ACUTE & CHRONİC BRONCHİTİS

Bronchitis is one of the most common types of lower respiratory tract infections. Bronchitis, which is limited inflammation of the major Airways, can be acute or chronic. It is more common during childhood.
The factors that cause acute bronchitis are also viruses that cause upper respiratory tract infection (Turk thorax, 2009). If the symptoms of bronchitis spread over a period of time and are permanent, chronic bronchitis is mentioned. However, many sources use the tables of chronic bronchitis and chronic obsureative lung disease (COPD) in the same way. This is due to the fact that both terms point to a very close clinical picture (Öztürk et al, 2010). Chronic bronchitis is characterized as a cardinal cough symptom not less than two years and three months following each other and not related to any other disease (Atasoy, 2010).

Symptoms and clinical table

The most important symptoms of the disease are cough and increased phlegm. It usually develops after an upper respiratory tract infection. It is separated from upper respiratory tract infection by a cough that lasts 5 days. There may be no abnormal findings on the whole blood count. Some blood counts show mild leukocytosis. In patients diagnosed with acute bronchitis and over 75 years of age, routine lung imaging is recommended. No differential diagnostic value in lung graph (Evrin, 2009).

Problems develop more rapidly in children compared to adults. Sneezing and runny nose mild upper respiratory infection symptoms are accompanied by loss of appetite and fever. Then, coughs become apparent in the patient. In physical examination, rustiness and tachypnea and respiratory distress are important signs (Okutan and Paddy, 2005).

Their symptoms are not resistant. Other respiratory infections should be considered in the presence of long-term and resistant symptoms. The bacterial species Mycoplasma and bronchitis caused by Chlamydophila pneumoniae can cause outbreaks in public places such as schools or barracks in communities where vaccination is low (Evrin, 2009).

In chronic bronchitis and obstructive bronchiolitis, fibrosis, inflammation, and proliferation of smooth muscles increase resistance in the airways (Atasoy, 2010).

Risk Factors
The risk factors for bronchitis are summarized in the table below.

Viral

Bacterial

Fungal

Non infection

Coronavirus

Influenza A ve B

Parainfluenza virüs

Metapneumovirüs

Adenovirüs

Mycoplasma virüs

Bordetella pneumonia

Chlamydia pneumonia

Candida albicans

Candida tropicalis

Smoking

Biomass

In cases where there is no underlying lung disease, microorganisms have rarely been identified. In acute bronchitis, especially in young people and adults, Bordotella pertussis and B. parapertussis strains have been reported to be active (Turk thorax, 2009).

Smoking is one of the most important risk factors and supports the appearance of “dirty lung” on the lung chart. On the other hand, thorax CT results show no specific symptoms of chronic bronchitis (Öztürk et al, 2010).

Treatment Methods
In the treatment of the disease, the cause of the disease needs to be well known. Viral, bacterial, fungal or other causes of some differences in the treatment process is observed. Symptoms are treated with plenty of fluids, nasal decongestants, antiinflammatory drugs that lower fever, antitussive agents such as codeine and dectromethorphan, and antipyretic drugs that relieve pain. Generally there is no need to use antimicrobials.

Smoking and biomass exposure are controllable environmental conditions. The annual influenza vaccine is recommended as a precaution. Because of the heavy clinical picture during childhood, vaccination against pertussis is recommended.

Utilized resources
Atasoy, P. (2010). "Pathology in COPD". Turkish Thoracic Journal, 1 (2), 119-123.
Evrin, T. (2018). “Approach to Acute Bronchitis and Pneumonia Patient”. Department of Emergency Medicine, Ufuk University.
Okutan Ö and Çeltik, C. (2005). “Current Information in Acute Bronchiolitis”. Sted, 14 (1), 5-7.
Öztürk Ö, Köroğlu M, Zorlu Karayiğit D and Gündüz M. (2010). “New approaches in radiological evaluation of chronic obstructive pulmonary disease”. S.D.Ü. Faculty of Medicine. Journal, 17 (4) / 29-37.
Turkish Thorax, (2009). “Pulmonary Thromboembolism Diagnosis and Treatment Consensus Report”. Turkish Thoracic Journal.