Acute bronchitis refers to an infection of the bronchial mucosa caused by various pathogens. Since the trachea is often involved simultaneously, it is also referred to as acute tracheobronchitis. It is a common respiratory disease during childhood.
Etiology
The pathogens responsible for this condition include various viruses, bacteria, or mixed infections. Any pathogen capable of causing upper respiratory tract infections can also lead to bronchitis. Risk factors include compromised immune function, atopic constitution, nutritional disorders, rickets, and structural abnormalities of the bronchi.
Clinical Manifestations
Symptoms often begin with those of an upper respiratory tract infection, followed by cough as the primary symptom. Initially, the cough is dry but later becomes productive. Young children typically experience more severe symptoms, which may include fever, vomiting, and diarrhea, though systemic symptoms are usually not pronounced. Lung auscultation reveals coarse breath sounds, along with scattered, variable dry rales and coarse-medium moist rales. Infants and young children may have difficulty expelling sputum, with phlegm sounds audible in the throat or lungs.
Auxiliary Examinations
Chest X-rays may show normal findings or indicate increased pulmonary markings and accentuated hilar opacities.
Diagnosis
The diagnosis is primarily based on clinical findings. If differentiation from pneumonia or atelectasis is required, chest X-ray examination may be conducted.
Treatment
General Management
Management is similar to that for upper respiratory tract infections. Position changes and increased fluid intake support clearance of respiratory secretions. Maintaining appropriate humidity is helpful for promoting sputum expectoration.
Infection Control
As the majority of cases are caused by viruses, antibiotics are generally not used. For suspected bacterial infections, appropriate antibacterial agents are employed. In cases of Mycoplasma infection, macrolide antibiotics are the preferred treatment.
Symptomatic Treatment
Cough suppressants are generally avoided to prevent interference with sputum clearance. When sputum is thick and sticky, expectorants may be used. Bronchodilators and/or glucocorticoids are administered for patients with wheezing, and short-term oral glucocorticoids may be considered in cases of severe wheezing.