Welcome to the MedLibrary.org Wikipedia Supplement on Chronic bronchitis -- Please Click to Return to Front Page

This article or section is missing citations or needs footnotes. Using inline citations helps guard against copyright violations and factual inaccuracies. (January 2008)

This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (January 2008)

Bronchitis Classification and external resources
ICD-10	J42.
ICD-9	491
MeSH	D029481

Bronchitis is an inflammation of the bronchi (medium-size airways) in the lungs. Acute bronchitis is usually caused by viruses 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.

Contents 1 Signs and symptoms 2 Causes 3 Diagnosis 4 Treatment 4.1 Antibiotics 4.2 Bronchodilators 4.3 Corticosteroids 4.4 Smoking cessation 5 References 6 External links

Signs and symptoms

Bronchitis may be indicated by an expectorating cough (also known as a productive cough, i.e. one that produces sputum), shortness of breath (dyspnea) and wheezing. Occasionally chest pains, fever, and 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.^[1]. Pneumoconiosis and long-term fume inhalation are other causes.^[1]

Diagnosis

A physical examination will often reveal decreased intensity of breath sounds, wheeze (rales) and prolonged 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 granulocytes (inflammatory white blood cells) and culture showing that has pathogenic microorganisms such as 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 bronchodilators may help.^[2]

Corticosteroids

For acute exacerbations of chronic bronchitis, a clinical practice guideline by the American College of Physicians found that corticosteroids may help.^[2]

Smoking cessation

Main article: smoking cessation

References

1. ^ ^{a b} MedlinePlus - Bronchitis
2. ^ ^{a b} Bach PB, Brown C, Gelfand SE, McCrory DC (2001). "Management of acute exacerbations of chronic obstructive pulmonary disease: a summary and appraisal of published evidence". Ann. Intern. Med. 134 (7): 600–20. PMID 11281745. 

External links

• About.com - Chronic Bronchitis
• NIH Medline Plus - Bronchitis
• Familydoctor.org - Chronic Bronchitis
• eMedicineHealth - Bronchitis
• Bronchitis And Sinus Infection

v • d • e Pathology of respiratory system (J, 460-519), respiratory diseases Upper RT (including URTIs, Common cold) Head sinuses: Sinusitis nose: Rhinitis (Vasomotor rhinitis, Atrophic rhinitis, Hay fever) - Nasal polyp - Deviated septum tonsil: Tonsillitis - Adenoid hypertrophy - Peritonsillar abscess Neck pharynx: Pharyngitis (Strep throat) larynx: Laryngitis - Croup - Laryngospasm - vocal folds: Vocal fold nodule - epiglottis: Epiglottitis trachea: Tracheitis - Tracheal stenosis Lower RT/lung disease (including LRTIs) Pneumonia Viral - Bacterial/Atypical pneumonia (Mycoplasma) - Fungal pneumonia (Pneumocystis pneumonia) - Parasitic pneumonia - Bronchopneumonia - Chemical pneumonia (Mendelson's syndrome) Bronchial/ obstructive Acute: Bronchitis (Acute, Chronic) - Bronchiolitis Chronic: Emphysema - COPD - Asthma (Status asthmaticus) - Diffuse panbronchiolitis - Bronchiectasis Interstitial/ restrictive External agents/ occupational lung disease Pneumoconiosis (Asbestosis, Baritosis, Bauxite fibrosis, Berylliosis, Caplan's syndrome, Chalicosis, Coalworker's pneumoconiosis, Siderosis, Silicosis, Byssinosis) Hypersensitivity pneumonitis (Bagassosis, Bird fancier's lung, Farmer's lung) Other ARDS - Pulmonary edema - Löffler's syndrome/Eosinophilic pneumonia - Respiratory hypersensitivity (Allergic bronchopulmonary aspergillosis) Hamman-Rich syndrome - Idiopathic pulmonary fibrosis Obstructive or restrictive Atelectasis - Bronchiolitis obliterans Pleural cavity/mediastinum Suppuration Empyema - Lung abscess Pleural disease/pleural effusion Hemothorax - Pneumothorax (Tension pneumothorax) - Hemopneumothorax - Hydrothorax - Chylothorax - Pleurisy Mediastinal disease Mediastinal emphysema - Mediastinitis Other/general Respiratory failure - Influenza - SARS - Idiopathic pulmonary haemosiderosis see also congenital, neoplasia

Wikipedia content modification information:

• This page was last modified on 6 October 2008, at 14:42.

Wikipedia Authorship and Review

Wikipedia content provided here is not reviewed directly by MedLibrary.org. Wikipedia content is authored by an open community of volunteers and is not produced by or in any way affiliated with MedLibrary.org.

Wikipedia Usage Guidelines

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article on "Chronic bronchitis".

The URL for this specific entry is:

• http://medlibrary.org/medwiki/Chronic_bronchitis

All Wikipedia text is available under the terms of the GNU Free Documentation License. (See Copyrights for details). Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc.