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American Family Physician Oct 2016Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to... (Review)
Review
Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in patients with tachypnea, tachycardia, dyspnea, or lung findings suggestive of pneumonia, and radiography is warranted. Pertussis should be suspected in patients with cough persisting for more than two weeks that is accompanied by symptoms such as paroxysmal cough, whooping cough, and post-tussive emesis, or recent pertussis exposure. The cough associated with acute bronchitis typically lasts about two to three weeks, and this should be emphasized with patients. Acute bronchitis is usually caused by viruses, and antibiotics are not indicated in patients without chronic lung disease. Antibiotics have been shown to provide only minimal benefit, reducing the cough or illness by about half a day, and have adverse effects, including allergic reactions, nausea and vomiting, and Clostridium difficile infection. Evaluation and treatment of bronchitis include ruling out secondary causes for cough, such as pneumonia; educating patients about the natural course of the disease; and recommending symptomatic treatment and avoidance of unnecessary antibiotic use. Strategies to reduce inappropriate antibiotic use include delayed prescriptions, patient education, and calling the infection a chest cold.
Topics: Acute Disease; Bronchitis; Cough; Diagnosis, Differential; Humans
PubMed: 27929206
DOI: No ID Found -
Italian Journal of Pediatrics Feb 2023Bronchiolitis is an acute respiratory illness that is the leading cause of hospitalization in young children. This document aims to update the consensus document... (Review)
Review
Bronchiolitis is an acute respiratory illness that is the leading cause of hospitalization in young children. This document aims to update the consensus document published in 2014 to provide guidance on the current best practices for managing bronchiolitis in infants. The document addresses care in both hospitals and primary care. The diagnosis of bronchiolitis is based on the clinical history and physical examination. The mainstays of management are largely supportive, consisting of fluid management and respiratory support. Evidence suggests no benefit with the use of salbutamol, glucocorticosteroids and antibiotics with potential risk of harm. Because of the lack of effective treatment, the reduction of morbidity must rely on preventive measures. De-implementation of non-evidence-based interventions is a major goal, and educational interventions for clinicians should be carried out to promote high-value care of infants with bronchiolitis. Well-prepared implementation strategies to standardize care and improve the quality of care are needed to promote adherence to guidelines and discourage non-evidence-based attitudes. In parallel, parents' education will help reduce patient pressure and contribute to inappropriate prescriptions. Infants with pre-existing risk factors (i.e., prematurity, bronchopulmonary dysplasia, congenital heart diseases, immunodeficiency, neuromuscular diseases, cystic fibrosis, Down syndrome) present a significant risk of severe bronchiolitis and should be carefully assessed. This revised document, based on international and national scientific evidence, reinforces the current recommendations and integrates the recent advances for optimal care and prevention of acute bronchiolitis.
Topics: Infant, Newborn; Child; Infant; Humans; Child, Preschool; Bronchiolitis; Hospitalization; Risk Factors; Albuterol; Respiratory Syncytial Virus Infections
PubMed: 36765418
DOI: 10.1186/s13052-022-01392-6 -
Immunology and Allergy Clinics of North... May 2023Smoking-related interstitial lung diseases (ILDs) are a group of heterogeneous, diffuse pulmonary parenchymal disease processes associated with tobacco exposure. These... (Review)
Review
Smoking-related interstitial lung diseases (ILDs) are a group of heterogeneous, diffuse pulmonary parenchymal disease processes associated with tobacco exposure. These disorders include pulmonary Langerhans cell histiocytosis, respiratory bronchiolitis-associated ILD, desquamative interstitial pneumonia, acute eosinophilic pneumonia, and combined pulmonary fibrosis and emphysema. This review summarizes the current evidence of pathogenesis, clinical manifestations, diagnostic approach, prognosis, and treatment modalities for these diseases. We also discuss the interstitial lung abnormalities incidentally detected in radiologic studies and smoking-related fibrosis identified on lung biopsies.
