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BRONCHITIS

ACUTE BROCHITIS
DEFINITION:
Acute bronchitis is defined as the inflammation of the bronchi and it is
usually occurs in the trachea. It is also called Bracheo Bronchitis.
ETIOLOGY:

Chronic Lung Diseases


Extension of Upper Respiratory Tract Infection
Physical or Chemical agents such as dust, smoke, volatile fumes
Air Pollution
Climatic changes (Peak during later winter or spring)
Bacterial Pathogens (Streptococcus Pneumonia, Hemophilius

Influenza)
Viral Pathogens (Rhinovirus, Adenovirus)
PATHOPHYSIOLOGY:
Due to the etiological factors
(weakens in defense mechanism)
Pathogenic bacteria or virus reside in nose and pharynx
Colonization occurs in trachea and bronchi

Inflammatory process occurs in tracheal wall

Increased blood flow to the affected side


Increased pulmonary secretions
CLINICAL MANIFESTATIONS:

Signs and symptoms usually lasts from 1 week 1 month


Painful cough with sputum production
Low grade to high grade fever
Malaise
Coryza
Pain beneath sternum
Rhonchi and wheezes
Shortness of breath
Pleuritic chest pain (Pain on inspiration)
Rales (Crackles)
Rapid respiration
Sore throat
Back pain and muscle pain

DIAGNOSTIC FEATURES:
History Collection Regarding any history of chronic lung diseases
and their occupational pattern.
Physical Examination On palpation and percussion the patient is
having tenderness over sternum and increased in their respiratory rate.
On auscultation crackles sound can be heard and having mild to high
grade fever.

Sputum Culture To find out the presence of bacterial or viral


invasion and its colonization.
Chest X-Ray - It reveals there is normal in its findings.
MANAGEMENT:
Medical Management:
Mainly focus on symptomatic and supportive management only.
Increases the fluid intake such as hot water to 2-3 L / Day to loosen the
secretions.
Administration of mild analgesics and Antipyretics to reduce the
temperature and pain along with Aspirin, Acetaminophen, Ibuprofen
every 4-6 hours.
Codeine or Dextromethorphan may be administered to maintain a good
sleeping pattern.
Bronch-Active substances such as inhaled Beta2-Agonist is used for
patient with wheezing and other respiratory discomfort.
If the patient is diagnosed with bacterial infections, antibiotics are
prescribed.
Amantadine / Kimantadine may be given early for the patients affected
with influenza A viruses to minimize their symptoms at early stage.
The patient should avoid the exposure of respiratory irritant substances.

CHRONIC BRONCHITIS
DEFINITION:
Chronic Bronchitis is defined as the presence of a productive cough
that lasts 3 year for 2 consecutive years.
ETIOLOGY:

Cigarette smoking
Exposure to pollution
History of infections (Bacterial, Viral, Mycoplasmal)
Environmental Pollution

PATHOPHYSIOLOGY:

Due to the etiological factors


(Continuous irritation to mucosal layer)
Mucus secreting glands and globet cells increase in number
Reduced cilia function
More mucus production
Narrow and clogged bronchioles
Alveolar adjacent to bronchioles is damaged and fibrosed
Altered function of alveolar macrophages
More prone to get respiratory infection
Fibrotic changes occur in airways
Irreversible lung changes
Emphysema and bronchiectasis
CLINICAL MANIFESTATIONS:

Chronic productive cough


Early morning cough
Increasingly dyspnea
Using accessory muscles to breath
Cyanosis
Increased pulmonary vascular resistance
Hypoxemia
Overweight from edema (Cor Pulmonale)
Skin appears dusky

DIAGNOSITC FEATURES:
History Collection Regarding family history of any disease,
occupational pattern and environmental exposure.
Physical Examination On Inspection Skin appears dusky, cyanosis
and dyspnea.
Chest X-Ray It reveals enlarged heart. In Cor Pulmonale chest film
shows increased Broncho-Vascular markings.
Pulmonary Function Test There will be a decreased PTT from 2575%.
Arterial Blood Gas (ABG) Analysis PaO2 is less than 50 mm Hg and
PaCo2 is more than 50 mm Hg.
Sputum Culture In order to detect the presence of bacterial and viral
colonization.
MANAGEMENT:
Medical Management:
Avoid the repeated exposure to respiratory irritants.
Administration of Bronchodilators to relieve bronchospasm and reduce
airway obstruction by removing bronchial secretions.
In case of severe bronchospasm administration of IV fluids to restore
the hydration level.
Oral fluid is given to loosen the secretions and it can be removed by
coughing.
Corticosteroids may be administered along with bronchodilators for an
effective treatment.

Antibiotic therapy can be used for the chronic and recurrent respiratory
tract infection.
Based on culture and sensitivity results antimicrobial therapy should be
started.
Patients should be immunized against common viral agents such as
influenza and pneumonia.
Improve the alveolar ventilation by postural drainage and chest
percussion after treatments. So that O2 is distributed throughout the
lungs.
COMPLICATIONS:

INFECTION

RESPIRATO
RY FAILURE

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