The document provides a detailed overview of bronchitis, categorizing it into acute and chronic forms, and discussing their definitions, causes, symptoms, and treatment options. Acute bronchitis is characterized by a cough lasting less than 3 weeks and often caused by respiratory viruses, while chronic bronchitis is defined by a productive cough lasting at least 3 months over two consecutive years, primarily due to cigarette smoking. Treatment strategies include symptom alleviation for acute bronchitis and smoking cessation along with bronchodilators and glucocorticoids for chronic bronchitis.

1. Mbeya School of Dental
Therapist
Bronchitis
Dr. edward, MD

2. Content
 Definition
 Types
 Etiology
 Epidemiology
 Clinical features
 Differential diagnoses of bronchitis
 Investigations for bronchitis
 Treatment for acute and chronic bronchitis

3. Definition
 Bronchitis is the inflammation of the bronchial tubes.
 Bronchial tube allows air passages from the trachea into
the small airways and alveoli.
 Triggers of bronchitis;
-Infectious agents
viruses/bacteria.
-Non Infectious agents
smoking or chemical pollutants inhalation or dust.

4. Cont;
Types of bronchitis
-Acute bronchitis
-Chronic bronchitis.
Acute bronchitis is manifested by cough with occasionally,
productive sputum lasting for less than 3 weeks.
Chronic bronchitis is the presence of productive cough not
attributable to other causes on most days for at least 3 months
over 2 consecutive years.

5. Etiology of Acute bronchitis
-Respiratory viruses
-Most common causes of acute bronchitis
-The most common viruses include
-Influenza A and B, Parainfluenza, Respiratory syncytial virus and Corona virus
-Bacterial infections include;
Mycoplasma species
Chlamydia pneumoniae
Streptococcus pneumoniae
Moraxella catarrhalis
Haemophilus influenzae
-Exposure to irritants i.e pollution, chemicals, and tobacco smoke cause acute
bronchial irritation

6. cont
Aetiology of Chronic Bronchitis
Cigarette smoking is the predominant cause of chronic bronchitis.
-Cigarette smoking accounts for 85-90% of chronic bronchitis and
COPD.
-Smoking pipes, cigars, and marijuana causes similar damage.
-Smoking impairs ciliary movement, inhibits the function of alveolar
macrophages, and leads to hypertrophy and hyperplasia of mucus-
secreting glands.
-Smoking can also increase airway resistance via vagally mediated smooth
muscle constriction.
 Bacterial or viral infections
 Environmental pollution

7. Epidemiology
 Acute bronchitis is most frequently diagnosed in children
younger than 5 years, whereas
 Chronic bronchitis is more prevalent in people older than 50
years.
 Males more than females
 Bronchitis occurs more frequently in
 low socioeconomic population
Urban and highly industrialized areas

8. Clinical Features of Bronchitis
Symptom of Acute Bronchitis
 Cough is the most commonly observed symptom last from 10-20 days
 Purulent sputum is reported in 50% of patient.
 Sore throat
 Runny nose
 Headache
 Muscle aches
 Extreme fatigue
 General malaise and chest pain.

9. Signs of Acute Bronchitis
 Conjunctivitis, adenopathy, and rhinorrhea
-Suggestive of adenovirus infection
 Inspiratory stridor may occur
 Localized lymphadenopathy
 Rhinorrhea
 Use of accessory muscles

10. Symptoms of Chronic Bronchitis
Onset is typically at 50s
Productive cough
A morning ‘smoker's cough’ is frequent, small in amount.
Wheezes.
Dyspnoea
 Exercise tolerance becomes progressively limited.
Morning headache may indicate the onset of significant CO2retention
Weight loss in advanced disease

11. Signs of Chronic Bronchitis
the only abnormal may be wheezes on forced expiration.
hyperinflation
Increased anteroposterior diameter of the chest.
distant breath sounds.
inspiratory crackles .
• Cor pulmonale and right heart failure may be evidenced by
dependent oedema and an enlarged, tender liver.
Cyanosis

12. Differential diagnosis of bronchitis
Differential Diagnosis of Acute Bronchitis
 Asthma
 Pneumonia
 Bronchiectasis
 Chronic bronchitis
 Pharyngitis
 Sinusitis
Differential Diagnosis of Chronic Bronchitis
 Bronchiectasis
 Tuberculosis
 Congestive heart failure

13. Investigations
 Complete blood count (CBC) with differential
 A chest X-ray that reveals hyperinflation
 A sputum sample
-showing neutrophil granulocytes.
-Gram stain and Ziel Neilsen stain, culture showing that
has pathogenic microorganisms such as Streptococcus spp

14. Treatment of Acute Bronchitis
 Aimed towards alleviation of symptoms.
 Treatment of acute bronchitis is primarily supportive.
 For acute bronchitis
-Beta2-agonist bronchodilators may be useful in patients
who have associated wheezing with cough.

15. Treatment of Chronic Bronchitis
Treatment of chronic bronchitis is based on
The principles of prevention of further evolution of disease
Preservation of airflow
Preservation and enhancement of functional capacity
Management of physiologic complications
Avoidance of Acute exacerbations
Smoking cessation
Elimination of tobacco smoking confers significant survival benefit to
patients with chronic bronchitis.

16. Management principle include the following
-Bronchodilator
-Glucocorticoids
-Antibiotics
-Oxygen therapy

17. Bronchodilators
Improve dyspnea and exercise tolerance
Salbutamol (short acting beta 2 agonist).
Acute symptoms: 2 puff repeated 6 hourly
Other bronchodilators include Theophylline

18. Glucorticoids
-Chronic bronchitis is a disease associated with airway inflammation,
-Glucocorticoids reduce inflammation.
-The use of inhaled glucocorticoids ameliorates systemic side
effects. Examples include Beclomethasone dipropionate

19. Oxygen Therapy
Severe and progressive hypoxemia is often seen in advanced
chronic bronchitis and may result in cellular hypoxia.
Long-term O2 therapy
-Reverse secondary polycythemia; improve body weight;
ameliorate cor pulmonale; and enhance neuropsychiatric
function, exercise tolerance, and activities of daily living.
Oxygen is most frequently delivered through a nasal cannula at
rates of 2 to 5 L/min.

20. Antibiotics
Frequent organisms associated with mild chronic bronchitis
exacerbations include
-Streptococcus pneumoniae, Haemophilus influenzae, and
Moraxella catarrhalis.
Common drugs used are
-Cotrimoxazole 960 mg PO BD for 10-14 days
-Doxycycline 100 mg PO bid for 10 days.
-Amoxicillin and clavulanate 625 mg PO BD for 7-10 days