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Bronchitis is inflammation of the bronchi (large and medium-sized airways) in the
lung The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of ...
s that causes
cough A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three ph ...
ing. Bronchitis usually begins as an infection in the nose, ears, throat, or sinuses. The infection then makes its way down to the bronchi. Symptoms include coughing up sputum,
wheezing A wheeze is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract ...
,
shortness of breath Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing di ...
, and
chest pain Chest pain is pain or discomfort in the chest, typically the front of the chest. It may be described as sharp, dull, pressure, heaviness or squeezing. Associated symptoms may include pain in the shoulder, arm, upper abdomen, or jaw, along with ...
. Bronchitis can be
acute Acute may refer to: Science and technology * Acute angle ** Acute triangle ** Acute, a leaf shape in the glossary of leaf morphology * Acute (medicine), a disease that it is of short duration and of recent onset. ** Acute toxicity, the adverse ef ...
or chronic.
Acute bronchitis Acute bronchitis, also known as a chest cold, is short-term bronchitis – inflammation of the bronchi (large and medium-sized airways) of the lungs. The most common symptom is a cough. Other symptoms include coughing up mucus, wheezing, shor ...
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 Pathogenic bacteria are bacteria that can cause disease. This article focuses on the bacteria that are pathogenic to humans. Most species of bacteria are harmless and are often beneficial but others can cause infectious diseases. The number ...
such as '' Mycoplasma pneumoniae'' or ''
Bordetella pertussis ''Bordetella pertussis'' is a Gram-negative, aerobic, pathogenic, encapsulated coccobacillus of the genus ''Bordetella'', and the causative agent of pertussis or whooping cough. Like '' B. bronchiseptica'', ''B. pertussis'' is motile and exp ...
''. Risk factors include exposure to
tobacco smoke Tobacco smoke is a sooty aerosol produced by the incomplete combustion of tobacco during the smoking of cigarettes and other tobacco products. Temperatures in burning cigarettes range from about 400 °C between puffs to about 900 °C d ...
, dust, and other
air pollution Air pollution is the contamination of air due to the presence of substances in the atmosphere that are harmful to the health of humans and other living beings, or cause damage to the climate or to materials. There are many different type ...
. Treatment of acute bronchitis typically involves rest,
paracetamol Paracetamol, also known as acetaminophen, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol. At a standard dose, paracetamol only slightly decreases body temperature; it is inferio ...
(acetaminophen), and
nonsteroidal anti-inflammatory drug Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration o ...
s (NSAIDs) to help with the fever. Chronic bronchitis is defined as a productive cough – one that produces
sputum Sputum is mucus that is coughed up from the lower airways (the trachea and bronchi). In medicine, sputum samples are usually used for a naked eye examination, microbiological investigation of respiratory infections and cytological investigatio ...
– that lasts for three months or more per year for at least two years. Many people with chronic bronchitis also have
chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...
(COPD).
Tobacco smoking Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is beli ...
is the most common cause, with a number of other factors such as
air pollution Air pollution is the contamination of air due to the presence of substances in the atmosphere that are harmful to the health of humans and other living beings, or cause damage to the climate or to materials. There are many different type ...
and
genetics Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar work ...
playing a smaller role. Treatments include quitting smoking,
vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulat ...
s,
rehabilitation Rehabilitation or Rehab may refer to: Health * Rehabilitation (neuropsychology), therapy to regain or improve neurocognitive function that has been lost or diminished * Rehabilitation (wildlife), treatment of injured wildlife so they can be retur ...
, and often inhaled bronchodilators and
steroids A steroid is a biologically active organic compound with four rings arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter membrane fluidity; and ...
. Some people may benefit from long-term oxygen therapy. Acute bronchitis is one of the more common diseases. About 5% of adults and 6% of children have at least one episode a year. Acute bronchitis is the most common type of bronchitis. By contrast in the United States, in 2018, 9.3 million people were diagnosed with the less common chronic bronchitis.


Acute bronchitis

Acute bronchitis, also known as a chest cold, is short term
inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
of the bronchi of the
lung The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of ...
s. The most common symptom is a
cough A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three ph ...
, that may or may not produce sputum. Other symptoms may include coughing up mucus,
wheezing A wheeze is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract ...
,
shortness of breath Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing di ...
,
fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...
, and chest discomfort. Fever when present is mild. The infection may last from a few to ten days. The cough may persist for several weeks afterwards, with the total duration of symptoms usually around three weeks. Symptoms may last for up to six weeks.


