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  • Acute bronchitis
  • Inflammation of bronchi

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  • 466 Acute bronchitis and bronchiolitis
  • 490 Bronchitis, not specified as acute or chronic
  • 491 Chronic bronchitis

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  • 780.7 Malaise and fatigue
  • 786.0 Dyspnea and respiratory abnormalities
  • 786.05 Shortness of breath

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  • J20.9 Acute bronchitis, unspecified
  • J41.0 Simple chronic bronchitis

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Description

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  • Inflammation of the air passageways in the lungs
  • Categorized as chronic obstructive pulmonary disease (COPD)
  • Acute or chronic

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Essentials of Diagnosis

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  • Diagnosis based on clinical manifestation
  • Acute bronchitis usually occurs after a common cold (viral respiratory infection)
  • May get secondary bacterial infection

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General Considerations

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  • Influenza is a systemic illness involving the respiratory tract
  • Antibiotics have limited or no role in the treatment of a virus
  • Can develop into pneumonia
  • Can be acute or chronic

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Demographics

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  • Infants and young children
  • Elderly with weak immune system

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Signs and Symptoms

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  • Low-grade fever
  • Runny nose
  • Malaise
  • Pleurisy
  • Sore throat
  • Cough with productive mucus
  • Edema
  • Chest tightness
  • Rales sounds
  • Ankle, feet, leg swelling
  • Wheezing
  • Shoulder raised to allow increased air flow to lungs
  • Shortness of breath
  • Tensed muscles from dyspnea

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Functional Implications

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  • Disabling dyspnea when performing simple tasks involving arm elevation, such as reaching into a cabinet
  • Decreased exercise tolerance
  • Patients with mononucleosis should avoid contact sports for six weeks to avoid splenic rupture

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Possible Contributing Causes

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  • Smoking
  • Air pollution
  • Allergies
  • Occupations with poor air quality
  • Long-term exposure to lung irritants
  • Environmental irritants
  • Periodontal disease
  • Immunodeficiency disorders

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Differential Diagnosis

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  • Influenza
  • Measles
  • Asthma
  • Chickenpox
  • Gastroesophageal reflux disease
  • Ludwig’s angina
  • Bronchiectasis
  • Adult cystic fibrosis
  • Kawasaki disease
  • Pneumonia
  • Goiter
  • Upper respiratory tract infection
  • Asthma (reversible)
  • Central airway obstruction
  • Lung tumor
  • Tuberculosis

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Laboratory Tests

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  • Viral culture
  • Nasopharyngeal swab for influenza

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Imaging

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Diagnostic Procedures

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  • Lung function tests
  • Pulse oximetry
  • Abnormal lung sounds

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  • Mucus that is yellow-green in color likely indicates bacterial infection
  • Acute sinusitis on CT will show complete opacification and air-fluid level1

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  • For imaging, X-ray
  • For medication, anti-inflammatory agents, bronchodilators, expectorants, antihistamines, or vaccines
  • For surgical consult, if deviated septum
  • For ENT consult
  • For pulmonologist consult

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  • Exercise limitation
  • Shortness of breath
  • Limited endurance capacity

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  • Fluid intake
  • Smoking cessation
  • Manual sinus drainage
  • Coughing techniques
  • Manual lobe drainage
  • Pulmonary rehabilitation (PR)4
    • Enhances patient’s sense of well-being
    • Improves exercise capacity
  • Inspiratory muscle training (IMT)
  • Once controlled: exercise (aerobic, strength, flexibility, posture, breathing) ...

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