Topic Overview
Is this topic for you?
This topic is about acute bronchitis in
people who don't have other health problems. Acute bronchitis may be treated
differently if you have a long-term lung disease, such as
chronic obstructive pulmonary disease (COPD). For more
information, see the topics
Chronic Obstructive Pulmonary Disease (COPD) and
Pneumonia.
What is bronchitis?
Bronchitis means that the tubes that carry air
to the lungs (the bronchial tubes) are inflamed and
irritated. When this happens, the tubes swell and produce
mucus. This makes you cough.
There are
two types of bronchitis:
- Acute bronchitis usually comes on quickly and gets better after 2
to 3 weeks. Most healthy people who get acute bronchitis get better without any
problems. See a picture of
acute bronchitis.
- Chronic bronchitis keeps coming back and can last a
long time, especially in people who smoke. Chronic bronchitis means you have a
cough with mucus most days of the month for 3 months of the year for at least 2
years in a row.
This topic focuses on acute bronchitis. Both children and
adults can get acute bronchitis.
What causes acute bronchitis?
Acute bronchitis is usually caused by a
virus. Often a person gets acute bronchitis after
having an
upper respiratory tract infection such as a cold or
the flu. In rare cases, acute bronchitis is caused by
bacteria.
Acute bronchitis also can be
caused by breathing in things that irritate the bronchial tubes, such as smoke.
It also can happen if a person inhales food or vomit into the lungs.
What are the symptoms?
The most
common symptom of acute bronchitis is a cough that is dry and hacking at first.
After a few days, the cough may bring up mucus. You may have a low fever and
feel tired.
Acute bronchitis symptoms usually start 3 or 4 days
after an upper respiratory tract infection. Most people get better in 2 to 3
weeks. But some people continue to have a cough for more than 4 weeks.
Pneumonia can have symptoms like acute bronchitis.
Because pneumonia can be serious, it is important to know the differences
between the two illnesses. Symptoms of pneumonia can include a high fever,
shaking chills, and shortness of breath.
How is acute bronchitis diagnosed?
Your doctor will ask you about
your symptoms and examine you. This usually gives the doctor enough information
to find out if you have acute bronchitis.
In some cases, the
doctor may take a chest
X-ray to make sure that you don't have pneumonia or
another lung problem.
How is it treated?
Most people can treat symptoms of acute bronchitis
at home. Drink plenty of fluids. Use an
over-the-counter cough medicine with an expectorant if
your doctor recommends it. This can help you bring up mucus when you cough.
Suck on cough drops or hard candies to soothe a dry or sore throat. Cough drops
won't stop your cough, but they may make your throat feel better.
Most people don't need antibiotics for acute bronchitis.
Check with your doctor if you have heart or lung disease, such as
heart failure, COPD, or
asthma. You may need more treatment.
Frequently Asked Questions
Learning about acute bronchitis: | |
Being diagnosed: | |
Getting treatment: | |
Taking care of yourself: | |
Cause
Acute bronchitis is usually caused by a
virus. It is more common during the winter months and
often develops after an upper respiratory illness such as
influenza (flu) or a cold caused by a virus such as
coronavirus, adenovirus, or a rhinovirus.
Respiratory syncytial virus (RSV) may be a cause,
especially in adults older than 65. About 10% of the time, acute bronchitis is
caused by
bacteria.1
Acute bronchitis can also be caused by exposure to smoke, chemicals, or
air pollution, all of which can irritate the bronchial tubes. It can also
develop from accidentally inhaling (aspirating) food or vomit.
See
a picture of
acute bronchitis.
How acute bronchitis is spread
Acute bronchitis is
spread when an infected person coughs, sneezes, or talks and liquid droplets
containing virus particles or bacteria are released into the air and onto
objects. Then you may:
- Breathe air that contains the virus particles or bacteria.
- Touch an object that has been touched by an infected person and
then touch your eyes, nose, or mouth without washing your hands.
Symptoms
Symptoms of
acute bronchitis usually begin 3 to 4 days after an
upper respiratory infection, such as a cold or
influenza (flu). Symptoms usually include:
- A cough, which is the main symptom of acute bronchitis. It may be
dry at first (does not produce
mucus) and after a few days may bring up mucus from
the lungs (productive cough). The mucus may be clear, yellow, or green.
Sometimes, small streaks of blood may be present.
- A mild fever, usually less than
101°F (38.3°C). A higher fever
may indicate
pneumonia.