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 Tobacco smoke is a sooty aerosol produced by the incomplete combustion of tobacco during the smoking of cigarettes and other tobacco products. Temperatures in burning cigarettes range from about 400 °C between puffs to about 900 °C d ...
,
dust Dust is made of fine particles of solid matter. On Earth, it generally consists of particles in the atmosphere that come from various sources such as soil lifted by wind (an aeolian process), volcanic eruptions, and pollution. Dust in ...
, and other
air pollutants Air pollution is the contamination of air due to the presence of substances in the atmosphere that are harmful to the health of humans and other living beings, or cause damage to the climate or to materials. There are many different types ...
. A small number of cases are due to
bacteria Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were am ...
such as '' Mycoplasma pneumoniae'' or ''
Bordetella pertussis ''Bordetella pertussis'' is a Gram-negative, aerobic, pathogenic, encapsulated coccobacillus of the genus ''Bordetella'', and the causative agent of pertussis or whooping cough. Like '' B. bronchiseptica'', ''B. pertussis'' is motile and exp ...
''.


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 Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, co ...
,
pneumonia Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severit ...
, bronchiolitis,
bronchiectasis Bronchiectasis is a disease in which there is permanent enlargement of parts of the airways of the lung. Symptoms typically include a chronic cough with mucus production. Other symptoms include shortness of breath, coughing up blood, and chest ...
, and
COPD Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...
. A
chest X-ray A chest radiograph, called a chest X-ray (CXR), or chest film, is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in me ...
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 Influenza, commonly known as "the flu", is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptom ...
. 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 Paracetamol, also known as acetaminophen, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol. At a standard dose, paracetamol only slightly decreases body temperature; it is inferio ...
(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 Salbutamol, also known as albuterol and sold under the brand name Ventolin among others, is a medication that opens up the medium and large airways in the lungs. It is a short-acting β2 adrenergic receptor agonist which works by causing rel ...
may be useful in treating
wheezing A wheeze is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract ...
; however, it may result in nervousness and tremors.
Antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention ...
s should generally not be used. An exception is when acute bronchitis is due to pertussis. Tentative evidence supports
honey Honey is a sweet and viscous substance made by several bees, the best-known of which are honey bees. Honey is made and stored to nourish bee colonies. Bees produce honey by gathering and then refining the sugary secretions of plants (primar ...
and
pelargonium ''Pelargonium'' () is a genus of flowering plants that includes about 280 species of perennials, succulents, and shrubs, commonly called geraniums, pelargoniums, or storksbills. ''Geranium'' is also the botanical name and common name of a separa ...
to help with symptoms. Getting plenty of rest and drinking enough fluids are often recommended as well. Chinese medicinal herbs are of unclear effect.


Epidemiology

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. It occurs more often in the winter. More than 10 million people in the US visit a doctor each year for this condition, with about 70% receiving antibiotics which are mostly not needed. There are efforts to decrease the use of antibiotics in acute bronchitis. Acute bronchitis is the most common type of bronchitis.


