dr. Bintang Y. M. Sinaga Sp.P

Levels of competence

Standar Kompetensi Dokter , Konsil Kedokteran Indonesia, 2006

The Lungs

Infection of the lower respiratory tract

Generally follows an upper respiratory tract infection

From viral or bacterial infection Airways become inflamed; irritated Mucus production increases(CDC, Centre for Deseases Control and Prevention))

Acute bronchitis usually comes on quickly and gets better after several weeks.

Bronchoscopic examination

What causes acute bronchitis?•Acute bronchitis occurs most often due to a viral

infection that causes the inner lining of the bronchial tubes to become inflamed and undergo the changes

that occur with any inflammation in the body. Common viruses include the rhinovirus, respiratory

syncytial virus (RSV), influenza and the parainfluenza virus.

•Bacteria in rare cases can also cause bronchitis (a few examples include, Mycoplasma, Pneumococcus,

Klebsiella, Haemophilus.•Chemical irritants for example, tobacco smoke,

gastric reflux, solvents can

There are two types of bronchitis:

Acute bronchitis is caused in most cases over 90% by a viral infection and may begin after develop a cold or sore throat. Bronchitis usually begins with a dry cough. After a few days it progresses to a productive cough, which may be accompanied by fever, fatigue, and headache. The cough may last up to several weeks. If not treated acute bronchitis can progress to pneumonia.

Chronic bronchitis is caused in most cases by exposure to tobacco smoke or other irritants. As a result, the airways produce lots of mucus. Inflammation and extra mucus reduce air flow and cause severe coughing and spitting up of phlegm. Phlegm production and inflammation over many years may lead to permanent lung damage and cause disability or even death.

Signs and Symptoms of Bronchitis•Cough that produces mucus (may

be without mucus the first few days) •Soreness in the chest

•Fatigue •Mild headache

•Mild body aches •Low-grade fever (less than 40°C)

•Watery eyes•Sore throat

Fever Tachypnea Mild dyspnea Pleuritic chest pain (possible) Cough with clear to purulent sputum

production Diffuse rhonchi and crackles

Chest x-ray -rule out pneumonia Films show no evidence of lung

infiltrates

1. Bronchodilators Reduce brochospasm Promote sputum expectoration

2. Oral antibiotics if needed3. Symptom management for fever

and cough

Chest physiotheraphy to mobilize secretions

Hydration to liquefy secretions

1. Encourage mobilization of secretion Ambulation Coughing exercises Deep breathing exercises

2. Adequate fluid intake To liquefy secretions Prevent dehydration caused by

fever and tachypnea

3. Encourage rest4. Avoid bronchial irritants 5. Eat nutritious foods to facilitate

recovery 6. Instruct patient to comply taking medications7. Caution the patient on using OTCs medications

Complications of acute bronchitis•Acute bronchitis usually resolves spontaneously

(about 2-3 weeks) with supportive care. If wheezing and shortness of breath occurs the patient should

seek medical care.•In patients who have underlying lung conditions, the

inflammation can cause lung tissue to function improperly.

•Pneumonia or infection of the lung tissue itself may develop.

Acute Bronchitis at a Glance•Acute bronchitis describes an infection and inflammation of the

breathing tubes leading to cough and occasional wheezing.•Treatment is supportive keeping fever under control and the

patient well hydrated.•Wheezing is often treated with inhaled short acting bronchodilator, either by puffer (HFA) or nebulizer.

•Steroid medication may be used short term to help decrease the inflammation within the bronchial tubes.

•Patients with underlying lung diseases such as asthma or COPD may be at greater risk of developing acute bronchitis.

•Antibiotics are not commonly prescribed for acute bronchitis but may be prescribed if specifically indicated.

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