Bronchitis — Acute

Acute Bronchitis is caused by viruses, not bacteria (see Differences Among Germs).ย  So antibiotics don’t work!!!ย  The patient mainly has a cough, maybe some shortness of breath.ย  With a stethoscope, we can hear wheezes and/or rhonchi.ย  Wheezes are long, high-pitched sounds during expiration (breathing out), rhonchi are short squeaks and gurgles during inspiration or expiration.ย  We also hear expiration lasting longer than inspiration (normally, when listening with a stethoscope, inspiration sounds longer).

The latter is important, because a lot of clinicians don’t realize this. If they don’t hear an actual wheeze, they say “lungs are clear.” Actually, a long expiration phase really is a wheeze, but too high-pitched to hear; if we were dogs, we’d hear it. So if you ever have a cough, & your provider listens with a stethoscope & says “your lungs are clear,” ask them if expiration is longer than inspiration. If so, you’re wheezing.

Bronchitis usually just lasts 1-2 weeks.  But some people develop post-viral bronchospasm from the inflammation.  So even though the virus is dead, symptoms may last up to 3 months.

It’s impossible to tell the difference between Acute Bronchitis and Asthma.  If symptoms last over 3 months, asthma is likely.  I also diagnose asthma if another episode occurs — nobody tends to get frequent bronchitis.  I’ve seen this diagnosed over and over, however; some clinicians don’t realize that asthma can occur without wheezes, just rhonchi and a long expiration when heard by stethoscope. 

There are plenty of good ways to treat asthma, so the diagnosis is important.ย  However, even it’s just Acute Bronchitis from a virus, that will go away eventually on its own, medications for Asthma work well. Chronic Bronchitis is a form of COPD.ย  That’s a lot different.ย  See Chronic Obstructive Pulmonary Disease.

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