bronchitis

{{Main|Acute bronchitis}}

File:Bronchitis.png

Acute bronchitis, also known as a chest cold, is a short-term inflammation of the bronchi of the lungs. The most common symptom is a cough that may or may not produce sputum. Other symptoms may include coughing up mucus, wheezing, shortness of breath, fever, and chest discomfort. Fever when present is mild. The infection may last a few to ten days. The cough may persist for several weeks afterwards, with the total duration of symptoms usually around three weeks. Symptoms may last for up to six weeks.

In more than 90% of cases, the cause is a viral infection. These viruses may spread through the air when people cough or by direct contact. Risk factors include exposure to tobacco smoke, dust, and other air pollutants. A small number of cases are due to bacteria such as Mycoplasma pneumoniae or Bordetella pertussis.

Diagnosis is typically based on a person's signs and symptoms. The color of the sputum does not indicate if the infection is viral or bacterial. Determining the underlying organism is usually not required. Other causes of similar symptoms include asthma, pneumonia, bronchiolitis, bronchiectasis, and COPD. A chest X-ray may be useful to detect pneumonia.

Another common sign of bronchitis is a cough lasting ten days to three weeks. If the cough lasts longer than a month, it may become chronic bronchitis. In addition, a fever may be present. Acute bronchitis is normally caused by a viral infection. Typically, these infections are rhinovirus, adenovirus, parainfluenza, or influenza. No specific testing is normally needed to diagnose acute bronchitis.{{Cite web |url=https://www.merckmanuals.com/professional/pulmonary-disorders/acute-bronchitis/acute-bronchitis/|title=Acute Bronchitis |work=Merck Manuals Professional Edition|access-date=|first = Sanjay |last =Sethi|language=en-US|date = May 2023}}

One form of prevention is to avoid smoking and other lung irritants. Frequent hand washing may also be protective.{{cite web|title=How Can Bronchitis Be Prevented?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi/prevention|access-date=|date=August 4, 2011|url-status=dead|archive-url=https://web.archive.org/web/20150402184916/http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi/prevention|publisher = NIH|archive-date=2 April 2015 }} Treatment for acute bronchitis usually involves rest, paracetamol (acetaminophen), and NSAIDs to help with the fever. Cough medicine has little support for its use, and is not recommended in children under the age of six.{{cite journal|last1=Smith|first1=SM|last2=Schroeder|first2=K|last3=Fahey|first3=T|title=Over-the-counter (OTC) medications for acute cough in children and adults in community settings|journal=The Cochrane Database of Systematic Reviews|date=24 November 2014|volume=2014|issue=11|pages=CD001831|pmid= 25420096 |doi=10.1002/14651858.CD001831.pub5|pmc=7061814}} There is tentative evidence that salbutamol may be useful in treating wheezing; however, it may result in nervousness and tremors.{{Cite journal|last1=Becker|first1=Lorne A.|last2=Hom|first2=Jeffrey|last3=Villasis-Keever|first3=Miguel|last4=van der Wouden|first4=Johannes C.|date=2015-09-03|title=Beta2-agonists for acute cough or a clinical diagnosis of acute bronchitis |journal=The Cochrane Database of Systematic Reviews|volume=2015 |issue=9|pages=CD001726|doi=10.1002/14651858.CD001726.pub5|issn= 1469-493X|pmid=26333656 |pmc=7078572}} Antibiotics should generally not be used.{{Cite journal|last1=Smith|first1=Susan M.|last2=Fahey|first2= Tom |last3= Smucny|first3=John|last4=Becker|first4=Lorne A.|date=2017|title=Antibiotics for acute bronchitis|journal=The Cochrane Database of Systematic Reviews |volume= 2017|issue=6 |pages=CD000245|doi=10.1002/14651858.CD000245.pub4|issn=1469-493X|pmid=28626858|pmc=6481481|hdl=10779/rcsi.10778735.v1}} An exception is when acute bronchitis is due to pertussis. Tentative evidence supports honey and pelargonium to help with symptoms. Getting plenty of rest and drinking enough fluids are often recommended as well.{{Cite news|url=https://medlineplus.gov/acutebronchitis.html |title= Acute Bronchitis {{!}} Bronchitis Symptoms {{!}} MedlinePlus|access-date=2017-11-30|language=en}} Chinese medicinal herbs are of unclear effect.{{cite journal |last1=Jiang |first1=Lanhui |last2=Li |first2=Ka |last3=Wu |first3=Taixiang |title=Chinese medicinal herbs for acute bronchitis |journal=Cochrane Database of Systematic Reviews |issue=2 |pages=CD004560 |date=15 February 2012 |volume=2012 |doi=10.1002/14651858.CD004560.pub4 |pmid=22336804|pmc=7202254 }}

Acute bronchitis is one of the most common diseases and the most common type of bronchitis. About 5% of adults are affected, and about 6% of children have at least one episode yearly. It occurs more often in the winter. More than 10 million people in the U.S. visit a healthcare provider each year for this condition, with about 70% receiving antibiotics that are mostly unnecessary. There are efforts to decrease the use of antibiotics in acute bronchitis.