- A general feeling of tiredness.
- A sensation of tightness, burning, or dull pain in the chest
under the breastbone that usually is worse when breathing deeply or
coughing.
- Whistling noises (wheezing) when breathing, especially
during physical exertion.
- Hoarseness.
Most cases of acute bronchitis in otherwise healthy people
last only 2 to 3 weeks. But more than 20% of people with acute bronchitis have
a cough that lasts more than 4 weeks.2
Often it is hard to tell the difference between
viral and bacterial forms of acute bronchitis, and
many conditions have symptoms
similar to acute bronchitis, such as
asthma and
pneumonia. Because pneumonia can be a serious
complication, it is important to know the
differences between acute bronchitis and pneumonia.
For example, a high fever, shaking chills, and shortness of breath often occur
with pneumonia but not with acute bronchitis.
What Happens
Acute bronchitis is inflammation of the tubes that carry air to the lungs
(bronchial tubes). It is usually caused by a virus and follows an
upper respiratory tract infection such as a cold or
influenza (flu). The infection moves from the nose,
mouth, and throat to the bronchial tubes, causing the tubes to swell and mucus
production to increase.
At first, a dry, hacking cough is
present. After a few days, the cough may bring up mucus from the lungs. The
swollen tubes and increase in mucus may make it harder for you to
breathe.
See a picture of
acute bronchitis.
Most cases of acute bronchitis in otherwise
healthy people last only 2 to 3 weeks. But more than 20 out of 100 people with acute
bronchitis have a cough that lasts more than 4 weeks.2
How soon you get better depends on several things,
including:
- Your age and health.
- The organism causing the infection. Acute bronchitis from a
viral cause is usually less severe than from a
bacterial cause.
- Whether you smoke.
Complications
Most people get better without
having complications. If complications occur, they include:
- Pneumonia. Acute bronchitis that gets worse (increased
fatigue, high fever, chest pain, and increased shortness of breath) usually
means that pneumonia has developed.
- Repeated episodes of bacterial acute bronchitis. This condition
commonly occurs in people who smoke and in people with immune system problems,
such as
HIV infection,
cystic fibrosis, or cancer.
If you have a long-term (chronic) respiratory disease,
such as
asthma, acute bronchitis can make your coughing and
wheezing worse and can increase the risk of having complications. In this
case, acute bronchitis is a more serious problem and may be treated
differently.
Children and older adults are most at risk for
complications.
Children who have repeated bouts of acute bronchitis
need to be evaluated to see whether they may have a foreign object in the air
passage. Children may also be evaluated for asthma or other respiratory tract
problems, such as:
- Cystic fibrosis, an inherited disease that results in
the production of thick mucus in the lungs.
- Bronchiectasis, a lung condition in which the airways
of the lungs are damaged, get bigger, and are frequently infected. A common
symptom is a cough that brings up mucus.
- Allergies, which are an
immune system reaction to usually harmless substances.
Symptoms include cough and difficulty breathing.
Allergic rhinitis (hay fever) is a common
allergy.
- Sinusitis, an infection of the
mucous membranes that line the inside of the nose and
facial sinuses. Symptoms include pain and a chronic cough that produces
mucus.
- Adenoiditis, an inflammation of the
adenoids, which are small masses of tissue at the back
of the nose and throat.
What Increases Your Risk
Some things
increase your risk for
acute bronchitis.
Risk factors you cannot change
These
include:
- Chronic medical conditions, especially lung (pulmonary)
diseases such as
chronic obstructive pulmonary disease (COPD),
cystic fibrosis, or
asthma. In this case, acute bronchitis may be a more
serious problem and may be treated differently.
- Some conditions that cause
immune system problems, such as
diabetes and
HIV infection. An impaired immune system weakens the
body's ability to fight infection.
- A history of recent
upper respiratory infection, particularly
sinusitis, a cold, or
influenza (flu). An upper respiratory infection can
spread to the lungs.
- Allergies, such as
allergic rhinitis.
- An injury to the chest wall, such as a rib fracture.
Risk factors you can change
These include:
- Smoking or living with someone who smokes. Smoking or breathing
secondhand smoke makes the respiratory system less effective at removing
organisms from the lower airways.
- Living or working in an area with high levels of air pollution,
chemicals, or dust. Breathing in these irritants may make the respiratory
system less effective at removing organisms from the lower airways.