Topics: Humans; Lung Diseases, Interstitial; Smoking; Bronchiolitis; Lung
PubMed: 37055089
DOI: 10.1016/j.iac.2023.01.007 -
European Respiratory Review : An... Dec 2022Lower respiratory infections include acute bronchitis, influenza, community-acquired pneumonia, acute exacerbation of COPD and acute exacerbation of bronchiectasis. They... (Review)
Review
Lower respiratory infections include acute bronchitis, influenza, community-acquired pneumonia, acute exacerbation of COPD and acute exacerbation of bronchiectasis. They are a major cause of death worldwide and often affect the most vulnerable: children, elderly and the impoverished. In this paper, we review the clinical presentation, diagnosis, severity assessment and treatment of adult outpatients with lower respiratory infections. The paper is divided into sections on specific lower respiratory infections, but we also dedicate a section to COVID-19 given the importance of the ongoing pandemic. Lower respiratory infections are heterogeneous entities, carry different risks for adverse events, and require different management strategies. For instance, while patients with acute bronchitis are rarely admitted to hospital and generally do not require antimicrobials, approximately 40% of patients seen for community-acquired pneumonia require admission. Clinicians caring for patients with lower respiratory infections face several challenges, including an increasing population of patients with immunosuppression, potential need for diagnostic tests that may not be readily available, antibiotic resistance and social aspects that place these patients at higher risk. Management principles for patients with lower respiratory infections include knowledge of local surveillance data, strategic use of diagnostic tests according to surveillance data, and judicious use of antimicrobials.
Topics: Adult; Child; Humans; Aged; COVID-19; Respiratory Tract Infections; Community-Acquired Infections; Bronchitis; Pneumonia; Acute Disease; Anti-Infective Agents; Hospitals; Anti-Bacterial Agents
PubMed: 36261157
DOI: 10.1183/16000617.0092-2022 -
Annals of Internal Medicine Jun 2021Antimicrobial overuse is a major health care issue that contributes to antibiotic resistance. Such overuse includes unnecessarily long durations of antibiotic therapy in... (Review)
Review
DESCRIPTION
Antimicrobial overuse is a major health care issue that contributes to antibiotic resistance. Such overuse includes unnecessarily long durations of antibiotic therapy in patients with common bacterial infections, such as acute bronchitis with chronic obstructive pulmonary disease (COPD) exacerbation, community-acquired pneumonia (CAP), urinary tract infections (UTIs), and cellulitis. This article describes best practices for prescribing appropriate and short-duration antibiotic therapy for patients presenting with these infections.
METHODS
The authors conducted a narrative literature review of published clinical guidelines, systematic reviews, and individual studies that addressed bronchitis with COPD exacerbations, CAP, UTIs, and cellulitis. This article is based on the best available evidence but was not a formal systematic review. Guidance was prioritized to the highest available level of synthesized evidence.
BEST PRACTICE ADVICE 1
BEST PRACTICE ADVICE 2
BEST PRACTICE ADVICE 3
BEST PRACTICE ADVICE 4
Topics: Anti-Bacterial Agents; Bacterial Infections; Bronchitis; Cellulitis; Community-Acquired Infections; Cystitis; Drug Administration Schedule; Female; Humans; Male; Pneumonia, Bacterial; Prescription Drug Overuse; Primary Health Care; Pulmonary Disease, Chronic Obstructive; Pyelonephritis
PubMed: 33819054
DOI: 10.7326/M20-7355 -
American Family Physician Nov 2020
Review
Topics: Anti-Bacterial Agents; Antimicrobial Stewardship; Bronchitis; Humans
PubMed: 33118784
DOI: No ID Found -
Chest Jul 2022Organizing pneumonia (OP), characterized histopathologically by patchy filling of alveoli and bronchioles by loose plugs of connective tissue, may be seen in a variety... (Review)
Review
Organizing pneumonia (OP), characterized histopathologically by patchy filling of alveoli and bronchioles by loose plugs of connective tissue, may be seen in a variety of conditions. These include but are not limited to after an infection, drug reactions, radiation therapy, and collagen vascular diseases. When a specific cause is responsible for this entity, it is referred to as "secondary OP." When an extensive search fails to reveal a cause, it is referred to as "cryptogenic OP" (previously called "bronchiolitis obliterans with OP"), which is a clinical, radiologic, and pathologic entity classified as an interstitial lung disease. The clinical presentation of OP often mimics that of other disorders, such as infection and cancer, which can result in a delay in diagnosis and inappropriate management of the underlying disease. The radiographic presentation of OP is polymorphous but often has subpleural consolidations with air bronchograms or solitary or multiple nodules, which can wax and wane. Diagnosis of OP sometimes requires histopathologic confirmation and exclusion of other possible causes. Treatment usually requires a prolonged steroid course, and disease relapse is common. The aim of this article is to summarize the clinical, radiographic, and histologic presentations of this disease and to provide a practical diagnostic algorithmic approach incorporating clinical history and characteristic imaging patterns.
