Clinical immunology and allergy: Bronchitis

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Bronchitis is inflammation of the bronchi (large and medium-sized airways) in the lungs that causes coughing. Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain.Bronchitis can be acute or chronic.

Acute bronchitis usually has a cough that lasts around three weeks, and is also known as a chest cold.In more than 90% of cases the cause is a viral infection. These viruses may be spread through the air when people cough or by direct contact.A small number of cases are caused by a bacterial infection such as Mycoplasma pneumoniae or Bordetella pertussis. Risk factors include exposure to tobacco smoke, dust, and other air pollution. Treatment of acute bronchitis typically involves rest, paracetamol (acetaminophen), and nonsteroidal anti-inflammatory drugs (NSAIDs) to help with the fever.

Chronic bronchitis is defined as a productive cough – one that produces sputum – that lasts for three months or more per year for at least two years. Many people with chronic bronchitis have chronic obstructive pulmonary disease (COPD). Tobacco smoking is the most common cause, with a number of other factors such as air pollution and genetics playing a smaller role. Treatments include quitting smoking, vaccinations, rehabilitation, and often inhaled bronchodilators and steroids. Some people may benefit from long-term oxygen therapy.

Acute bronchitis is one of the most common diseases. About 5% of adults are affected and about 6% of children have at least one episode a year. Acute bronchitis is the most common type of bronchitis. In the United States, in 2016, 8.6 million people were diagnosed with chronic bronchitis.

Cause

In more than 90% of cases, the cause is a viral infection. These viruses may spread through the air when people cough or by direct contact. Risk factors include exposure to tobacco smoke, dust, and other air pollutants. A small number of cases are due to bacteria such as Mycoplasma pneumoniae or Bordetella pertussis.

Diagnosis

Diagnosis is typically based on a person's signs and symptoms. The color of the sputum does not indicate if the infection is viral or bacterial. Determining the underlying organism is usually not required. Other causes of similar symptoms include asthma, pneumonia, bronchiolitis, bronchiectasis, and COPD. A chest X-ray may be useful to detect pneumonia.

Another common sign of bronchitis is a cough which lasts ten days to three weeks. If the cough lasts for longer than a month, it may become chronic bronchitis. In addition, a fever may be present. Acute bronchitis is normally caused by a viral infection. Typically, these infections are rhinovirus, parainfluenza, or influenza. No specific testing is normally needed in order to diagnose acute bronchitis.

Treatment

One form of prevention is to avoid smoking and other lung irritants. Frequent hand washing may also be protective. Treatment for acute bronchitis usually involves rest, paracetamol (acetaminophen), and NSAIDs to help with the fever. Cough medicine has little support for its use, and is not recommended in children under the age of six. There is tentative evidence that salbutamol may be useful in treating wheezing; however, it may result in nervousness and tremors. Antibiotics should generally not be used. An exception is when acute bronchitis is due to pertussis. Tentative evidence supports honey and pelargonium to help with symptoms. Getting plenty of rest and drinking enough fluids are often recommended as well. Chinese medicinal herbs are of unclear effect.

Journal of Clinical Immunology and Allergy is a world class open access journal intended to publish the cutting edge research in the field of Immunology and Allergy.

Journal of Clinical Immunology and Allergy endeavors to publish both basic, fundamental and advanced developmental research in allergy, respiratory diseases, diagnosis, preventive treatment methodologies, New drug development, combinatorial anti allergen, anti-inflammatory and antibacterial drug therapy and research. Additionally the journal willing to publish new medical devices development, respiratory aids, drug delivery, diagnostics development in prevention and treatment of allergy,  respiratory infections. Last but not least Journal of Clinical Immunology and Allergy sought research in herbal or traditional medications in preventing and treating allergy and respiratory diseases.

 

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