Bronchitis

Question 1

Bronchitis

What is bronchitis?
Acute vs chronic bronchitis?

Answer 1

inflammation of bronchi of lower resp tract

Acute: (more common in cold seasons)
* cough ±sputum, resolves in 1-3 weeks
Chronic:
* cough >3 months

Question 2

Bronchitis

complications?

Answer 2

• superinfection w/ bacteria (if viral)
• pneumonia

Question 3

Bronchitis

common viral pathogens

Answer 3

• influenza
• rhinovirus
• coronavirus
• respiratory syncytial virus

Question 4

Bronchitis

common bacterial pathogens

Answer 4

• mycoplasma pneumoniae
• chlamydia pneumoniae
• bordetella pertussis

Question 5

Bronchitis

Typical patient presentation? (diagnosis is clinical)

Answer 5

• cough 1-3 weeks w/out signs of pneumonia (ie no fever or dullness at percussion)
• wheezing/rhonchi on auscultation (rhonchi disappear after coughing)

Question 6

Bronchitis

Differentials?

Answer 6

• pneumonia
• asthma
• HF
• PE
• GORD
• ACEi side effect

Pneumonia: characterised by cough accompanied by fever, tachypnoea or tachycardia, signs of consolidation/rales at auscultation and/or changes in mental status in the elderly

GORD: cough may be the only symptom
Asthma: characterised by wheezing, cough and shortness of breath, often following a particular trigger
ACEi: characterised by sharp, non-productive cough
Heart failure: characterised by cough and shortness of breath
Pulmonary embolism: characterised by cough, shortness of breath, haemoptysis and chest pain, along with tachypnoea and tachycardia

Question 7

Bronchitis

Investigations and why?

Answer 7

• CXR (?pneumonia)
• microbiology (?influenza)
• procalcitonin analysis (bacterial vs viral)

Question 8

Bronchitis

Management (prescribing + non-prescribing)

Answer 8

• OTC cough relief, lozenges
• NSAIDs
• stop smoking

Viral:
NO ABx
- neuraminidase inhibitors (influenza)

Bactieral
- NO ABx (mycoplasma pneumoniae / chlamydia pneumoniae)
- macrolides (borderella pertussis)