![]() The cough associated with acute bronchitis can be very bothersome, stripping the patient of days at work or school, as well as sleep. Production of sputum, whether it is purulent or not, is common and does not correlate with a bacterial infection. Prolonged coughing can also create substernal musculoskeletal pain. Mild dyspnea may be present, especially with physical activity. However, the rhonchi typically clear with a forceful cough. Rhonchi and wheezing may be auscultated upon exam. ![]() 1,2With involvement of the lower respiratory tract, the cough becomes the dominant symptom. The first few days of illness can produce elevated temperature, headache, mild fever of less than 100.9F, nasal/sinus congestion, and pharyngitis. 2Īcute bronchitis is often preceded by an ARS or URI. Therefore, an accurate history of present illness and physical exam are critical. The treatment plans for these differential diagnoses can vary widely. The diagnoses that have the most overlap with acute bronchitis are upper respiratory infection (URI), acute rhinosinusitis (ARS) and pneumonia. 1Because of the high likelihood of viral etiology, antibiotics are not recommended for treatment of acute bronchitis. 3,4It is typically a self-limited disease, resolving within 1 to 4 weeks 1,2,4, with a median duration of 18 days. ![]() In more than 90% of cases, acute bronchitis has a viral etiology with rhinovirus, enterovirus, influenza A and B, parainfluenza, coronavirus, and respiratory syncytial virus being the most commonly identified pathogens. The cough may be associated with either non-purulent or purulent sputum production. 1It is characterized by an acute cough for more than 5 days in the absence of chronic obstructive pulmonary disease or pneumonia. Acute bronchitis is one of the most common clinical conditions encountered in ambulatory care, accounting for about 10% of visits in the United States or 100 million visits per year. ![]()
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