Acute bronchitis


An acute inflammation of the bronchial mucosa, most commonly of viral origin. In older children it can be caused by Mycoplasma pneumoniae. In children over 2 years of age with repetitive acute bronchitis or ‘wheezing’ bronchitis, consider asthma (see Asthma). In children under 2 years of age, consider bronchiolitis (see Bronchiolitis).

Clinical features

Often begins with a rhinopharyngitis that descends progressively: pharyngitis, laryngitis, tracheitis.
– Heavy cough, dry at the beginning then becoming productive
– Low-grade fever
– No tachypnoea, no dyspnoea
– On pulmonary auscultation: bronchial wheezing

Treatment

– Fever: paracetamol PO (Chapter 1).

– Keep the patient hydrated, humidify air (with a bowl of water or a wet towel).

– Children: nasal irrigation with 0.9% sodium chloride or Ringer lactate, 4 to 6 times daily to clear the airway.

– Antibiotherapy is not useful for patients in good overall condition with rhinopharyngitis or influenza.

– Antibiotherapy is indicated only if:
• the patient is in poor general condition: malnutrition, measles, rickets, severe anaemia, cardiac disease, elderly patient etc.
• if the patient has dyspnoea, fever greater than 38.5 °C and purulent expectorations: a secondary infection with Haemophilus influenzae or with pneumococcus is probable.
amoxicillin PO
Children: 30 mg/kg 3 times daily (max. 3 g daily) for 5 days
Adults: 1 g 3 times daily for 5 days