Topics: Bronchiolitis Obliterans; Cryptogenic Organizing Pneumonia; Humans; Lung; Lung Diseases, Interstitial; Pneumonia
PubMed: 35038455
DOI: 10.1016/j.chest.2021.12.659 -
Deutsche Medizinische Wochenschrift... Feb 2019Respiratory tract infections and acute bronchitis are one of the major indications for which antibiotics are prescribed. As most of respiratory tract infections are...
Respiratory tract infections and acute bronchitis are one of the major indications for which antibiotics are prescribed. As most of respiratory tract infections are caused by viruses and antibiotic therapy is rarely indicated. Reasons for the unnecessary prescription of antibiotics in this patient population are false expectations regarding the course and duration of common cold symptoms and especially coughing. After exclusion of severe diseases acute coughing should be treated with a symptom-oriented therapy. There is no reliable data on the use of antibiotic therapy in patient groups with an increased risk for severe complications. Studies on the use of laboratory makers to identify persons with bacterial infections who might benefit from antibiotic therapy and to reduce unnecessary prescriptions have been negative for CRP and inconclusive for procalcitonin. Peer-review and delayed prescribing could be demonstrated to reduce the rate of unneeded antibiotic prescriptions. Most of the symptomatic therapies employed for cough and the common cold are not studied in methodologically sound randomized controlled trials. The most common expectorants used in Germany are Ambroxol and N-Acetylcytein. For both substances there is little data supporting a benefit in patients with an acute bronchitis. Antitussiva reduce the symptom burden, but there is also a strong placebo-effect on the cough reflex.
Topics: Acute Disease; Anti-Bacterial Agents; Bronchitis; Germany; Humans; Respiratory Tract Infections
PubMed: 30703838
DOI: 10.1055/a-0655-8058 -
Minerva Pediatrica Dec 2018Bronchiolitis is the most common acute lower respiratory tract infection in infants and the first cause of hospitalization in this age group. Despite it has been studied... (Review)
Review
Bronchiolitis is the most common acute lower respiratory tract infection in infants and the first cause of hospitalization in this age group. Despite it has been studied for over 70 years, its management remains controversial and nowadays the treatment is only supportive. Pediatricians should be well acquainted with the clinical course of the disease. In particular, they should know that the severity of respiratory symptoms peaks between days 3-7 of the disease and dehydration is a key sign to consider for the management. In this review, we will discuss the most controversial points in the management of bronchiolitis according to six evidence-based guidelines, six clinical practice guidelines and five consensus-based reviews.
Topics: Bronchiolitis; Hospitalization; Humans; Infant; Practice Guidelines as Topic; Severity of Illness Index
PubMed: 30334624
DOI: 10.23736/S0026-4946.18.05334-3 -
Avian Diseases Dec 2021Infectious bronchitis (IB) is an acute disease of chickens caused by a gammacoronavirus, infectious bronchitis virus (IBV). Infection of the nasal and tracheal mucosa...
Infectious bronchitis (IB) is an acute disease of chickens caused by a gammacoronavirus, infectious bronchitis virus (IBV). Infection of the nasal and tracheal mucosa causes a rapid loss of ciliated epithelium and impaired mucociliary clearance that predispose chickens to secondary bacterial infections. In poultry production, disease progression and severity are influenced by other live virus vaccines, immunosuppression, and coexisting pathogens. The digestive tract supports viral replication in the proventriculus, intestines, cloaca, and the bursa of Fabricius. Acute enteritis and stunted growth in young chickens are caused by an enterotropic IBV. IBV spreads systemically by infection of tracheal macrophages and blood monocytes, deep respiratory infections, and potentially ascending viral infection from the cloaca. Nephrotropic IBV causes severe disease in the kidney with necrosis of tubular epithelial cells, inflammation, and renal failure. Viral infection of the female reproductive tract in the first 2 weeks of life causes necrosis and scarring of the oviduct mucosa, resulting in a chronic cystic oviduct that precludes egg formation when the hen matures. Virus infection of mature hens causes necrosis and inflammation of the oviduct mucosa, leading to the deterioration of egg quality and transient interruption of egg production. In males, IBV infection of seminiferous tubules in the testicle and efferent ductules in the epididymis results in epididymitis and epididymal lithiasis, decreases in sperm production and fertility, and viral shed to semen, leading to venereal transmission. The role IBV in gastrointestinal and urogenital disease merits further study.
Topics: Animals; Bronchitis; Chickens; Coronavirus Infections; Female; Infectious bronchitis virus; Male; Poultry Diseases; Urogenital Diseases
PubMed: 35068104
DOI: 10.1637/aviandiseases-D-21-00096