Bronchitis is an inflammation of the air passages between the nose and the
lungs, including the windpipe or trachea and the larger air tubes of the
lung that bring air in from the trachea (bronchi). Bronchitis can either
be of brief duration (acute) or have a long course (chronic). Acute
bronchitis is usually caused by a viral infection but can also be caused
by a bacterial infection and can heal without complications. Chronic
bronchitis is a sign of serious lung disease that may be slowed but cannot
be cured. This form is found almost exclusively in adult smokers.
Bronchitis in children is often misdiagnosed as
Acute bronchitis is most prevalent in winter. It is most often caused by a
viral infection and may be accompanied by a secondary bacterial infection.
Acute bronchitis resolves within two weeks, although the
may persist longer. Acute bronchitis, like any upper airway inflammatory
process, can increase a child's likelihood of developing
Acute bronchitis is one of the more common illnesses affecting
and school-age children. It is more commonly diagnosed among children
under age five than any other age group. It occurs more often in young
males. It can occur anytime but is more frequent during the winter months.
In otherwise healthy children complications are few.
Causes and symptoms
Acute bronchitis usually begins with the symptoms of a cold, such as a
runny nose, sneezing, and dry cough. However, the cough soon becomes deep
and painful. Coughing brings up a greenish yellow phlegm or sputum. These
symptoms may be accompanied by a
of up to 102°F (38.8°C). Wheezing after coughing is common.
In uncomplicated acute bronchitis, the fever and most other symptoms,
except the cough, disappear after three to five days. Coughing may
continue for several weeks. Acute bronchitis is often complicated by a
bacterial infection, in which case the fever and a general feeling of
illness persist. To be cured, the bacterial infection should be treated
. A cough that does not go away may be a sign of another problem such as
asthma or pneumonia.
Physical findings of acute bronchitis vary with the age of the child, and
the stage of the disease, but may include the following:
Initial diagnosis of bronchitis is based on observing the child's
symptoms and health history. The physician will listen to the
child's chest with a stethoscope for specific sounds that indicate
lung inflammation, such as moist rales and crackling, and wheezing, that
indicate airway narrowing. Moist rales is a bubbling sound heard
Light micrograph of a five-year-old revealing acute bronchitis,
shown by a bronchial tube filled with pus.
(© Gladden Willis, M.D./Visuals Unlimited.)
with a stethoscope that is caused by fluid secretion in the bronchial
A sputum culture may be performed, particularly if the sputum is green or
has blood in it, to determine whether a bacterial infection is present and
to identify the disease-causing organism so that an appropriate antibiotic
can be selected. Normally, the patient will be asked to cough deeply then
spit the material that comes up from the lungs (sputum) into a cup. This
sample is then grown in the laboratory to determine which organisms are
present. The results are available in two to three days.
Occasionally, in diagnosing a chronic lung disorder, the sample of sputum
is collected using a procedure called a bronchoscopy. In this procedure,
the patient is given a local anesthetic, and a tube is passed into the
airways to collect a sputum sample.
To better determine what type of obstructive lung disease a patient has,
the doctor may do a chest x ray and order blood tests. Other tests may be
used to measure how effectively oxygen and carbon dioxide are exchanged in
When no secondary infection is present, acute bronchitis is treated in the
same way as the
. Home care includes drinking plenty of fluids, resting, not
, increasing moisture in the air with a cool mist humidifier, and taking
(Datril, Tylenol, Panadol) for fever and
. Aspirin should not be given to children because of its association with
the serious illness
are used only when the cough is dry and produces no sputum. If the
patient is coughing up phlegm, the cough should be allowed to continue.
The purpose of the cough is to bring up extra mucus and irritants from the
lungs. When coughing is suppressed, the mucus accumulates in the plugged
airways and can become a breeding ground for pneumonia bacteria.
Expectorant cough medicines, unlike cough suppressants, do not stop the
cough. Instead they are used to thin the mucus in the lungs, making it
easier to cough up. This type of cough medicine may be helpful to
individuals suffering from bronchitis. People who are unsure about what
type of medications are in over-the-counter cough syrups should ask their
pharmacist for an explanation.
If a secondary bacterial infection is present, the infection is treated
with an antibiotic. Patients need to take the entire amount of antibiotic
prescribed. Stopping the antibiotic early can lead to a return of the
infection. Tetracycline or ampicillin is often used to treat adults. Other
possibilities include trimethoprim/sulfamethoxazole (Bactrim or Septra)
and the newer erythromycin-like drugs, such as azithromycin (Zithromax)
and clarithromycin (Biaxin). Children under age eight are usually given
amoxicillin (Amoxil, Pentamox, Sumox, Trimox) because tetracycline
discolors permanent teeth that have not yet come in.
For some children with acute bronchitis, doctors may prescribe medicines
often used to treat asthma. These medicines can help open the bronchial
tubes and clear out mucus. Bronchial dilators are usually given with an
inhaler. An inhaler sprays the medicine right into the bronchial tree.
When treated, acute bronchitis normally resolves in one to two weeks
without complications, although a cough may continue for several more
weeks. The progression of chronic bronchitis, on the other hand, may be
slowed, but an initial improvement in symptoms may be achieved.
Parents should make sure their children are getting adequate
and rest to boost their immunity during cold and flu season. Children
should be taught to wash their hands regularly to avoid spreading bacteria
and viruses. Other preventative steps include avoiding chemical and
environmental irritants, such as air pollution. Immunizations against
certain types of pneumonia (as well as
) are an important preventative measure for the very young or those
children with chronic diseases.
—Refers to a disease or symptom that has a sudden onset and lasts
a relatively short period of time.
—Singular, bronchus; the large tubular passages that carry air to
the lung and allow air to be expelled from the lungs.
—Refers to a disease or condition that progresses slowly but
persists or recurs over time.
Acute Bronchitis: A Medical Dictionary, Bibliography, and Annotated
Research Guide to Internet References.
San Diego, CA: Icon Group International, 2004.
Bronchitis: A Medical Dictionary, Bibliography, and Annotated Research
Guide to Internet References.
San Diego, CA: Icon Group International, 2003.
Ivker, Robert S.
Sinus Survival: The Holistic Medical Treatment for Allergies,
Bronchitis, Colds, and Sinus.
East Rutherford, NJ: Penguin Group, 2000.
Asthma and Bronchitis.
Northfield, IL: How to Books, 2004.
American Lung Association.
1740 Broadway, New York, NY 10019. Web site:
National Heart, Lung, and Blood Institute.
PO Box 30105, Bethesda, MD 20824–0105. Web site:
National Jewish Center for Immunology and Respiratory Medicine.
1400 Jackson St., Denver, CO 80206. Web site:
Available online at
December 17, 2004).