When To Call a Doctor
Call 911 or other emergency services immediately if:
- You have chest pain that is crushing or squeezing, is increasing
in intensity, or occurs with any
other symptoms of a heart attack.
- You have severe difficulty breathing.
- You are coughing up large amounts of blood (more than streaks of
blood or blood mixed with
mucus).
Call your doctor today if you:
- Feel short of breath, even when at rest.
- Notice new or increasing whistling sounds when breathing (wheezing) or difficulty breathing, even at
rest.
- Have a cough that frequently produces yellow or green sputum from
the lungs (not postnasal drainage), lasts longer than 2 days, and occurs along
with a fever of 101°F (38.3°C)
or higher.
- Are coughing up small streaks of blood.
- Develop symptoms of acute bronchitis and you have a chronic lung
disease such as
asthma or
chronic obstructive pulmonary disease (COPD).
Call your doctor in 1 to 2 days if you:
- Notice increased shortness of breath after any physical
activity.
- Have a cough that causes you to vomit frequently.
- Have a cough that has lasted longer than 4 weeks.
- Are being treated for acute bronchitis and your symptoms have not
improved after 14 days of treatment.
Watchful waiting
Watchful waiting is a period of time during
which you and your doctor observe your symptoms or condition without using
medical treatment. Watchful waiting is often appropriate in otherwise healthy
people with acute bronchitis unless you have:
- A persistent cough and increasing amounts of mucus being
coughed up from the lungs (especially if the mucus is becoming thicker and has
more color).
- Shortness of breath.
- Pain in the chest.
- Ongoing fever or fever that gets worse.
Who to see
Acute bronchitis can
be diagnosed and treated by most health professionals, including:
If you have complications, such as
pneumonia or repeated episodes of acute bronchitis
caused by bacteria, you may go to a
pulmonologist for diagnosis and treatment.
Complications rarely occur.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
There are no routine tests to diagnose
acute bronchitis. Diagnosis is usually based on your
medical history, including your symptoms, and a
physical exam. Your doctor will make sure you do not have
pneumonia or risk factors for more serious diseases,
such as
chronic obstructive pulmonary disease (COPD), that may
affect treatment.
If your doctor feels that your acute bronchitis
is caused by:
- A virus, then no more testing is needed in most cases.
- Bacteria, then more testing may be done and antibiotics may be
prescribed.
More testing may be needed for infants and people older
than 65, or if:
- Acute bronchitis does not clear up in 2 to 3 weeks.
- Pneumonia,
heart failure, or
tuberculosis is suspected or has been recently
diagnosed.
- Your immune system is not functioning well (impaired immune system). People with immune problems
are more likely to develop complications, such as pneumonia.
- You have a chronic respiratory disease, such as
asthma or chronic obstructive pulmonary disease
(COPD).
- You do not get better with antibiotic therapy, or you require
hospitalization.
- You have a heart rate greater than 100 beats per minute, a
respiratory rate greater than 24 breaths per minute, and a fever greater than
100.4°F (38°C).
- Whooping cough, a bacterial infection of the
respiratory system, is suspected.
- Influenza (flu), a viral upper respiratory illness, is
suspected.
Sometimes other tests may be needed. These tests
may include:
- Chest X-ray. The result of a chest X-ray of people who
have acute bronchitis is usually normal.
- Gram stain and culture and sensitivity of the mucus
from the lungs. These tests may help your doctor find out if bacteria are causing the
infection and which antibiotic will be effective.
- Other tests, including tests to measure blood oxygen
levels and tests that can help identify bacteria and viruses. The test results can help your doctor know
whether acute bronchitis is seriously harming lung function.
Treatment Overview
Treatment for
acute bronchitis in otherwise healthy people usually
includes taking steps to reduce cough, fever, and pain. Prescription medicines,
such as antibiotics, generally are not beneficial. If you already have a
disease, such as
chronic obstructive pulmonary disease (COPD),
heart failure, or
asthma, evaluation and treatment may be more
extensive.
Most cases of acute bronchitis go away in 2 to 3 weeks,
but some may last more than 4 weeks. Home treatment to relieve symptoms is
usually all that is needed. This includes:
- Stopping smoking, if you smoke, and not letting other people smoke around you.
- Relieving your cough by drinking fluids, using cough
drops, and avoiding lung irritants. Over-the-counter cough suppressants may help you to stop coughing. And expectorants may
make coughing easier so you can bring up
mucus. Cough and cold medicines may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and in some cases weight.
