Acute bronchitis: Difference between revisions
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==Background== | ==Background== | ||
*Inflammation of large airways of the lung | |||
*PNA must be excluded by clinical evaluation or by CXR | |||
**If all 5 are negative PNA is safely excluded: | |||
***1. HR >100 | |||
***2. RR >24 | |||
***3. Temp >38 (100.4) | |||
***4. Exam findings c/w focal consolidation, egophony, or fremitus | |||
***5. Age >64yr | |||
==Epidemiology== | |||
*Viruses are most common cause | |||
**Influenza, paraflu, RSV, corona, adeno, rhino | |||
*Bacterial cause occurs in <10% of cases | |||
**Mycoplasma, C. pneumoniae, pertussis (1% of bronchitis cases) | |||
==Diagnosis== | ==Diagnosis== | ||
*Cough, with or without sputum, without e/o PNA, common cold, or asthma | |||
**Cough >5d is more suggestive of bronchitis than common cold | |||
**Cough may persist for 10-20d | |||
**Cough >3wk suggests asthma, COPD, pertussis, postnasal drip, GERD | |||
*Often follows URI | |||
==Work-Up== | ==Work-Up== | ||
*CXR only indicated in elderly or suspicion for PNA | |||
==Treatment== | ==Treatment== | ||
*American College of Chest Physicians 2006 Guidelines | |||
**Routine treatment w/ abx is not justified | |||
**Antitussive agents can be useful (codeine, DM) | |||
**Little evidence pro or con regarding mucolytics | |||
**Bronchodilators only useful if there is wheezing | |||
==Source== | ==Source== | ||
Revision as of 21:34, 22 July 2011
Background
- Inflammation of large airways of the lung
- PNA must be excluded by clinical evaluation or by CXR
- If all 5 are negative PNA is safely excluded:
- 1. HR >100
- 2. RR >24
- 3. Temp >38 (100.4)
- 4. Exam findings c/w focal consolidation, egophony, or fremitus
- 5. Age >64yr
- If all 5 are negative PNA is safely excluded:
Epidemiology
- Viruses are most common cause
- Influenza, paraflu, RSV, corona, adeno, rhino
- Bacterial cause occurs in <10% of cases
- Mycoplasma, C. pneumoniae, pertussis (1% of bronchitis cases)
Diagnosis
- Cough, with or without sputum, without e/o PNA, common cold, or asthma
- Cough >5d is more suggestive of bronchitis than common cold
- Cough may persist for 10-20d
- Cough >3wk suggests asthma, COPD, pertussis, postnasal drip, GERD
- Often follows URI
Work-Up
- CXR only indicated in elderly or suspicion for PNA
Treatment
- American College of Chest Physicians 2006 Guidelines
- Routine treatment w/ abx is not justified
- Antitussive agents can be useful (codeine, DM)
- Little evidence pro or con regarding mucolytics
- Bronchodilators only useful if there is wheezing
Source
Tintinalli