Bronchitis

• Acute bronchitis
• Inflammation of bronchi

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

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

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

• 6C: Impaired ventilation, respiration/gas exchange, and aerobic capacity/endurance associated with airway clearance dysfunction1
• 6F: Impaired ventilation and respiration/gas exchange associated with respiratory failure2

Description

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

Essentials of Diagnosis

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

General Considerations

• 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

Demographics

• Infants and young children
• Elderly with weak immune system

Signs and Symptoms

• 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

Functional Implications

• 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

Possible Contributing Causes

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

Differential Diagnosis

• 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

Laboratory Tests

• Viral culture
• Nasopharyngeal swab for influenza

Imaging

• Chest radiograph3
• CT for sinuses

Diagnostic Procedures

• Lung function tests
• Pulse oximetry
• Abnormal lung sounds

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

• 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

• Exercise limitation
• Shortness of breath
• Limited endurance capacity

• 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 ...