Bronchitis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Bronchitis Main page

Patient Information

Overview

Causes

Classification

Acute bronchitis
Chronic bronchitis

Differential Diagnosis

Overview

Bronchitis is usually a diagnosis of exclusion. Presence of cough without fever lasting more than 5 days and with normal vitals (no tachypnea or tachycardia) is suggestive of acute bronchitis. The presentation may vary according to the pathogen involved.

History

  • Bronchitis is common in patients with a history of smoking, low socio-economic status, residing in industrial or heavy pollutant areas, and exposure to toxic substance. Thus, obtaining a personal and socio-economic history is very important.
  • Bronchitis is usually a diagnosis of exclusion. Thus, past medical history to rule out asthma, and allergic history is important.

Symptoms

Acute Bronchitis

  • Cough with sputum production (clear, yellow, green, or even blood-tinged) is the (commonest) symptom. Initially, it may be difficult to distinguish a acute bronchitis from upper respiratory tract infection. However, a cough lasting > 5 days indicates a diagnosis of Bronchitis. Cough usually last for 1-2 weeks in acute bronchitis. Even after acute bronchitis has cleared, you may have a dry, nagging cough that lingers for several weeks. A yellow-green sputum production is more likely to be a bacterial infection.
  • Sore throat, runny nose.
  • Fatigue, muscle aches
  • Fever -- may suggest pathogens like influenza or adenovirus as causative organisms
  • Shortness of breath, worsened by exertion or mild activity
  • Wheezing
  • Chest discomfort
  • Difficulty in breathing and blue discoloration of extremities can be seen in late stages of the disease

Additional symptoms of chronic bronchitis include:

Additional Symptoms Based on Different Pathogens

Influenza virus, Adenovirus

  • Fever, chills, headache, myalgia

Parainfluenza Virus

  • Children may present with a hoarse, ringing cough and stridulous, difficult breathing
  • Common in autumn season
  • Common cause of outbreak in nursing homes.

Respiratory Syncytial Virus

  • Common in winter and spring.
  • family history of exposure to an infant with bronchiolitis is important.

Rhinovirus

  • Mild symptoms

Atypical Bacteria

Bordetella Pertusis

  • Commonly affects young adults
  • Incubation 1-3 weeks
  • cough lasting > 2 weeks
  • Fever uncommon

Mycoplasma Pneumoniae and Chlamydiae Pneumonia

  • Subacute onset, 2-3 week (helps in differentiating from Influenza)
  • Common in closed environment (military bases, schools, hostels)

Chronic Bronchitis

  • Cough with sputum expectoration for at least 3 months a year during a period of 2 consecutive years. The patient may give a history of seasonal worsening of cough (winters)followed by progression of cough from seasonal to perennial, increased frequency, duration and severity of symptoms.
  • Difficulty in breathing and blue discoloration of extremities can be seen in late stages of the disease.
  • Shortness of breath, worsened by exertion or mild activity
  • Wheezing
  • Chest discomfort

References


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