BRONCHITIS.ppt

Health centre

1. BRONCHITIS
BY FRANK.S
PRESENTATION OUTLINE
1.Definition
2. Causes
3. Risk factors
4. Pathophysiology
5. Classification
6. Signs and symptoms
7. Differentials
8. Investigations
9. Management

2. Definition and causes of BRONCHITIS
Definition
This is an inflammation of the bronchi associated with
excessive sputum production and a barking cough
Causes
Viral causes
Influenza
Rhino virus
Corona virus
Adeno virus
Respiratory syncytial virus (RSV)

3. Causes cont’d
Bacterial causes
Streptococcus pneumoniae
Haemophilus influenza
Mycoplasma pneumoniae
Chlamydia pneumoniae
Moraxella catarrhalis
Bordertella pertusis

4. Risk factors of BRONCHITIS
Cigarette smoking
Viral infections of RT
Chronic obstructive pulmonary diseases, COPD e.g asthma
and Emphysema
Prolonged exposure to coldness
Exposure to heavy amounts of second hand smoke and
pollution
Frequent use of cooking fire without proper ventilation
Prolonged exposure to dust and smoke
Whooping cough

5. Pathophysiology of BRONCHITIS
Chronic smoking destroys the cilia in RT lining
Mucus in lower lungs stagnates there as it cant be brought
by cilia to Carinii junction (where trachea bifurcates into
two bronchi).
At this jxn there is high nerve endings which will stimulate
a cough reflex & in this case it won’t be initiated.
Mucus plugging will favor bacterial invasion destroying
lung tissue & capillaries.
Forceful coughing leads to rapture of capillaries leading to
haemoptysis.

6. Pathophysiology cont’d
Increased number (hyperplasia) and increased size
(hypertrophy) of goblet cells & mucus glands in the air way.
Increased mucus produced >narrowing of the airway
causing a barking cough and excessive sputum production.
Inflammation is followed by scarring and remodeling the
thickness of the walls>further narrowing=fibrosis of lung
tissue.
Emphysema=lung damage &inflammation of air sacs
(alveoli) or enlargement of the air sacs distal to terminal
bronchioles with destruction of their walls.

7. Classification of BRONCHITIS
Acute Bronchitis-sudden inflammation of bronchi
Usually viral but may be complicated by bacterial infections
especially in smokers and in patients with COPD/asthma.
Commonly mild but can become severe in
immunosuppressed patients and those with chronic lung or
heart diseases.
Infants usually get bronchiolitis (inflammation of
bronchioles) causing symptoms similar to asthma.

8. Classification of BRONCHITIS cont’d
Chronic Bronchitis
This chronic inflammation of bronchi characterized
by excessive sputum production with cough present
on most days for at least 3 months in a year with
positive history of smoking.
It is not primarily an infective condition but acute
exacerbations or can become worse by viral and
bacterial infections

9. Signs and symptoms of BRONCHITIS
Dry cough followed by a productive cough with a lot of
mucus production/sputum (>3/12)
Wheezing with occasional crackles/crepitations
Muscle aches/weakness/fatigue
Chest tightness/chest pain
Shortness of breath/dysponea
Fever with chills
History of cigarrette smoking for a long time

10. D.DX OF BRONCHITIS
Asthma
Emphysema
PTB
Whooping cough (Pertusis)
Laryngotracheobronchitis(LTB/croup)
Investigations
Chest X-ray
Pulmonary function test (spirometry)
ZN staining
Gram staining
FBC/CBC and C/S of Sputum
Chest CT scan

11. MANAGEMENT OF BRONCHITIS
Supportive Mgt
•Viral bronchitis only symptomatic RX is needed
•Bed rest until a febrile
•Fluid intake to maintain hydration and facilitate
expectoration
•Cough expectorants e.g Zedex, Brozedex, Zecuff, Deleased,
Lubyamira, Kisakyamuzade, Kabuuti etc
•Steam inhalation/warm moist air to facilitate expectoration
•Stopping smoking, Steroids
•Analgesics e.g paracetamol, ASA, Ibuprofen etc.

12. MGT OF BRONCHITIS cont’d
Drug mgt=Chronic bronchitis or if high temp persist or mucus
becomes prulent in acute bronchitis.
•Caps Amoxicillin 500mg tds for 7-10days
•Tabs Co-Amoxiclav 625mg bd for 7days
•Tabs Erythromycin 500mg qid for 7 days
•Tabs Azithromycin 500mg od for 5days
•Tabs Cefuroxime 250mg bd for 7 days
•Caps Doxycycline 100mg bd for 7 days
•Tabs Clarithromycin 250mg-500mg bd for 7 days
•Other antibiotics can also RX Bronchitis (IM/IV)

13. Thank you for listening