaled medications may be indicated. However, the health care practitioner should be contacted when a patient considers altering their medication usa

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