Chronic bronchitis

Chronic bronchitis is a lower respiratory tract disease, defined by a productive cough that lasts for three months or more per year for at least two years. The cough is sometimes referred to as a ''smoker's cough'' since it often results from smoking. When chronic bronchitis occurs together with decreased airflow it is known as
chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...
(COPD). Many people with chronic bronchitis have COPD however, most people with COPD do not also have chronic bronchitis. Estimates of the number of people with COPD who have chronic bronchitis are 7 to 40%. Estimates of the number of people who smoke and have chronic bronchitis who also have COPD is 60%. The term "chronic bronchitis" was used in previous definitions of COPD but is no longer included in the definition. The term is still used clinically. While both chronic bronchitis and
emphysema Emphysema, or pulmonary emphysema, is a lower respiratory tract disease, characterised by air-filled spaces ( pneumatoses) in the lungs, that can vary in size and may be very large. The spaces are caused by the breakdown of the walls of the alv ...
are often associated with COPD, neither is needed to make the diagnosis. A Chinese consensus commented on symptomatic types of COPD that include chronic bronchitis with frequent exacerbations. Chronic bronchitis is marked by mucus hypersecretion and mucins. The excess mucus is produced by an increased number of
goblet cell Goblet cells are simple columnar epithelial cells that secrete gel-forming mucins, like mucin 5AC. The goblet cells mainly use the merocrine method of secretion, secreting vesicles into a duct, but may use apocrine methods, budding off their s ...
s, and enlarged
submucosal gland Submucosal glands can refer to various racemose exocrine glands of the mucous type. These glands secrete mucus to facilitate the movement of particles along the body's various tubes, such as the throat and intestines. The mucosa is the lining of the ...
s in response to long-term irritation. The mucous glands in the submucosa secrete more than the goblet cells. Mucins thicken mucus, and their concentration has been found to be high in cases of chronic bronchitis, and also to correlate with the severity of the disease. Excess mucus can narrow the airways, thereby limiting airflow and accelerating the decline in lung function, and result in COPD. Excess mucus shows itself as a chronic productive cough and its severity and volume of sputum can fluctuate in periods of acute exacerbations. In COPD, those with the chronic bronchitic phenotype with associated chronic excess mucus, experience a worse quality of life than those without. The increased secretions are initially cleared by coughing. The cough is often worse soon after awakening, and the sputum produced may have a yellow or green color and may be streaked with specks of blood. In the early stages, a cough can maintain mucus clearance. However, with continued excessive secretion mucus clearance is impaired, and when the airways become obstructed a cough becomes ineffective. Effective mucociliary clearance depends on airway hydration, ciliary beating, and the rates of mucin secretion. Each of these factors is impaired in chronic bronchitis. Chronic bronchitis can lead to a higher number of exacerbations and a faster decline in lung function. The
ICD-11 The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...
lists chronic bronchitis with emphysema (emphysematous bronchitis) as a "certain specified COPD".


Cause

Most cases of chronic bronchitis are caused by
tobacco smoking Tobacco smoking is the practice of burning tobacco and ingesting the resulting smoke. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is beli ...
. Chronic bronchitis in young adults who smoke is associated with a greater chance of developing COPD. There is an association between smoking
cannabis ''Cannabis'' () is a genus of flowering plants in the family Cannabaceae. The number of species within the genus is disputed. Three species may be recognized: '' Cannabis sativa'', '' C. indica'', and '' C. ruderalis''. Alternative ...
and chronic bronchitis. In addition, chronic inhalation of
air pollution Air pollution is the contamination of air due to the presence of substances in the atmosphere that are harmful to the health of humans and other living beings, or cause damage to the climate or to materials. There are many different type ...
, or irritating fumes or dust from hazardous exposures in occupations such as coal mining, grain handling, textile manufacturing, livestock farming, and metal moulding may also be a risk factor for the development of chronic bronchitis. Bronchitis caused in this way is often referred to as industrial bronchitis, or occupational bronchitis. Rarely genetic factors also play a role. Air quality can also affect the respiratory system with higher levels of
nitrogen dioxide Nitrogen dioxide is a chemical compound with the formula . It is one of several nitrogen oxides. is an intermediate in the industrial synthesis of nitric acid, millions of tons of which are produced each year for use primarily in the productio ...
and
sulfur dioxide Sulfur dioxide (IUPAC-recommended spelling) or sulphur dioxide (traditional Commonwealth English) is the chemical compound with the formula . It is a toxic gas responsible for the odor of burnt matches. It is released naturally by volcanic a ...
contributing to bronchial symptoms. Sulfur dioxide can cause inflammation which can aggravate chronic bronchitis and make infections more likely. Air pollution in the workplace is the cause of several
non-communicable disease A non-communicable disease (NCD) is a disease that is not transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, most heart diseases, most cancers, diabetes, chronic kidney disease, ...
s (NCDs) including chronic bronchitis.