- Avoiding caffeine and alcohol, which cause you to lose extra
fluid from your body and may lead to
dehydration.
- Getting enough rest so your body has the energy needed to fight
the infection. In general, you feel better sooner if you rest more than usual
while you have acute bronchitis.
- Using nonprescription medicine, such as acetaminophen, ibuprofen,
or aspirin, to relieve fever and body aches.
Follow all directions on the label. If you give medicine to your baby, follow your doctor’s advice about what amount to give. Do not give aspirin to anyone younger than age
20 because of the risk of Reye syndrome, a rare but serious disease.
- Breathing moist air from a humidifier, hot shower, or sink filled
with hot water. The heat and moisture can help keep mucus in your airways moist
so it can be coughed out easily.
If prescription medicines are required, they may
include:
What to Think About
Most cases of acute bronchitis
are caused by viruses, which are not affected by antibiotics. Using antibiotics
when they are not needed is expensive, it can lead to side effects from
antibiotic therapy, and some bacteria may become
resistant to the antibiotic. This resistance may make
the antibiotic less effective the next time it is used. Talk to your doctor
about antibiotics. Find out whether they are needed and what their benefits
and risks are in treating acute bronchitis.
It is important to
seek medical care if you have a long-term (chronic) lung disease such as
asthma or
chronic obstructive pulmonary disease (COPD) and you
have signs of acute bronchitis. Early treatment of acute bronchitis may
prevent complications, such as
pneumonia or repeated episodes of acute bronchitis
caused by bacteria. This commonly occurs in people who smoke and in people with
immune system problems, such as
HIV infection,
cystic fibrosis, and cancer.
Prevention
You can help prevent
acute bronchitis.
- Avoid cigarette smoke. If you smoke, stop. People who smoke or
are around others who smoke have more frequent bouts of acute bronchitis. Smoke
(including secondhand smoke) reduces the body's ability to remove bacteria and
viruses that can cause infections in the lungs.
- Wear a face mask while working around irritants, such as dust.
Specially designed masks are available to filter out dangerous chemicals or
dust.
- Avoid contact with those who have an
upper respiratory tract infection, such as a cold,
especially if you have an
impaired immune system or another medical condition.
Wash your hands often during the cold and flu season. If you catch a cold or
influenza (flu), you are at an even higher risk for
getting bronchitis.
- Discuss with your doctor whether you should get a vaccine for
the flu.
If you have an upper respiratory tract infection, it may help to:
- Get plenty of rest.
- Drink enough liquids to avoid getting
dehydrated.
Home Treatment
Most cases of
acute bronchitis go away in 2 to 3 weeks. Home
treatment may help you feel better.
Home treatment may
include:
- Relieving your cough by drinking fluids, using cough
drops, and avoiding lung irritants. Over-the-counter cough suppressants may help you to stop coughing. And expectorants may
make coughing easier so you can bring up
mucus. Cough and cold medicines may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and in some cases weight.
- Avoiding caffeine and alcohol, which cause you to lose extra
fluid from your body and may lead to
dehydration.
- Cutting back or stopping smoking, if you smoke.
- Getting enough rest so your body has the energy needed to fight
the infection. In general, you feel better sooner if you rest more than usual
while you have acute bronchitis.
- Using nonprescription medicine, such as acetaminophen,
ibuprofen, or aspirin, to relieve fever and body aches.
Do not give aspirin to anyone younger than age
20.
- Breathing moist air from a humidifier, hot shower, or sink filled
with hot water. The heat and moisture can help keep mucus in your airways moist
so it can be coughed out easily.
Contact your doctor if your acute bronchitis gets worse,
because this may mean you have
pneumonia. Signs of acute bronchitis getting worse
include:
- A persistent cough and increasing amounts of mucus being coughed
up from the lungs (especially if the mucus is becoming thicker and has more
color).
- Shortness of breath.
- Pain in the chest wall.
- Ongoing fever or fever that gets worse.
Medications
Most cases of
acute bronchitis in otherwise healthy people go away
in 2 to 3 weeks. You typically only need nonprescription medicines to treat
your symptoms. Most people do not need to use prescription medicines, such as
antibiotics.
Medication Choices
- Over-the-counter cough suppressants may help you to stop coughing. And expectorants may
make coughing easier so you can bring up
mucus. Cough and cold medicines may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and in some cases weight.
