Acute bronchitis

Acute bronchitis (plural: bronchitides) refers to acute-onset, short-term bronchial inflammation. It is usually self-limiting and often the result of a viral infection. Chest radiography is rarely necessary.

Epidemiology

Acute bronchitis can affect people of all ages, but it is commonest in children, especially those under the age of 3 years. It is often associated with the common cold, a sore throat and/or flu.

Clinical presentation

The main symptom is a hacking cough that may be associated with sputum production. Sputum is usually yellow or clear and different from the green sputum that is more often associated with lower respiratory tract infections.

Patients will often have nasal and sinus infection and describe a runny nose or sinus symptoms which include pain. As well as cough and sputum production, patients may describe other general symptoms including wheezing, shortness of breath, chest pain and headache.

Pathology

Acute bronchitis is usually an inflammatory reaction to a virus. However, rarely, there may a bacterial cause, or possibly an inflammatory response to an irritant, e.g. smoke, dust, or fumes.

Radiographic features

Chest radiographs are not routinely indicated in cases of simple acute bronchitis. Indications for chest x-rays in adult patients with acute bronchitis are primarily to evaluate for pneumonia and include ¹:

• tachycardia
• tachypnoea
• fever >38ºC
• egophony or fremitus on examination

Plain radiograph

These are usually normal. Sometimes, bronchial wall thickening, which is non-specific, is attributed to acute bronchitis ^1,2. 

Treatment and prognosis

Treatment is supportive, consisting of analgesia and sometimes bronchodilators ².