Bronchitis history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Bronchitis Main page |
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:
- Ankle, feet, and leg swelling
- Blue-colored lips from low levels of oxygen
- Frequent respiratory infections (such as colds or the flu)
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