Bronchitis
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Definition

The term bronchitis can be confusing. It is poorly defined, and sometimes mis-used. Bronchitis can be acute – typically caused by respiratory tract infections (usually viral), or chronic, typically associated with COPD.

  • Bronchitis is an inflammation of the bronchi in the lungs. This causes a narrowing of the airways due to a combination of tissue swelling and excess mucus production
  • Patients may associate the term “bronchitis” with an upper respiratory tract infection – and colloquially some doctors also use this term – sometimes when prescribing antibiotics.
    • Author’s opinion – I find this use of “bronchitis” unhelpful. It doesn’t make any reference to the cause of the bronchitis. This could be anything from a mild common cold, through to a life threatening pneumonia. Usually it is caused by a simple viral infection. In my experience patients tend to use the term bronchitis when requesting antibiotics for an URTI with a troublesome cough.
  • In adults, it should be more properly used to chronic bronchitis, a chronic inflammation of the bronchi, which is a component of COPD.
  • In children it is more commonly used to refer to inflammation of the bronchi as a feature of an acute infection.
Features of acute bronchitis
  • Cough (‘chesty cough’)
    • Often productive of sputum – typically clear, yellow or green coloured
    • Dark brown or grey coloured sputum may be more suggestive of a true pneumonia
  • Fever
  • Cough usually lasts about 2 weeks (can be longer with pertussis and mycoplasma infections)
  • Generally, no treatments have been proven to speed up recovery – and as the condition is self limiting, no treatment should be given. Reassure anxious patients

References

  • Murtagh’s General Practice. 6th Ed. (2015) John Murtagh, Jill Rosenblatt
  • Oxford Handbook of General Practice. 3rd Ed. (2010) Simon, C., Everitt, H., van Drop, F.
  • Beers, MH., Porter RS., Jones, TV., Kaplan JL., Berkwits, M. The Merck Manual of Diagnosis and Therapy

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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