Acute bronchitis Definition: inflammation of the large airways without evidence of pneumonia Epidemiology: approx 5% of adults develop one in a year, with high burden on the management of cough, its main symptom. Common in fall and winter. Etiology: Viruses (90%): rhinovirus, coronavirus, parainfluenza. respiratory syncytial virus. HMPV, influenza. Bacteria: B. pertussis, M. pneumonia, Chlamydia pneumoniae (in immunocompetent); Moraxella catarrhalis, H. influenzae, S. pneumoniae (COPD/smokers) H&P: Cough , with/wo sputum , lasting 10-20 days sometimes 1 mo. Headache, rhinorrhea, systemic symptoms. Fever +/- Sputum purulency DOES NOT define bacterial infection or benefit from antibiotic therapy Must be differentiated with: pneumonia, asthma exacerbation, COPD, CHF In elderly, cxr and simple labs may be needed Tx: Supportive; routine antitussive, steroids, and BD not recommended Red flags: hemoptysis, worsening dyspnea, weight loss, difficulty swallowing, persistent fever...
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