Acute bronchitis is a _____________ inflammation of the bronchi, caused by ____________ inflammation.
What is the etiology of acute bronchitis?
cause by microbial infection
#1 cause is VIRAL
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 is a common bacteria found in the sputum of pts with trach or on the vent?
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
The most common cause of antibiotic abuse is....
acute bronchitis (b/c most are viral).
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
Cough suppressants should only be taken.....
(d/t risk of drowsiness, danger driving, etc)
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
"Whooping cough" is caused by......
(a gram neg coccobacillus)
What are the three stages of pertussis?
1. catarrhal phase (~1wk)
2. Paroxysmal phase (several weeks)
3. Convalescent phase (up to 1 month)
The first stage of pertussis may be missed because it can mask as ______
a viral URI or bronchitis
In the _________ stage of pertussis, people may cough so hard that they bring up gastric contents, causing vomiting and possible aspiration, known as
pertussis is most common in children age _______
< 6 months
_________ of adults can have sweats with pertussis.
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)
Acute bronchitis can often lead to _______, which can be fatal.