B R O N C H I T I S

ACUTE BRONCHITIS. Acute bronchitis is occasionally a primary disease but usually develops as a secondary infection following the common cold, sinusitis, measles, whooping cough, or some other acute illness. It consists of diffuse inflammation of the bronchi, the mucous membrane of which are injected, edematous and covered with a sticky, grayish, mucoid exudates. Productive cough, hoarseness, chills, sweats, fever and general malaise are usually present. They may develop suddenly or gradually. The sputum, at first mucoid, usually becomes purulent and tenacious. Examination of the chest often reveals coarse or fine moist rales and sometimes sonorous sibilant ones. Occasionally there are small areas of atelectasis over which the breath sound may be diminished in intensity. Sometimes there are no physical signs at all. The fever usually subsides within a few days. Its failure to do so brings up for different complications such as sinusitis, bronchopneumonia, measles, whooping cough, typhoid and paratyphoid fevers, chills, sweats and cough.

CHRONIC BRONCHITIS. A chronic cough, productive of mucoid or purulent sputum, with little impairment of the general health, is not uncommonly encountered in persons with asthma, sinusitis, emphysema, over-indulgence in smoking, exposure to dusty atmospheres, or with heart disease producing early manifestations of congestive failure. Chronic bronchitis is never a primary disease and it always warrants determining of its primary cause.

The physical signs of chronic bronchitis consist chiefly of coarse or fine moist rales in addition to signs characteristic to the associated primary condition. Some persons have a predisposition to residual bronchitis of this type which follows every attack of respiratory infection. In persons in later life suffering from the prodromal stages of congestive heart failure “winter-cough” is frequently seen with freedom from symptoms during the summer months.

The prognosis in young persons when the primary cause can be determined and eradicated is favorable but beyond middle life chronic bronchitis is a persistent and annoying disease.

Date: 2015-01-02; view: 915