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Bronchitis - acute

Acute bronchitis is swelling and inflammation of the main air passages to the lungs. This swelling narrows the airways, making it harder to breathe and causing other symptoms, such as a cough. Acute means the symptoms have only been present for a short time.

Bronchitis

Causes, incidence, and risk factors

Acute bronchitis almost always follows a cold or flu-like infection. The infection is caused by a virus. At first, it affects your nose, sinuses, and throat. Then it spreads to the airways leading to your lungs.

Cause of Acute Bronchitis

Sometimes, bacteria also infect the airways. This is called a secondary infection.

Chronic bronchitis is a long-term condition. To be diagnosed with chronic bronchitis, you must have a cough with mucus most days of the month for at least 3 months.

Cause of chronic bronchitis

Symptoms

The symptoms of acute bronchitis may include:

  • Chest discomfort
  • Cough that produces mucus; it may be clear or yellow-green
  • Fatigue
  • Fever -- usually low-grade
  • Shortness of breath that gets worse with activity
  • Wheezing , in people with asthma

Even after acute bronchitis has cleared, you may have a dry, nagging cough that lingers for 1 to 4 weeks.

At times, it may be hard to know whether you have pneumonia or only bronchitis. If you have pneumonia, you are more likely to have a high fever and chills, feel sicker, or feel short of breath.

 

Signs and tests

The health care provider will listen to your lungs with a stethoscope. Abnormal, coarse breathing sounds may be heard.

Lung anatomy

Tests may include:

  • Chest x-ray , if the health care provider suspects pneumonia
  • Pulse oximetry to help determine the amount of oxygen in your blood by using a device placed on the end of your finger

Treatment

Most people DO NOT need antibiotics for acute bronchitis. The infection will almost always go away on its own within 1 week. Take the following steps to get relief:

  • Drink plenty of fluids.
  • If you have asthma or another chronic lung condition, use your inhaler (such as albuterol).
  • Rest.
  • Take aspirin or acetaminophen (Tylenol) if you have a fever. DO NOT give aspirin to children
  • Use a humidifier or steam in the bathroom.

Certain medicines that you can buy without a prescription can help break up or loosen mucus. Look for the word "guaifenesin" on the label.

If your symptoms do not improve, your doctor may prescribe an inhaler to open your airways if you are wheezing.

Sometimes, bacteria may also infect the airways along with the virus. If your doctor thinks this has happened, you may be prescribed antibiotics.

Other tips include:

  • DO NOT smoke.
  • Avoid secondhand smoke and air pollution.
  • Wash your hands (and your children's hands) often to avoid spreading viruses and other infections.

Expectations (prognosis)

Symptoms usually go away in 7 to 10 days if you do not have a lung disorder. However, a dry, hacking cough can linger for a number of months.

Calling your health care provider

Call your doctor if:

  • You have a cough on most days, or you have a cough that often returns
  • You are coughing up blood
  • You have a high fever or shaking chills
  • You have a low-grade fever for 3 or more days
  • You have thick, greenish mucus, especially if it has a bad smell
  • You feel short of breath or have chest pain
  • You have a chronic illness, like heart or lung disease

References

Walsh EE. Acute bronchitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 61.

Ferri FF. Acute bronchitis. In: Ferri FF, ed. Ferri's Clinical Advisor 2013. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2012:section 1.

Updated: 7/15/2012

Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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