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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | __NOTOC__ |
| | '''For Chronic bronchitis patient information click [[Chronic bronchitis (patient information)|here]]''' |
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| | '''''see also:''''' [[Acute bronchitis]], [[COPD]] |
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| {{DiseaseDisorder infobox |
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| Name = Bronchitis |
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| ICD10 = {{ICD10|J|42||j|40}}|
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| ICD9 = {{ICD9|491}} |
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| MeshID = D029481 | Bronchitis, Chronic [C08.127.446.567]
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| }}
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| {{Chronic bronchitis}} | | {{Chronic bronchitis}} |
| | | {{CMG}}{{AE}}{{MehdiP}} |
| {{CMG}} | |
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| ==[[Chronic bronchitis overview|Overview]]== | | ==[[Chronic bronchitis overview|Overview]]== |
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| ==[[Chronic bronchitis historical perspective|Historical Perspective]]== | | ==[[Chronic bronchitis historical perspective|Historical Perspective]]== |
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| | ==[[Chronic bronchitis classification|Classification]]== |
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| ==[[Chronic bronchitis pathophysiology|Pathophysiology]]== | | ==[[Chronic bronchitis pathophysiology|Pathophysiology]]== |
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| ==[[Chronic bronchitis epidemiology and demographics|Epidemiology & Demographics]]==
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| ==[[Chronic bronchitis risk factors|Risk Factors]]==
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| ==[[Chronic bronchitis screening|Screening]]==
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| ==[[Chronic bronchitis causes|Causes]]== | | ==[[Chronic bronchitis causes|Causes]]== |
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| ==[[Chronic bronchitis differential diagnosis|Differentiating Chronic bronchitis]]== | | ==[[Chronic bronchitis differential diagnosis|Differentiating Chronic bronchitis from other Diseases]]== |
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| ==[[Chronic bronchitis natural history|Complications & Prognosis]]== | | ==[[Chronic bronchitis epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Diagnosis== | | ==[[Chronic bronchitis risk factors|Risk Factors]]== |
| [[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]] | |
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| ==Treatment== | | ==[[Chronic bronchitis screening|Screening]]== |
| [[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]] | |
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| ==Signs and symptoms== | | ==[[Chronic bronchitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| 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.
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| ==Diagnosis== | | ==Diagnosis== |
| 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 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]] |
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| A variety of tests may be performed in patients presenting with cough and shortness of breath:
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| * 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.
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| * 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.
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| * 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.]]
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| * A [[blood test]] would indicate inflammation (as indicated by a raised [[white blood cell]] count and elevated [[C-reactive protein]]).
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| *Neutrophils infiltrate the lung tissue, aided by damage to the airways caused by irritation.
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| *Damage caused by irritation of the airways leads to inflammation and leads to neutrophils being present
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| *Mucosal hypersecretion is promoted by a substance released by neutrophils
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| *Further obstruction to the airways is caused by more goblet cells in the small airways. This is typical of chronic bronchitis
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| *Although infection is not the reason or cause of chronic bronchitis it is seen to aid in sustaining the bronchitis.'''''
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| ==Treatment== | | ==Treatment== |
| | [[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]] |
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| ===Antibiotics=== | | ==Case Studies== |
| 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>
| | [[Chronic bronchitis case study one|Case Study #1]] |
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| ===Bronchodilators===
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| 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>
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| ===Corticosteroids===
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| 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"/>
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| ===Smoking cessation=== | | ==Related Chapters== |
| {{main|smoking cessation}} | | * [[Emphysema]] |
| | * [[Acute bronchitis]] |
| | * [[Acute bronchitis (patient information)]] |
| | * [[Emphysema (patient information)]] |
| | {{clr}} |
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| == References ==
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| <references/>
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| {{Respiratory pathology}}
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| {{SIB}}
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| [[Category:Inflammations]]
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| [[Category:Pulmonology]]
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| [[Category:General practice]]
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| [[Category:Overview complete]]
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| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |
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| [[de:Chronische Bronchitis]] | | [[Category:Pulmonology]] |
| [[es:Bronquitis crónica]] | | [[Category:Emergency medicine]] |
| [[eu:Bronkitis kroniko]] | | [[Category:Disease]] |
| [[lb:Bronchite (chronesch)]] | | [[Category:Up-To-Date]] |
| [[sr:Хронични бронхитис]] | | [[Category:Infectious disease]] |