Bronchitis

Bronchitis is when the airways in the lungs become inflamed, leading to coughing and other symptoms. It usually starts as an infection in the nose, ears, throat, or sinuses before moving to the bronchi, the large airways of the lungs. People with bronchitis often experience coughing up sputum, wheezing, shortness of breath, and chest pain.

There are two main types of bronchitis: acute and chronic. Acute bronchitis typically lasts about three weeks and is often called a chest cold. It is usually caused by a viral infection, spread through the air when people cough or by direct contact, though sometimes bacterial infections like Mycoplasma pneumoniae or Bordetella pertussis can be the cause. Risk factors include exposure to tobacco smoke, dust, and other air pollution. Rest, paracetamol, and nonsteroidal anti-inflammatory drugs are common treatments.

Chronic bronchitis is defined as a productive cough lasting at least three months per year for two years. It is often linked to chronic obstructive pulmonary disease (COPD). The most common cause is tobacco smoking, with air pollution and genetics also playing roles. Treatments include quitting smoking, vaccinations, rehabilitation, and medications like inhaled bronchodilators and steroids. Some people may need long-term oxygen therapy. Acute bronchitis is very common, affecting about 5% of adults and 6% of children each year, while chronic bronchitis is less common.

Acute bronchitis

Main article: Acute bronchitis

Acute bronchitis, also called a chest cold, is a short-term inflammation of the bronchi in the lungs. The main symptom is a cough, which might bring up mucus. Other signs include wheezing, shortness of breath, fever, and chest discomfort. Most fevers are mild, and the infection usually lasts from a few days to about ten days. However, the cough can continue for several weeks, with total symptoms often lasting around three weeks.

Most cases of acute bronchitis are caused by viruses spread through the air when people cough or by direct contact. Risk factors include exposure to tobacco smoke, dust, and other air pollutants. Only a small number of cases are due to bacteria. Diagnosis is based on symptoms, and a chest X-ray might be used to rule out pneumonia. Treatment includes rest, paracetamol for fever, and plenty of fluids. Cough medicine is not recommended for children under six, and antibiotics are generally not needed unless the infection is due to certain bacteria.

Chronic bronchitis

Chronic bronchitis is a long-term condition where a person coughs up mucus for at least three months in each of two consecutive years. It is often called a "smoker's cough" because smoking is the main cause. When chronic bronchitis happens together with reduced airflow in the lungs, it is known as chronic obstructive pulmonary disease (COPD). Many people with chronic bronchitis also have COPD, but not everyone with COPD has chronic bronchitis.

This condition is caused mainly by smoking, but other factors like air pollution, dusty or irritating work environments, and some rare genetic factors can also play a role. Treating chronic bronchitis often includes stopping smoking, using certain medications, and sometimes oxygen therapy. It can slow the decline of lung function and improve quality of life.

History

Bronchitis has been known for many centuries across different cultures, including Ancient Greek, Chinese, and Indian. Early treatments included natural remedies like garlic and cinnamon.

The British physician Charles Badham first described acute bronchitis in 1808 and later expanded on his work in 1814. By the mid-20th century, modern treatments began to develop. Research in the 1950s linked chronic bronchitis closely with emphysema, especially in people who smoked. Definitions of chronic bronchitis were formalized in medical meetings during the late 1950s and early 1960s.

Eosinophilic bronchitis

Main article: Eosinophilic bronchitis

Eosinophilic bronchitis causes a persistent dry cough. It is identified by a higher number of a specific type of white blood cell called eosinophils. People with this condition usually have normal results on chest X-rays and do not experience difficulty breathing.

Protracted bacterial bronchitis

Protracted bacterial bronchitis is a condition in children that causes a long-lasting cough. It happens when certain bacteria, such as Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis, infect the lungs. Doctors can often help treat this condition with antibiotics, and the cough usually gets better after treatment.

This type of bronchitis lasts longer than four weeks, but with the right care, children can feel much better.

Plastic bronchitis

Plastic bronchitis is a rare condition where thickened secretions form rubbery or plastic-feeling plugs in the bronchi, called bronchial casts. These casts are firmer than typical phlegm and can take the shape of the bronchi they fill. This condition mostly affects children and can sometimes be linked to abnormalities in the lymphatic vessels. In more advanced cases, it may look similar to another lung condition called bronchiectasis on imaging tests.

A subtype called eosinophilic plastic bronchitis is more common in children and can cause coughing, wheezing, and sometimes a completely collapsed lung on imaging. Depending on the size and location of the casts, symptoms can range from mild to severe.

Aspergillus bronchitis

Aspergillus bronchitis is a type of aspergillosis, a fungal infection caused by Aspergillus, a common mold. This mold affects the bronchi, the large airways in the lungs. Unlike other lung infections caused by this mold, Aspergillus bronchitis can affect people who have strong immune systems. In these individuals, it may cause ongoing cough and breathing problems that do not get better with regular antibiotics but can improve with special medicines called antifungals.