- Nonprescription pain relievers and fever reducers, such as
aspirin, ibuprofen, or acetaminophen.
Do not give aspirin to anyone younger than age
20.
Your doctor may prescribe:
What to Think About
Most cases of acute bronchitis
are caused by viruses, which are not affected by antibiotics. Using antibiotics
when they are not needed is expensive, it can lead to side effects from
antibiotic therapy, and some bacteria may become
resistant to the antibiotic. This resistance may make
the antibiotic less effective the next time you use it. Talk to your doctor
about antibiotics. Find out whether they are needed and what their benefits
and risks are in treating acute bronchitis.
If your doctor
prescribes antibiotics, take them as directed. Do not stop taking them just
because you feel better. You need to take the full course of
antibiotics.
Corticosteroids, which may help relieve
difficulty breathing, frequent wheezing, or a persistent cough, may be
prescribed if other medical conditions such as
chronic obstructive pulmonary disease (COPD) or
asthma are present.
Other medicines may
be prescribed to treat complications, such as
pneumonia. The medicine used depends on the
complication.
Other Places To Get Help
Organizations
| American Lung Association |
| 1301 Pennsylvania Avenue NW |
| Suite 800 |
| Washington, DC 20004 |
| Phone: | 1-800-LUNG-USA (1-800-586-4872)
1-800-548-8252 (to speak with a lung professional)
(212) 315-8700 |
| Email: | info@lungusa.org |
| Web Address: | www.lungusa.org |
| |
The American Lung Association provides programs of
education, community service, and advocacy. Some of the topics available
include asthma, tobacco control, emphysema, infectious disease, asbestos, carbon monoxide, radon,
and ozone. |
|
| Centers for Disease Control and Prevention
(CDC) |
| 1600 Clifton Road |
| Atlanta, GA 30333 |
| Phone: | 1-800-CDC-INFO (1-800-232-4636) |
| TDD: | 1-888-232-6348 |
| Email: | cdcinfo@cdc.gov |
| Web Address: | www.cdc.gov |
| |
The Centers for Disease Control and Prevention (CDC) is
an agency of the U.S. Department of Health and Human Services. The CDC works
with state and local health officials and the public to achieve better health
for all people. The CDC creates the expertise, information, and tools that
people and communities need to protect their health—by promoting health,
preventing disease, injury, and disability, and being prepared for new health
threats. |
|
| KidsHealth for Parents, Children, and
Teens |
| 10140 Centurion Parkway North |
| Jacksonville, FL 32256 |
| Phone: | (904) 697-4100 |
| Fax: | (904) 697-4220 |
| Web Address: | www.kidshealth.org |
| |
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health, from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest. |
|
| National Heart, Lung, and Blood Institute
(NHLBI) |
| P.O. Box 30105 |
| Bethesda, MD 20824-0105 |
| Phone: | (301) 592-8573 |
| Fax: | (240) 629-3246 |
| TDD: | (240) 629-3255 |
| Email: | nhlbiinfo@nhlbi.nih.gov |
| Web Address: | www.nhlbi.nih.gov |
| |
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
and treating: - Diseases affecting the heart and circulation, such as heart
attacks, high cholesterol, high blood pressure, peripheral artery disease, and
heart problems present at birth (congenital heart diseases).
- Diseases that affect the lungs, such as asthma, chronic
obstructive pulmonary disease (COPD), emphysema, sleep apnea, and
pneumonia.
- Diseases that affect the blood, such as anemia,
hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.
|
|
References
Citations
- Gonzales RG, et al. (2001). Principles of appropriate
antibiotic use for treatment of uncomplicated acute bronchitis: Background.
Annals of Internal Medicine, 134(6): 521–529.
- Katz JT (2009). Pneumonia and other pulmonary
infections. In EG Nabel, ed., ACP Medicine,
section 7, chap. 20. Hamilton, ON: BC Decker.
Other Works Consulted
- Knutson D, Braun C (2002). Diagnosis and management of
acute bronchitis. American Family Physician, 65(10):
2039–2044.
- Wenzel RP, Fowler AA III (2006). Acute bronchitis.
New England Journal of Medicine, 355(20):
2125–2130.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Robert L. Cowie, MB, FCP(SA), MD, MSc, MFOM - Pulmonology |
|---|
| Last Revised | August 4, 2010 |
|---|
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.