Chronic bronchitis
302753
225717310
2008-07-15T01:40:11Z
64.81.18.202
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{{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]]