BRONCHITIS

TYPES: (1) Acute, viz. (i) Catarrhal bronchitis. (ii) Capillary bronchitis, (iii) Suppurative bronchitis (IV) Fibrinous bronchitis, (2) Chronic, viz. (i) Catarrhal, (ii) Suppurative, (iii) Fibrinous

ACUTE BRONCHITIS

Definition: Acute inflammation of the trachea and bronchi caused by pyogenic organisms.

Aetiology: Infection by Streptococcus, H. influenza, Staph. Pyogenes etc. is a common sequel to Coryza, influenza, measles and whooping cough.

Predisposing factors: Cold, damp, foggy and dusty atmospheres, cigarette smoking.

Pathology: The lower part of the trachea and the main bronchi are affected. The mucous membrane is hyperemic in the early stages, with little secretion; later thin mucous exudates appear which becomes mucopurulent & finally ceases.

Clinical Features: (a) General malaise, headache, anorexia etc. (b) Irritating, unproductive cough. (c) Upper retrosternal discomfort or pain. (d) Sputum — scanty, mucoid. (e) Tracheitis without bronchitis produces no abnormal physical signs. As the bigger bronchi are involved: (a) Tightness of the chest (b) Dyspnoea and wheeze, (c) Mucopurulent & copious sputum, sometimes streaks of blood

Signs (a) Vesicular breathe sound. (b) Bilateral sonorous rhonchus and coarse crepitations.

As the small bronchi are involved : (a) Fever — 100-102°F and neutrophil leucocytosis, (b) Dyspnoea increases, (c) High pitch ronchi & fine crepitations, (d) If the infection reaches the smallest bronchi and bronchioles the condition becomes indistinguishable from lobular pneumonia.

Course: Mostly recovery takes place within 4 to 8 days.

Differential Diagnosis: (I) Tuberculosis. (2) Bronchiectasis.

(3) Bronchogenic carcinoma. (4) At the onset the possibility of diseases, e. g., Measles, whooping cough etc. should be kept in mind.

Prognosis: Good, unless the patient is very old.

Complications: Chronic bronchitis.

Treatment: (I) Bed rest. (2) Avoidance of cold, dust, smoke etc.

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