Bronchitis%20-%20uncomplicated%20acute Signs and Symptoms

Signs and Symptoms

Definition

Uncomplicated Acute Bronchitis

A self-limiting acute lower respiratory tract infection (LRTI) characterized by the sudden onset of cough with or without sputum production, in an otherwise healthy individual
Diagnosis is based on clinical findings

Pathogenesis

An inflammatory response to infections of the bronchial epithelium of the large airways of the lungs
- Begins with mucosal injury, epithelial cell damage and release of proinflammatory mediators
- Transient airflow obstruction and bronchial hyper-responsiveness
Purulence can result from either bacterial or viral infection

Etiology

Viral

The most common cause (90% of cases) of bronchial inflammation in otherwise healthy adults presenting with acute bronchitis
- Influenza A and B, parainfluenza 3 and respiratory syncytial virus produce primarily lower respiratory tract disease
- Coronavirus, adenovirus and rhinoviruses more commonly produce upper respiratory tract symptoms

Non-viral

Mycoplasma pneumoniae, Chlamydia pneumoniae, Bordetella pertussis (5-10% of cases)
- B pertussis most likely to cause prolonged cough
Environmental cough triggers (eg dust, dander, toxic fume inhalation)

Signs and Symptoms

Lower Respiratory Tract Infection (LRTI)

Cough and/or increase in sputum production
Breathlessness/wheeze
Sweats and/or sore throat
Increase in temperature

Typical Clinical Presentation of Uncomplicated Acute Bronchitis

Predominant symptom: Cough with or without sputum production that persists for <3 weeks
- The cough generally lasts 7-10 days but occasionally persists for >1 month
- Influenza (flu) virus typically causes a nonproductive cough
- If cough persists for >3 weeks, consider investigation of other diagnoses (eg tuberculosis in endemic areas)
Sputum may be clear, white, yellow, green or even tinged with blood
- Green/yellow (purulent) sputum production is indicative of an inflammatory reaction that can result from either viral or bacterial infection
Cough may be accompanied by clinical features that suggest an acute respiratory tract infection (eg sore throat, rhinorrhea, hoarseness)
Patient may also present with retrosternal chest pain on coughing, dyspnea, wheezing, fever, fatigue or night cough

Dual and triple therapy in COPD and asthma care

Prof. Wisia Wedzicha, 19 Apr 2023

Long-acting beta-agonist (LABA), long-acting muscarinic antagonist (LAMA) and inhaled corticosteroid (ICS) are standard agents used in management of chronic obstructive pulmonary disease (COPD) and asthma. At the Autumn Respiratory Seminar 2022, Professor Wisia Wedzicha of the Imperial College London, UK, discussed current evidence and recommendations regarding the use of dual bronchodilator therapy with a LABA/LAMA combination in patients with COPD as well as when triple therapy with a LABA/LAMA/ICS combination is appropriate in those with poorly controlled symptomatic COPD or asthma.

Tackling multidrug-resistant gram-negative bacterial infections in critically ill patients: Challenging the standard approach

Dr. Asok Kurup, Dr. Kenneth Chan, 07 Dec 2020

The rising incidence of infections caused by multidrug-resistant (MDR) gram-negative bacteria has become a serious health threat and a major challenge for intensivists. Against a backdrop of high patient mortality and risk factors for infection in intensive care units (ICU), early adequate therapy is of paramount importance. At a recent Pfizer-sponsored symposium, Dr Asok Kurup, Infectious Disease Physician, Singapore presented the implications of MDR gram-negative infections in critically ill patients in Asia, while Dr Kenneth Chan, Respiratory Physician and Intensivist, Singapore highlighted the role of ceftazidime-avibactam (Zavicefta) and shared published real-world data on ceftazidime-avibactam.

Multidisciplinary approach to eosinophilic disorders: Why and how?

Dr. Terence Tam, Dr. Ho SO, Prof. Michael Wechsler, 19 Dec 2023

Eosinophilic disorders, such as eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES), often necessitate the use of corticosteroids due to diverse signs and symptoms. However, long-term corticosteroid use is associated with various complications. Patients with poor response to corticosteroids may experience disease recurrence. At an industry-sponsored symposium jointly organized by the Hong Kong Society of Rheumatology and the Hong Kong Thoracic Society, experts shared insights on multidisciplinary team management of eosinophilic disorders and discussed clinical evidence supporting the use of add-on medications, such as mepolizumab, in EGPA and HES.