Bronchitis acute

Description

Acute bronchitis occurs when the airways (trachea and bronchi) are inflamed. A distinction is made according to the exact location of the inflammation, in tracheitis (inflammation of the trachea), tracheobronchitis, bronchitis and bronchiolitis.

Very often the respiratory tract is inflamed during a cold or flu. Apart from the strong urge to cough, acute bronchitis usually has no complications.

Acute infections of the (upper) respiratory tract, including bronchitis, are among the most common diseases worldwide. On average, an adult falls ill with it 2-3 times a year, especially during the transitional period. Children, the elderly and people with weakened immune systems even more often.

Viruses

Most often, a cold caused by viruses is responsible for acute bronchitis. The cold spreads from the throat deeper into the airways. The exact causative agents may be adeno-, rhino-, corona-, influenza-, and parainfluenza viruses. In children, respiratory-sincytial (RS), ECHO or Coxsackie viruses are possible causes.

Bacteria

Bacteria also often cause bronchitis as a secondary infection (at the same time or after a viral infection). Pathogens include chlamydia and mycoplasma, which multiply inside cells and are therefore difficult for the immune system to fight. The pathogens haemophilus influenzae (meningitis in children) and pneumococci (pneumonia) can also be triggers.

Other diseases

Bronchitis may be the concomitant of other diseases. These include whooping cough, measles, brucellosis, and typhoid fever.

Fungi

Especially in immunocompromised persons (HIV-infected, cancer patients, etc.), fungi such as Candida Albicans (thrush bronchitis) can also trigger acute bronchitis.

Irritants

Vapours, gases, dust and fine dust favour a possible bronchitis. They can also (more rarely) lead to inflammation of the tracheal tree.

Difference to allergic asthma

In bronchitis, the airways are narrowed by inflamed cells and mucus. In contrast, allergic asthma represents an overreaction to certain stimuli, causing the bronchial tubes to suddenly constrict, resulting in an asthma attack.

Favouring factors

• Cigarette smoke
• Cold and damp weather
• Air pollution
• Crowds

Characteristic symptoms

• sensitive airways, painful cough
• increased mucus production; viral cause whitish mucous, bacterial cause yellowish, greenish
• Inflammation symptoms fever, fatigue, headache, malaise
• pain in the sternum area due to strong coughing or pleurisy
• Giemen (noticeable noise when breathing)

If breathing is impeded and there is an increased urge to cough due to an inflammatory swelling of the bronchial mucosa, this is referred to as spastic or obstructive bronchitis.

When to see a doctor

As soon as the following symptoms appear, a doctor should be consulted:

• difficulty breathing, shortness of breath, chest pain
• bloody sputum
• high fever
• stubborn yellowish sputum (bacterial superinfection)
• persistent illness for more than 7 days
• pre-existing conditions (COPD, bronchial asthma, heart failure)
• immunodeficiency (HIV infection, cancer, cortisone therapy)
• acute bronchitis in children or elderly persons

Normally, the following tests are needed to diagnose acute bronchitis:

• Anamnesis (medical history and complaints)
• Tapping and listening to the lungs (rales or wheezing indicate progression and localisation of the inflammation)
• Examination of the mouth and throat (may provide clues to pathogens).

If bronchitis is severe, additional tests may be necessary:

• Blood analysis (inflammation levels: C-reactive protein CRP, increased platelet sedimentation rate = BKS, increased leukocyte count).
• X-ray of the chest (to exclude pneumonia)
• Analysis of the sputum (determination of the type of bacteria in order to be able to use targeted antibiotics)

Important information for the doctor

• If there is a fever, how high and since when?
• When did the symptoms start, are they getting stronger or weaker?
• Do you have sputum? If so, how much and what does it look like (color, consistency)?
• Which vaccinations have you already received? (Take your vaccination certificate with you!)
• Do you suffer from any illnesses such as bronchial asthma, COPD, heart disease or immune deficiency?
• Are you exposed to irritants (gas, smoke, dust) at your workplace?

Depending on the cause and severity of bronchitis, there are different treatment options. If the cause is bacterial, antibiotics are used. Viral diseases, however, can only be treated symptomatically, since there are no drugs against viruses.

Viral acute bronchitis

• Antitussive drugs: Herbal preparations have a decongestant and calming effect. Chemically produced drugs often act on the cough centre in the brain. There is a risk that the stimulus to cough is reduced to such an extent that mucus is no longer coughed up and the airways become obstructed. They should therefore only be used in the case of dry or intense night-time coughs.
• Expectorants: The effect of mucolytics or secretolytics (e.g. N-acetylcysteine) has not yet been sufficiently proven. It is assumed that these drugs have no relevant influence on acute bronchitis.

Bacterial acute bronchitis

• Antibiotics: They are used when there is a risk of superinfection following viral bronchitis.
• Antipyretic and analgesic drugs: They can relieve flu-like symptoms (e.g., aching limbs) and reduce fever.

If obstructive or spastic bronchitis is present (especially in children), it is important to use short-acting bronchodilator medication (usually in the form of an inhaler). To thin the mucus, inhalation with a saline solution can also be used.

What you can do yourself

• Allow your body to rest.
• Drink plenty of fluids, especially warm drinks and tea, to help liquefy the mucus. Alcohol is taboo.
• Try to go without cough suppressant medication during the day so that you can cough up enough mucus. Cough suppressants should only be used if it is a dry irritating cough without mucus production.
• Home remedies such as compresses and homemade cough syrup can help.
• Avoid physical exertion, cold or smoky air, and exhaust fumes. These factors further irritate your airways.
• Use frequent non-irritating inhalations, chest compresses and sweating cures.

Normally, acute viral bronchitis passes without complications and heals within 7 days.

If there is a superinfection by bacteria, bronchitis can last 2-3 weeks.

As the bronchial tubes become very irritated during the course of bronchitis, they are very sensitive even after recovery and the irritation of the cough can last for several weeks.

In rare cases, chronic bronchitis, spastic or obstructive bronchitis, bronchiolitis (inflammation of the small bronchial tubes) or pneumonia (inflammation of the lungs) develop. This usually affects people with pre-existing conditions (e.g. asthmatics), smokers, the elderly or immunocompromised.

The risk of catching a cold or bronchitis can be reduced by taking simple preventive measures:

• If you smoke, try to give it up.
• Strengthen your immune system through regular exercise, a healthy mixed diet and enough sleep.
• Avoid dry indoor air. If the humidity is below 50%, humidifiers or damp cloths will help.
• Ventilate regularly!
• Avoid dusty and smoky air.
• Vaccinations against influenza and bacteria (e.g. pneumococci, which cause pneumonia) are useful for elderly people, chronically ill people or people who are frequently exposed to pathogens.