Acute bronchitis is a _____________ inflammation of the bronchi, caused by ____________ inflammation.
What are some viral infections that can cause acute bronchitis?
influenza A and B
RSV (typically in peds)
What are some bacterial infections that can cause acute bronchitis?
chlamydophila pneumoniae (rare)
Bacterial causes are RARE, except in patients with...
What are the signs and symptoms of acute bronchitis?
-s/sx of the "common cold"
-fever (less common)
What are the characteristics of a cough with acute bronchitis?
-lasting > 5 days
-typically last 10-20 days
-sputum - purulent in 50%
True or false: Thick, yellowish sputum suggests a bacterial cause of acute bronchitis.
Even if sputum is thick and yellowish, the most common cause is still usually viral.
True or False: A CXR is usually normal in acute bronchitis.
but they may have an underlying lung disease, so still need to get CXR in some cases
What are 3 cases when you should order a CXR for acute bronchitis?
-rales on chest exam
-advanced age ( >75)
What diagnostic tests should you order for acute bronchitis?
-sputum culture (but this is non-diagnostic)
-culture posterior nasopharynx (if cough >2 weeks, or if you suspect pertussis or MRSA)
-influenza A and B titers
What might be in the Ddx for acute bronchitis?
- chronic bronchitis with A/E
-postnasal drip syndrome
If you prescribe antibiotics for a patient, you should also prescribe (or advise them to get) ________ in order to prevent ________.
c.diff (also yeast infections in women)
What are 4 possible types of medications used for treatment of acute bronchitis?
2. cough suppressant
3. cough expectorant
In pts with acute bronchitis who are bronchospastic, you can give them ________.
(but usually only for a couple weeks)
What can you use for symptomatic treatment of acute bronchitis?
? 7-day course of inhaled or oral steroids +/- albuterol
typically self-limiting so just treat symptomatically
Per the ACP and CDC, _______ is the ONLY indication for antibiotics with acute bronchitis.
Per NICE recommendations, you should only use Abx in acute bronchitis in:
patients >65 plus 2 of the following, or patients >85 plus one:
-hospitalized in past yr
-T1 or T2 DM
-Hx of CHF
-use of oral steroids
What are the three stages of pertussis?
1. catarrhal phase (~1wk)
2. Paroxysmal phase (several weeks)
3. Convalescent phase (up to 1 month)
In the _________ stage of pertussis, people may cough so hard that they bring up gastric contents, causing vomiting and possible aspiration, known as
What are 4 treatment options for pertussis?
-erythromycin (7-14 days)
-clarithromycin (500mg BID x 7 days)
-Bactrim DS (BID x 14 days)
If a person received a pertussis vaccine as a child but you suspect it clinically, what would be important to ask?
Have they received a booster?
Which people have indications for a pertussis booster (Dtap)?
everyone, but especially health care workers, elderly exposed to infants/children (like grandparents)