Chronic bronchitis: Difference between revisions
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==Overview== | ==[[Chronic bronchitis overview|Overview]]== | ||
==[[Chronic bronchitis historical perspective|Historical Perspective]]== | |||
==[[Chronic bronchitis pathophysiology|Pathophysiology]]== | |||
==[[Chronic bronchitis epidemiology and demographics|Epidemiology & Demographics]]== | |||
==[[Chronic bronchitis risk factors|Risk Factors]]== | |||
==[[Chronic bronchitis screening|Screening]]== | |||
==[[Chronic bronchitis causes|Causes]]== | |||
==[[Chronic bronchitis differential diagnosis|Differentiating Chronic bronchitis]]== | |||
==[[Chronic bronchitis natural history|Complications & Prognosis]]== | |||
==Diagnosis== | |||
[[Chronic bronchitis history and symptoms|History and Symptoms]] | [[Chronic bronchitis physical examination|Physical Examination]] | [[Chronic bronchitis staging|Staging]] | [[Chronic bronchitis laboratory tests|Laboratory tests]] | [[Chronic bronchitis electrocardiogram|Electrocardiogram]] | [[Chronic bronchitis x ray|X Rays]] | [[Chronic bronchitis CT|CT]] | [[Chronic bronchitis MRI|MRI]] [[Chronic bronchitis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Chronic bronchitis other imaging findings|Other images]] | [[Chronic bronchitis other diagnostic studies|Alternative diagnostics]] | |||
==Treatment== | |||
[[Chronic bronchitis medical therapy|Medical therapy]] | [[Chronic bronchitis surgery|Surgical options]] | [[Chronic bronchitis primary prevention|Primary prevention]] | [[Chronic bronchitis secondary prevention|Secondary prevention]] | [[Chronic bronchitis cost-effectiveness of therapy|Financial costs]] | [[Chronic bronchitis future or investigational therapies|Future therapies]] | |||
==Signs and symptoms== | ==Signs and symptoms== | ||
Revision as of 19:49, 27 January 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
Pathophysiology
Epidemiology & Demographics
Risk Factors
Screening
Causes
Differentiating Chronic bronchitis
Complications & Prognosis
Diagnosis
History and Symptoms | Physical Examination | Staging | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics
Treatment
Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies
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.
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 a meta-analysis found that "amoxicillin/clavulanic acid, macrolides, second-generation or third-generation cephalosporins, and quinolones" may be more effective.[1]
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
References
- ↑ Dimopoulos G, Siempos II, Korbila IP, Manta KG, Falagas ME (2007). "Comparison of first-line with second-line antibiotics for acute exacerbations of chronic bronchitis: a metaanalysis of randomized controlled trials to Joe Fo Sho". Chest. 132 (2): 447–55. doi:10.1378/chest.07-0149. PMID 17573508.
- ↑ 2.0 2.1 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.
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de:Chronische Bronchitis eu:Bronkitis kroniko lb:Bronchite (chronesch) sr:Хронични бронхитис