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.
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.
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.
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.
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 more difficult for you to
breathe.
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
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
developing complications. If complications occur, they include:
Pneumonia. Acute bronchitis that gets worse (increased
fatigue, high fever, chest pain, and increased shortness of breath) usually
indicates 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 developing 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.
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.
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.
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.
There are no routine tests to diagnose
acute bronchitis. Diagnosis is usually based on your
medical history, including your symptoms, and a
physical examination. 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 necessary for infants and people older
than 65, or if:
Acute bronchitis does not clear up in 2 to 3 weeks.
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).
Influenza (flu), a viral upper respiratory illness, is
suspected.
Sometimes other tests may be needed. Possible tests
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 determine if bacteria are causing the
infection and which antibiotic will be effective.
Other tests, including tests to measure blood oxygen
levels. These tests can help identify bacteria and viruses and can determine
whether acute bronchitis is seriously harming lung function.
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 necessary. This includes:
Relieving your cough by drinking fluids, using cough
drops, and avoiding lung irritants. You may also use nonprescription cough
suppressants, which may help you to stop coughing, and expectorants, which may
make coughing easier so you can bring up
mucus. Research on cough suppressants and expectorants
does not show that they stop a cough, but some people might find them helpful.
Do not give cough and cold medicines to a child younger than 2 unless your
child’s doctor has told you to. If your child’s doctor tells you to give a
medicine, be sure to follow what he or she tells you to do.
Avoiding caffeine and alcohol, which cause you to lose extra
fluid from your body and may lead to
dehydration.
Stopping smoking, if you smoke.
Getting enough rest so your body has the energy needed to fight
the infection. Generally, 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.
If prescription medicines are required, they may
include:
Inhaled beta2-agonists, which open up (dilate) the
airways and may relieve coughing in people who have a hard time breathing. But
the possible benefit should be weighed against possible side effects of
shaking, tremor, and nervousness.
Antibiotics, which may be used to treat
people who are at increased risk for complications
from acute bronchitis. They may also be used if symptoms do not improve after
using a beta2-agonist and home treatment. For acute bronchitis in otherwise
healthy people, antibiotics generally are not beneficial. For more information,
see:
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 necessary 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
develop 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.
Avoiding 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.
Wearing a face mask while working around irritants, such as dust.
Specially designed masks are available to filter out dangerous chemicals or
dust.
Avoiding 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
developing bronchitis.
Discussing with your doctor whether you should get a vaccine for
the flu.
If you have had acute bronchitis in the past, you can help
avoid getting it again by:
Avoiding air pollution and other irritants in the air. Stay
indoors with the doors and windows closed if air pollution is at a high
level.
Avoiding the use of wood-burning stoves in the winter, if
possible.
Avoiding situations that may trigger an
allergic reaction, if you have an allergy.
If you have an upper respiratory tract infection, it never
hurts to:
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. You may also use nonprescription cough
suppressants, which help you stop coughing, and expectorants, which make
coughing easier so you can bring up
mucus. Research on cough suppressants and expectorants
does not show that they stop a cough, but some people might find them helpful.
Do not give cough and cold medicines to a child younger than 2 unless your
child’s doctor has told you to. If your child’s doctor tells you to give a
medicine, be sure to follow what he or she tells you to do.
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. Generally, you feel better sooner if you rest more than usual
while you have acute bronchitis.
Using nonprescription medication, 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 indicate
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).
Most cases of
acute bronchitis in otherwise healthy people go away
in 2 to 3 weeks. You generally only need nonprescription medicines to treat
your symptoms. Most people do not need to use prescription medicines, such as
antibiotics.
Medication Choices
Nonprescription cough suppressants, which may help
relieve coughing, and expectorants, which may make
coughing easier so you can bring up
mucus. Do not give cough and cold medicines to a child
younger than 2 unless your child’s doctor has told you to. If your child’s
doctor tells you to give a medicine, be sure to follow what he or she tells you
to do.
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:
Inhaled beta2-agonists, such as albuterol, which open
up the airways and may relieve coughing in people who have a hard time
breathing. But the possible benefits should be weighed against possible side
effects of shaking, tremor, and nervousness.
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 necessary 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.
Rest, fluids, and home
treatment are all that is needed to treat most cases of
acute bronchitis in otherwise healthy people. People
who have certain chronic respiratory diseases, such as
chronic obstructive pulmonary disease (COPD), may need
additional treatment.
1-800-LUNG-USA (1-800-586-4872) 1-800-548-8252 (to speak with a lung professional) (212) 315-8700
Web Address:
www.lungusa.org
The American Lung Association, along with its medical branch, the
American Thoracic Society, provides programs of education, community service,
and advocacy. Some of the topics available include asthma, tobacco control,
emphysema, asbestos, carbon monoxide, radon, and ozone.
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.
Simon HB (2006). Pneumonia and other pulmonary
infections. In DC Dale, DD Federman, eds., ACP Medicine,
section 7, chap. 20. New York: WebMD.
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.
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
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