Treatment

Decline in lung function in chronic bronchitis may be slowed by stopping smoking. Chronic bronchitis may be treated with a number of
medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
s and occasionally
oxygen therapy Oxygen therapy, also known as supplemental oxygen, is the use of oxygen as medical treatment. Acute indications for therapy include hypoxemia (low blood oxygen levels), carbon monoxide toxicity and cluster headache. It may also be prophylactic ...
.
Pulmonary rehabilitation Pulmonary rehabilitation, also known as respiratory rehabilitation, is an important part of the management and health maintenance of people with chronic respiratory disease who remain symptomatic or continue to have decreased function despite stand ...
may also be used. A distinction has been made between exacerbations (sudden worsenings) of chronic bronchitis, and otherwise stable chronic bronchitis. Stable chronic bronchitis can be defined as the normal definition of chronic bronchitis, plus the absence of an acute exacerbation in the previous four weeks. A Cochrane review found that mucolytics in chronic bronchitis may slightly decrease the chance of developing an exacerbation. The mucolytic
guaifenesin Guaifenesin, also known as glyceryl guaiacolate, is an expectorant medication that aids in the elimination of sputum from the respiratory tract. Chemically it is an ether of guaiacol and glycerine. It is often used in combination with other ...
is a safe and effective treatment for stable chronic bronchitis. This has an advantage in that it is available as an extended use tablet which lasts for twelve hours. Erdosteine is a mucolytic recommended by NICE. GOLD also supports the use of some mucolytics that are advised against when inhaled corticosteroids are being used, and singles out erdosteine as having good effects regardless of corticosteroid use. Erdosteine also has antioxidant properties. Erdosteine has been shown to significantly reduce the risk of exacerbations, shorten their duration, and hospital stays. In those with the chronic bronchitic phenotype of COPD, the phosphodiesterase-4 inhibitor roflumilast may decrease significant exacerbations.


Epidemiology

Chronic bronchitis affects about 3.4% to 22% of the general population. Individuals over 45 years of age, smokers, those that live or work in areas with high air pollution, and anybody with asthma all have a higher risk of developing chronic bronchitis. This wide range is due to the different definitions of chronic bronchitis that can be diagnosed based on signs and symptoms or the clinical diagnosis of the disorder. Chronic bronchitis tends to affect men more often than women. While the primary risk factor for chronic bronchitis is smoking, there is still a 4%-22% chance that non smokers can get chronic bronchitis. This might suggest other risk factors such as the inhalation of fuels, dusts, fumes and genetic factor. In the United States, in 2016, 8.6 million people were diagnosed with chronic bronchitis, and there were 518 reported deaths. Per 100,000 of population the death rate of chronic bronchitis was 0.2.


History

The condition of bronchitis has been recognised for many centuries, in several different cultures including the Ancient Greek, Chinese, and Indian, with the presence of excess phlegm and cough noted in recognition of the same condition. Early treatments of chronic bronchitis included garlic, cinnamon and ipecac, among others. Modern treatments were developed during the second half of the 20th century. In Britain in 1808, a physician Charles Badham was the first person to describe the condition and name the acute form as ''acute bronchitis''. This was written of in a book entitled ''Inflammatory conditions of the bronchia''. In this book Badham distinguished three forms of bronchitis including acute and chronic. A second edition of this book was renamed ''An Essay on Bronchitis'' and published in 1814. Bradham used the term catarrh to refer to the cardinal symptoms of chronic cough and mucus hypersecretion of chronic bronchitis, and described chronic bronchitis as a disabling disorder. In 1901 an article was published on the treatment of chronic bronchitis in the elderly. The symptoms described have remained unchanged. The cause was thought to be brought on by dampness, cold weather, and foggy conditions, and treatments were aimed towards various cough mixtures, respiratory stimulants, and tonics. It was noted that something other than the weather was thought to be at play. Exacerbations of the condition were also described at this time. Another physician Harry Campbell was referred to who had written in the ''British Medical Journal'' a week before. Campbell had suggested that the cause of chronic bronchitis was due to toxic substances, and recommended pure air, simple food, and exercise to remove them from the body. A joint research programme was undertaken in Chicago and London from 1951 to 1953 in which the clinical features of one thousand cases of chronic bronchitis were detailed. The findings were published in the Lancet in 1953. It was stated that since its introduction by Badham, chronic bronchitis had become an increasingly popular diagnosis. The study had looked at various associations such as the weather, conditions at home, and at work, age of onset, childhood illnesses, smoking habits, and breathlessness. It was concluded that chronic bronchitis invariably led to emphysema, particularly when the bronchitis had persisted for a long time. In 1957 it was noted that at the time there were many investigations being carried out into chronic bronchitis and emphysema in general, and among industrial workers exposed to dust. Excerpts were published dating from 1864 in which Charles Parsons had noted the occurring consequence of the development of emphysema from bronchitis. This was seen to be not always applicable. His findings were in association with his studies on chronic bronchitis among pottery workers. A CIBA (now
Novartis Novartis AG is a Swiss-American multinational pharmaceutical corporation based in Basel, Switzerland and Cambridge, Massachusetts, United States (global research).name="novartis.com">https://www.novartis.com/research-development/research-lo ...
) meeting in 1959, and a meeting of the American Thoracic Society in 1962, defined chronic bronchitis as a component of COPD, in the terms that have not changed.


