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{{DiseaseDisorder infobox |
__NOTOC__
  Name        = Bronchitis |
'''For Chronic bronchitis patient information click [[Chronic bronchitis (patient information)|here]]'''
  ICD10      = {{ICD10|J|42||j|40}}|
  ICD9        = {{ICD9|491}} |
  MeshID      = D029481 | Bronchitis, Chronic [C08.127.446.567]  
}}
{{SI}}


==Overview==
'''''see also:''''' [[Acute bronchitis]], [[COPD]]
'''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.


==Signs and symptoms==
{{Chronic bronchitis}}
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.
{{CMG}}{{AE}}{{MehdiP}}


==Diagnosis==
==[[Chronic bronchitis overview|Overview]]==
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.
 
==[[Chronic bronchitis historical perspective|Historical Perspective]]==
 
==[[Chronic bronchitis classification|Classification]]==
 
==[[Chronic bronchitis pathophysiology|Pathophysiology]]==
 
==[[Chronic bronchitis causes|Causes]]==


A variety of tests may be performed in patients presenting with cough and shortness of breath:
==[[Chronic bronchitis differential diagnosis|Differentiating Chronic bronchitis from other Diseases]]==
* 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.'''''


==[[Chronic bronchitis epidemiology and demographics|Epidemiology and Demographics]]==


==Treatment==
==[[Chronic bronchitis risk factors|Risk Factors]]==


===Antibiotics===
==[[Chronic bronchitis screening|Screening]]==
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.<ref name="pmid17573508">{{cite journal |author=Dimopoulos G, Siempos II, Korbila IP, Manta KG, Falagas ME |title=Comparison of first-line with second-line antibiotics for acute exacerbations of chronic bronchitis: a metaanalysis of randomized controlled trials to Joe Fo Sho |journal=Chest |volume=132 |issue=2 |pages=447-55 |year=2007 |pmid=17573508 |doi=10.1378/chest.07-0149}}</ref>


===Bronchodilators===
==[[Chronic bronchitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
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===
==Diagnosis==
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"/>
[[Chronic bronchitis history and symptoms|History and Symptoms]] | [[Chronic bronchitis physical examination|Physical Examination]] | [[Chronic bronchitis laboratory findings|Laboratory Findings]] | [[Chronic bronchitis electrocardiogram|Electrocardiogram]] | [[Chronic bronchitis chest x ray|Chest X Ray]] | [[Chronic bronchitis CT|CT]] | [[Chronic bronchitis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Chronic bronchitis other imaging findings|Other Imaging Findings]] | [[Chronic bronchitis other diagnostic studies|Other Diagnostic Studies]]


===Smoking cessation===
==Treatment==
{{main|smoking cessation}}
[[Chronic bronchitis medical therapy|Medical Therapy]] | [[Chronic bronchitis primary prevention|Primary Prevention]] | [[Chronic bronchitis secondary prevention|Secondary Prevention]] | [[Chronic bronchitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Chronic bronchitis future or investigational therapies|Future or Investigational Therapies]]


== References ==
==Case Studies==
<references/>
[[Chronic bronchitis case study one|Case Study #1]]


{{Respiratory pathology}}
==Related Chapters==
{{SIB}}
* [[Emphysema]]
* [[Acute bronchitis]]
* [[Acute bronchitis (patient information)]]
* [[Emphysema (patient information)]]
{{clr}}


[[Category:Inflammations]]
[[Category:Pulmonology]]
[[Category:General practice]]


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[[de:Chronische Bronchitis]]
[[Category:Pulmonology]]
[[es:Bronquitis crónica]]
[[Category:Emergency medicine]]
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[[Category:Disease]]
[[lb:Bronchite (chronesch)]]
[[Category:Up-To-Date]]
[[sr:Хронични бронхитис]]
[[Category:Infectious disease]]

Latest revision as of 20:56, 29 July 2020

For Chronic bronchitis patient information click here

see also: Acute bronchitis, COPD

Chronic Obstructive Pulmonary Disease Page

Bronchitis Main Page

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chronic bronchitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

Echocardiography or Ultrasound

Treatment

Medical Therapy

Lung Transplant

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Risk calculators and risk factors for Chronic bronchitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chronic bronchitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case Study #1

Related Chapters


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