Acute bronchitis:
acute inflammation of the bronchial mucosa, usually viral. It is sometimes caused by Mycoplasma pneumoniae in older children.
In children over 2 years, acute recurrent bronchitis or bronchitis ‘wheezing’ should consider asthma (see Asthma, page 73). In children under 2 years of age, consider bronchiolitis (see Bronchiolitis, page 64).
Clinical signs:
often begins with nasopharyngitis that “descends” progressively: pharyngitis,
laryngitis, tracheitis and tracheobronchitis.
– Significant cough, dry at first, then productive
– Moderate fever
– No tachypnea or dyspnea
– On pulmonary auscultation: rattling
Treatment:
– Fever: paracetamol PO (see Fever, page 26).
– Although moisturize, moisturize the atmosphere (bowl of water or a wet towel).
– In children: unblocking the nasopharynx by washing with sodium chloride
0.9% or Ringer’s lactate, 4-6 times / day.
– Good ground, context nasopharyngitis or flu unnecessary antibiotics
– Antibiotic treatment only if:
• bad ground: malnutrition, measles, rickets, severe anemia, heart disease, elderly patients, etc.
• onset of dyspnea with fever higher than 38.5 ° C and purulent sputum: a bacterial infection caused by Haemophilus influenzae or Pneumococcus is likely.
PO amoxicillin
Children: 100 mg / kg / day divided into 2 or 3 doses for 5 days
Adults: 3 g / day in 2 or 3 doses for 5 days or chloramphenicol PO
Children over 2 months: 50 to 100 mg / kg / day in 3 divided doses for 5 days
Adults: 3 g / day in 3 divided doses for 5 days.
Chronic bronchitis:
chronic inflammation of the bronchial mucosa original irritative (tobacco, pollution), allergy (asthma), infectious (acute recurrent bronchitis), which may progress to chronic respiratory insufficiency.
Clinical signs:
– Cough for 3 consecutive months per year for at least two consecutive years.
– Dyspnea absent at first. It appears after several years of evolution, effort and permanent.
– On pulmonary auscultation: rattling (always eliminate tuberculosis).
In acute exacerbation of chronic bronchitis:
– New or increased dyspnoea.
– Increase in volume of sputum.
– Change becomes purulent expectoration.
Treatment:
– In cases of chronic bronchitis easy: unnecessary antibiotics.
– In acute exacerbation of chronic bronchitis, only on a fragile ground, an antibiotic treatment may be useful. See acute bronchitis, previous page.
– Discourage tobacco and irritants.