Eosinophilic bronchitis

Eosinophilic bronchitis Eosinophilic bronchitis (EB) is a type of airway inflammation due to excessive mast cell recruitment and activation in the superficial airways as opposed to the smooth muscles of the airways as seen in asthma. It often results in a chronic cough. ...
is a chronic dry cough, defined by the presence of an increased number of a type of
white blood cell White blood cells, also called leukocytes or leucocytes, are the cells of the immune system that are involved in protecting the body against both infectious disease and foreign invaders. All white blood cells are produced and derived from mult ...
known as eosinophils. It has a normal finding on X-ray and has no airflow limitation.


Protracted bacterial bronchitis

Protracted bacterial bronchitis in children, is defined as a chronic productive cough with a positive
bronchoalveolar lavage Bronchoalveolar lavage (BAL) (also known as bronchoalveolar washing) is a diagnostic method of the lower respiratory system in which a bronchoscope is passed through the mouth or nose into an appropriate airway in the lungs, with a measured amoun ...
that resolves with
antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention ...
s. Protracted bacterial bronchitis is usually caused by '' Streptococcus pneumoniae'', non-typable ''
Haemophilus influenzae ''Haemophilus influenzae'' (formerly called Pfeiffer's bacillus or ''Bacillus influenzae'') is a Gram-negative, non-motile, coccobacillary, facultatively anaerobic, capnophilic pathogenic bacterium of the family Pasteurellaceae. The bact ...
'', or '' Moraxella catarrhalis''. Protracted bacterial bronchitis (lasting more than 4 weeks) in children may be helped by antibiotics.


Plastic bronchitis

Plastic bronchitis Plastic bronchitis (PB) is a disorder in which branching casts of the airways are expectorated. PB is not a single disease with a defined mechanism that explains the cast formation in all conditions. Examples of diseases associated with expectora ...
is a rarely found condition in which thickened secretions plug the bronchi. The plugs are rubbery or plastic-feeling (thus the name). The light-colored plugs take the branching shape of the bronchi that they fill, and are known as ''bronchial casts''. When these casts are coughed up, they are firmer in texture from typical
phlegm Phlegm (; , ''phlégma'', "inflammation", " humour caused by heat") is mucus produced by the respiratory system, excluding that produced by the nasal passages. It often refers to respiratory mucus expelled by coughing, otherwise known as sput ...
or the short, softer mucus plugs seen in some people with asthma. However, some people with asthma have larger, firmer, and more complex plugs. These differ from the casts seen in people whose plastic bronchitis is associated with congenital heart disease or lymphatic vessel abnormalities mainly because eosinophils and
Charcot–Leyden crystals Charcot–Leyden crystals are microscopic crystals composed of eosinophil protein galectin-10 found in people who have allergic diseases such as asthma or parasitic infections such as parasitic pneumonia or ascariasis. Appearance Charcot–Ley ...
are present in the asthma-associated casts but not in the others. Casts obstruct the airflow, and can result in the overinflation of the opposite lung. Plastic bronchitis usually occurs in children. Some cases may result from abnormalities in the
lymphatic vessel The lymphatic vessels (or lymph vessels or lymphatics) are thin-walled vessels (tubes), structured like blood vessels, that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph ves ...
s. Advanced cases may show imaging similarities to
bronchiectasis Bronchiectasis is a disease in which there is permanent enlargement of parts of the airways of the lung. Symptoms typically include a chronic cough with mucus production. Other symptoms include shortness of breath, coughing up blood, and chest ...
.


Aspergillus bronchitis

Aspergillus bronchitis is one of the ''
Aspergillosis Aspergillosis is a fungal infection of usually the lungs, caused by the genus ''Aspergillus'', a common mould that is breathed in frequently from the air around, but does not usually affect most people. It generally occurs in people with lung dis ...
'' spectrum of diseases, in which the bronchi are specifically subject to a fungal infection. This differs from the other pulmonary aspergillosis conditions, in that it need not affect just the immunocompromised.


References


External links

* NIH entry o
Bronchitis
*
MedlinePlus MedlinePlus is an online information service produced by the United States National Library of Medicine. The service provides curated consumer health information in English and Spanish with select content in additional languages. The site brings ...
entries o
Acute bronchitis
an

*
Mayo Clinic The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staf ...
br>factsheet on bronchitis
{{Authority control Chronic lower respiratory diseases Bronchus disorders Wikipedia medicine articles ready to translate Wikipedia emergency medicine articles ready to translate