RESPIRATORY DISORDER

Bronchitis

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What is Bronchitis?
The bronchial tubes, or bronchi, connect the windpipe to the lungs. When the lining of the bronchial tubes becomes inflamed or infected, this condition is called bronchitis. Bronchitis reduces the amount of air and oxygen that can flow into the lungs and causes a heavy mucus or phlegm to form in the airways. Bronchitis may be short-lived (acute) or chronic, meaning that it lasts a long time and often recurs.

Causes of Bronchitis
Causes of Acute Bronchitis :-

Acute bronchitis is most often caused by viruses that infect the epithelium of the bronchi, resulting in inflammation and increased secretion of mucus. In addition to viruses, bacteria, exposure to tobacco smoke, exposure to pollutants or solvents, and gastro esophageal reflux disease (GERD) can also cause acute bronchitis.

Causes of Chronic Bronchitis :-

Chronic bronchitis, a type of chronic obstructive pulmonary disease, is defined by a productive cough that lasts for 3 months or more per year for at least 2 years. It is most commonly caused by cigarette smoking. However, it can also be the result of continuous attacks of acute bronchitis. Air pollution, dust, toxic gases, and other industrial fumes are known to be responsible for the condition.

Symptoms of Bronchitis

Signs and symptoms for both acute and chronic bronchitis include:

Inflammation or swelling of the bronchi. Coughing Production of clear, white, yellow, grey or green mucus. Shortness of breath Wheezing Fatigue

Fever and chills Chest pain or discomfort Blocked or runny nose Additional symptoms of chronic bronchitis include : Ankle, feet and leg swelling Blue-colored lips from low levels of oxygen. Frequent respiratory infections (such as colds or the flu).

Effects of Bronchitis
Acute bronchitis usually results in a nagging cough that lingers for several weeks even after the bronchitis resolves. Chronic bronchitis's long-term inflammation leads to scarring of the bronchial tubes and airways, which leads to production of excessive mucus.

Bronchitis : Preventions
These measures help prevent bronchitis and protect your lungs in general:

Avoid tobacco smoke Whether it includes your own smoke or secondhand smoke from others, try to avoid it. Get an annual flu shot Most cases of acute bronchitis result from influenza. So, getting your yearly flu shot can help protect you from both bronchitis and the flu.

Limit the use of cough suppressants since mucus should be coughed up to help unblock bronchi. Reduce intake of foods such as sugar, white flour, dairy and others that may be mucusproducing.

Wash your hands. To reduce your risk of catching a viral infection, wash your hands frequently and get in the habit of using hand sanitizers. Use an air humidifier. Warm, moist air loosens mucus in the airways and helps to relieve coughing.

Chronic bronchitis. Bronchogram with localized view of left hilum. Rounded collections of contrast lie adjacent to bronchial walls and are particularly well seen below the left main stem bronchus (arrow) in this film. They are caused by contrast in dilated mucous gland ducts. (From Armstrong P, Wilson AG, Dee P: Imaging of diseases of the chest, St. Louis, 1990, Mosby.)

Emphysema

Bronchitis

Asthma

Chronic obstructive pulmonary disease. Bronchitis, emphysema, and asthma may present alone or in combination.

Chest X-ray film of a patient with chronic bronchitis. Note the translucent (dark) lung fields, depressed diaphragms, and long and narrow heart.

Chronic Bronchitis

Chronic bronchitis. Inset, Weakened distal airways in emphysema, a common secondary anatomic alteration of the lungs.

ACUTE BRONCHITIS
Acute inflammation of the tracheobronchial tree, generally self-limited and with eventual complete healing and return of function. Though commonly mild, bronchitis may be serious in debilitated patients and those with chronic lung or heart disease. Pneumonia is a critical complication.

Acute bronchitis:
Acute infectious bronchitis Acute irritative bronchitis Cough-variant asthma

Acute infectious bronchitis

It may develop after a common cold or other viral infection of the nasopharynx, throat, or tracheobronchial tree, often with secondary bacterial infection. Mycoplasma pneumoniae and Chlamydia also cause a. in. b., often in young adults.

Acute infectious bronchitis

Recurrent attacks often complicate chronic bronchopulmonary diseases, which impair bronchial clearance mechanisms. Repeated infections may be associated with:
chronic sinusitis bronchiectasis bronchopulmonary alergy in children hypertrophied tonsils and adenoids.

Acute irritative bronchitis

May be caused by various mineral and vegetable dusts; fumes from strong acids, ammonia, certain volatile organic solvents, chlorine, hydrogen sulfide, sulfur dioxide, or bromine; the environmental irritants ozone and nitrogen dioxide; or tobacco or other smoke.

Cought-variant asthma
Asthma in which the degree of bronchoconstriction is not sufficient to produce overt wheezing. It may be caused by allergen inhalation, or chronic exposure to an airways irritant (airways hyperreactivity relatively mild)

Acute bronchitis: pathology and pathophysiology

Hyperemia of the mucous membranes desquamation, edema leukocytic infiltration of the submucosa production of sticky or mucopurulent exudate

Acute bronchitis: pathology and pathophysiology

The protective functions of bronchial cilia, phagocytes, and lymphatics are disturbed bacteria may invade the bronchi accumulation of cellular debris and mucopurulent exudate

Acute bronchitis: pathology and pathophysiology

Cough, though distressing, is essential to eliminate bronchial secretions

edema of the bronchial walls retained secretions in same cases spasm of bronchial muscules

Acute bronchitis: Symptoms and signs

Acute infectious bronchitis is often preceded by symptoms of a URI:

coryza malaise chilliness slight fever back and muscle pain sore throat

Acute bronchitis: symptoms and signs

Onset of cough usually signals onset of bronchitis.
The cough is initially dry and nonproductive small amounts of viscid sputum are raised after a few hours or days it may later become more abundant and mucoid or mucopurulent

Acute bronchitis: symptoms and signs

Frankly purulent sputum suggests
superimposed bacterial infection

Acute bronchitis: symptoms and signs

In a severe uncomplicated case, fever ~38,5C may be present for up to 3 to 5 days, following which acute

symptoms subside.

Acute bronchitis: symptoms and signs

Though cough may continue for several weeks.

Acute bronchitis: symptoms and signs

Persistent fever

suggests
complicating pneumonia.

Acute bronchitis: symptoms and signs

Dyspnea may be noted

secondary to the airways

obstruction.

Acute bronchitis: symptoms and signs

Pulmonary signs are few

in uncomplicated acute
bronchitis.

Acute bronchitis: symptoms and signs

scattered high- or low-pitched rhonchi occasional crackling or moist rales at the bases wheezing, especially after cough.

Acute bronchitis: symptoms and signs

Persistent localized signs

suggest development of
bronchopneumonia.

Acute bronchitis: diagnosis

Diagnosis is usually based on the symptoms and signs

If the symptoms and signs are serious or prolonged chest x-ray

Acute bronchitis: diagnosis

Arterial blood gases should be monitored when serious underlying chronic respiratory disease is present.

Acute bronchitis: diagnosis

In persons who do not respond to antibiotic therapy, or in special circumstances, Gram stain and sputum culture should be done to determine the causative organism.