Chronic bronchitis 302753 225717310 2008-07-15T01:40:11Z 64.81.18.202 /* External links */ {{Citations missing|date=January 2008}} {{Refimprove|date=January 2008}} {{DiseaseDisorder infobox | Name = Bronchitis | ICD10 = {{ICD10|J|42||j|40}}| ICD9 = {{ICD9|491}} | MeshID = D029481 | Bronchitis, Chronic [C08.127.446.567] }} '''Bronchitis''' is an [[inflammation]] of the [[bronchus|bronchi]] (medium-size airways) in the [[lung]]s. ''[[Acute bronchitis]]'' is usually caused by [[virus]]es or [[bacteria]] and may last several days or weeks. '''Chronic bronchitis''' is not necessarily caused by infection and is generally part of a syndrome called [[chronic obstructive pulmonary disease]] (COPD); it is defined clinically as a persistent [[cough]] that produces [[sputum]] (phlegm) and mucus, for at least three months in two consecutive years. Chronic bronchitis can also be more severe ==Signs and symptoms== Bronchitis may be indicated by an [[expectorate|expectorating]] [[cough]] (also known as a productive cough, i.e. one that produces [[sputum]]), shortness of breath ([[dyspnea]]) and wheezing. Occasionally [[chest pain]]s, [[fever]], and [[Fatigue (physical)|fatigue]] or [[malaise]] may also occur. Mucus is normally green or yellowish green and also may be a neon orange or green, depending on the pathogen causing the inflammation. ==Causes== [[Tobacco smoking]] is the most common cause.<ref name=MedlinePlus> [http://www.nlm.nih.gov/medlineplus/bronchitis.html MedlinePlus - Bronchitis]</ref>. [[Pneumoconiosis]] and long-term fume inhalation are other causes.<ref name=MedlinePlus/> ==Diagnosis== A [[physical examination]] will often reveal decreased intensity of breath sounds, wheeze ([[rales]]) and prolonged [[Exhalation|expiration]]. Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis. A variety of tests may be performed in patients presenting with cough and shortness of breath: * Pulmonary Function Tests (PFT) (or [[spirometry]]) must be performed in all patients presenting with chronic cough. An [[FEV1]]/[[FVC]] ratio below 0.7 that is not fully reversible after bronchodilator therapy indicates the presence of [[COPD]], that requires more aggressive therapy and carries a more severe prognosis than simple chronic bronchitis. * A [[chest X-ray]] that reveals hyperinflation; collapse and consolidation of lung areas would support a diagnosis of [[pneumonia]]. Some conditions that predispose to bronchitis may be indicated by chest radiography. * A sputum sample showing [[neutrophil granulocyte]]s (inflammatory white blood cells) and [[microbiological culture|culture]] showing that has pathogenic microorganisms such as [[Streptococcus|Streptococcus spp.]] * A [[blood test]] would indicate inflammation (as indicated by a raised [[white blood cell]] count and elevated [[C-reactive protein]]). *Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation. *Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present *Mucosal hypersecretion is promoted by a substance released by neutrophils *Further obstruction to the airways is caused by more goblet cells in the small airways. This is typical of chronic bronchitis *Although infection is not the reason or cause of chronic bronchitis it is seen to aid in sustaining the bronchitis.''''' == Treatment == ===Antibiotics=== For acute exacerbations of chronic bronchitis, if antibiotics are used, [[amoxycillin]] or [[doxycycline]] is recommended. ===Bronchodilators=== For acute exacerbations of chronic bronchitis, a [[clinical practice guideline]] by the [[American College of Physicians]] found that [[bronchodilator]]s may help.<ref name="pmid11281745">{{cite journal |author=Bach PB, Brown C, Gelfand SE, McCrory DC |title=Management of acute exacerbations of chronic obstructive pulmonary disease: a summary and appraisal of published evidence |journal=Ann. Intern. Med. |volume=134 |issue=7 |pages=600–20 |year=2001 |pmid=11281745 |doi=}}</ref> ===Corticosteroids=== For acute exacerbations of chronic bronchitis, a [[clinical practice guideline]] by the [[American College of Physicians]] found that [[corticosteroid]]s may help.<ref name="pmid11281745"/> ===Smoking cessation=== {{main|smoking cessation}} == References == <references/> == External links == {{Wikisource1911Enc|Bronchitis}} *[http://www.nlm.nih.gov/medlineplus/bronchitis.html NIH Medline Plus - Bronchitis] *[http://familydoctor.org/online/famdocen/home/articles/280.printerview.html Familydoctor.org - Chronic Bronchitis] *[http://www.emedicinehealth.com/bronchitis/article_em.htm eMedicineHealth - Bronchitis] *[http://www.sinusinfectionhelp.com/bronchitis.html Bronchitis And Sinus Infection] *[http://www.wellsphere.com/wellmix360/Chronic-bronchitis Chronic Bronchitis Discussions] {{Respiratory pathology}} [[Category:Inflammations]] [[Category:Pulmonology]] [[Category:General practice]] [[de:Chronische Bronchitis]] [[es:Bronquitis crónica]] [[eu:Bronkitis kroniko]] [[it:Bronchite cronica]] [[lb:Bronchite (chronesch)]] [[pl:Przewlekłe zapalenie oskrzeli]] [[sr:Хронични бронхитис]]