BRONCHITIS

ACUTE BRONCHITIS

DEFINITION
Acute bronchitis is defined as the inflammation of the
bronchi and it is usually occurs in the trachea. It is also
called Bracheo Bronchitis.

ETIOLOGICAL FACTORS
Chronic Lung Diseases
Extension of Upper Respiratory Tract Infection
Physical or Chemical agents such as dust, smoke, volatile
fumes

Air Pollution
Climatic changes (Peak during later winter or spring)
Bacterial Pathogens (Streptococcus Pneumonia, Hemophilius
Influenza)

Viral Pathogens (Rhinovirus, Adenovirus)

PATHOPHYSIOLOGY
Due to the etiological factors
(weakens in defense mechanism)
Pathogenic bacteria or virus reside
in nose and pharynx
Colonization occurs in trachea and
bronchi
Inflammatory process occurs in
tracheal wall
Increased blood flow to the affected
side
Increased pulmonary secretions

CLINICAL
Pleuritic
MANIFESTATIONS
Shortness of
chest pain

Signs and
symptoms usually
lasts from 1 week
1 month

breath

(Pain on
inspiration)

Painful
cough with
sputum
production

Rhonchi and
wheezes

Rales
(Crackles)

Low grade
to high
grade fever

Pain
beneath
sternum

Rapid
respiration

Malaise

Coryza

Sore throat

DIAGNOSTIC FEATURES

History Collection Regarding any history of chronic lung

diseases and their occupational pattern.

Physical Examination On palpation and percussion the

patient is having tenderness over sternum and increased in
their respiratory rate. On auscultation crackles sound can be
heard and having mild to high grade fever.

Sputum Culture To find out the presence of bacterial or

viral invasion and its colonization.

Chest X-Ray - It reveals there is normal in its findings.

MEDICAL MANAGEMENT
Mainly focus on symptomatic and supportive management
only.
Increases the fluid intake such as hot water to 2-3 L / Day to
loosen the secretions.
Administration of mild analgesics and Antipyretics to reduce
the temperature and pain along with Aspirin, Acetaminophen,
Ibuprofen every 4-6 hours.
Codeine or Dextromethorphan may be administered to
maintain a good sleeping pattern.

MEDICAL MANAGEMENT
Broncho-Active substances such as inhaled Beta2-Agonist is
used for patient with wheezing and other respiratory
discomfort.
If the patient is diagnosed with bacterial infections, antibiotics
are prescribed.
Amantadine / Kimantadine may be given early for the
patients affected with influenza A viruses to minimize their
symptoms at early stage.
The patient should avoid the exposure of respiratory irritant
substances.

CHRONIC BRONCHITIS

DEFINITION
Chronic Bronchitis is defined as the presence of a
productive cough that lasts 3 year for 2 consecutive
years.

ETIOLOGICAL FACTORS

Cigarette
smoking

Exposure
to
pollution

History of
infections
(Bacterial
, Viral,
Mycoplas
mal)

Environm
ental
Pollution

PATHOPHYSIOLOGY
Mucus secreting glands and globet cells increase in number
Reduced cilia function
More mucus production
Narrow and clogged bronchioles
Alveolar adjacent to bronchioles is damaged and fibrosed
Altered function of alveolar macrophages
More prone to get respiratory infection
Fibrotic changes occur in airways
Irreversible lung changes

CLINICAL MANIFESTATIONS

Chronic productive cough

Early morning cough
Increasingly dyspnea

Using accessory muscles to breath

Cyanosis
Increased pulmonary vascular resistance
Hypoxemia
Overweight from edema (Cor Pulmonale)
Skin appears dusky

DIAGNOSTIC FEATURES

History Collection Regarding family history of any disease,

occupational pattern and environmental exposure.

Physical Examination On Inspection Skin appears dusky, cyanosis

and dyspnea.

Chest X-Ray It reveals enlarged heart. In Cor Pulmonale chest film

shows increased Broncho-Vascular markings.

Pulmonary Function Test There will be a decreased PTT from 2575%.

Arterial Blood Gas (ABG) Analysis PaO2 is less than 50 mm Hg and

PaCo2 is more than 50 mm Hg.

Sputum Culture In order to detect the presence of bacterial and viral

colonization.

MEDICAL MANAGEMENT

Avoid the repeated exposure to respiratory irritants.

Administration of Bronchodilators to relieve bronchospasm

and reduce airway obstruction by removing bronchial
secretions.
In case of severe bronchospasm administration of IV fluids to
restore the hydration level.
Oral fluid is given to loosen the secretions and it can be
removed by coughing.
Corticosteroids

may

be

administered

bronchodilators for an effective treatment.

along

with

MEDICAL MANAGEMENT

Antibiotic therapy can be used for the chronic and recurrent

respiratory tract infection.

Based on culture and sensitivity results antimicrobial therapy

should be started.

Patients should be immunized against common viral agents

such as influenza and pneumonia.

Improve the alveolar ventilation by postural drainage and

chest percussion after treatments. So that O2 is distributed
throughout the lungs.

COMPLICATIONS

INFECTION

RESPIRATO
RY FAILURE