{{See also|Chronic obstructive pulmonary disease}}

Chronic bronchitis is a lower respiratory tract disease,{{cite web |title=ICD-11 - ICD-11 for Mortality and Morbidity Statistics |url=https://icd.who.int/browse11/l-m/en#http%3a%2f%2fid.who.int%2ficd%2fentity%2f290835130 |website=icd.who.int |access-date=15 August 2021}} defined by a productive cough that lasts for three months or more per year for at least two years.{{cite book |title=Global Initiative for Chronic Obstructive Lung Disease - GOLD |date=2018 |pages=4–5, 25 |url=https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf |access-date=29 May 2019}} The cough is sometimes referred to as a smoker's cough since it often results from smoking. When chronic bronchitis occurs together with decreased airflow it is known as chronic obstructive pulmonary disease (COPD).{{cite web |title=Chronic Obstructive Pulmonary Disease (COPD) - Pulmonary Disorders |url=https://www.msdmanuals.com/en-gb/professional/pulmonary-disorders/chronic-obstructive-pulmonary-disease-and-related-disorders/chronic-obstructive-pulmonary-disease-copd?query=Chronic%20Obstructive%20Pulmonary%20Disease%20(COPD) |website=MSD Manual Professional Edition |access-date=3 June 2019 |quote=Chronic bronchitis becomes chronic obstructive bronchitis if spirometric evidence of airflow obstruction develops.}} Many people with chronic bronchitis have COPD; however, most people with COPD do not also have chronic bronchitis.{{cite journal |last1=Widysanto |first1=A |last2=Mathew |first2=G |date=January 2019 |title=Chronic Bronchitis |url=https://www.ncbi.nlm.nih.gov/books/NBK482437/ |journal=StatPearls [Internet] |pmid=29494044 |id=NBK482437 |quote=Chronic bronchitis ... is very often secondary to chronic obstructive pulmonary disease (COPD).}} Estimates of the number of people with COPD who have chronic bronchitis are 7–40%.{{cite book |last1=Lee |first1=Sang-Do |title=COPD: Heterogeneity and Personalized Treatment |date=2017 |publisher=Springer |isbn=9783662471784 |page=150 |url=https://books.google.com/books?id=uHg5DwAAQBAJ&pg=PA150 |language=en}}{{Cite journal|last=Maselli|first=DJ|date=May 2019|journal=Chest|volume=156|issue=2|pages=228–238|title=Clinical Epidemiology of COPD: Insights From 10 Years of the COPDGene Study|pmid=31154041|doi=10.1016/j.chest.2019.04.135|pmc=7198872}} Estimates of the number of people who smoke and have chronic bronchitis who also have COPD is 60%.{{cite journal |last1=Dotan |first1=Y |last2=So |first2=JY |last3=Kim |first3=V |title=Chronic Bronchitis: Where Are We Now? |journal=Chronic Obstructive Pulmonary Diseases |date=9 April 2019 |volume=6 |issue=2 |pages=178–192 |doi=10.15326/jcopdf.6.2.2018.0151 |pmid=31063274|pmc=6596437 |quote=with CB by symptoms (18.9%), approximately 60% had COPD (i.e., had also airflow obstruction on spirometry)}}

The term "chronic bronchitis" was used in previous definitions of COPD but is no longer included in the definition.{{cite web |title=Chronic obstructive pulmonary disease (COPD) |url=https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) |website=www.who.int |access-date=15 July 2019 |language=en|quote = The more familiar terms "chronic bronchitis" and "emphysema" have often been used as labels for the condition.}}{{cite web |title=COPD: Definition |url=https://www.who.int/respiratory/copd/definition/en/ |website=WHO |access-date=15 July 2019|quote=The more familiar terms 'chronic bronchitis' and 'emphysema' are no longer used, but are now included within the COPD diagnosis.}} The term is still used clinically. While both chronic bronchitis and emphysema are often associated with COPD, neither is needed to make the diagnosis.{{Cite book|title=Ferri's Clinical Advisor|last=Ferri|first=Fred|publisher=Elsevier|year=2019|isbn=9780323530422|pages=331}} A Chinese consensus commented on symptomatic types of COPD that include chronic bronchitis with frequent exacerbations.{{Cite journal|last=Shen|first=Y|date=30 January 2018|title=Management of airway mucus hypersecretion in chronic airway inflammatory disease: Chinese expert consensus (English edition)|journal= International Journal of Chronic Obstructive Pulmonary Disease|volume=13|pages=399–407|doi=10.2147/COPD.S144312|pmid=29430174|pmc=5796802|doi-access=free}}

Chronic bronchitis is marked by mucus hypersecretion and mucins.{{Cite journal|last=Voynow|first=J|date=Feb 2009|title=Mucins, mucus, and sputum|journal=Chest|volume=135|issue=2|pages=505–512|pmid=19201713|doi=10.1378/chest.08-0412}} The excess mucus is produced by an increased number of goblet cells, and enlarged submucosal glands in response to long-term irritation. The mucous glands in the submucosa secrete more than the goblet cells.{{Cite book|title=Principles of Pulmonary Medicine|last=Weinberger|first=Steven|publisher=Elsevier|year=2019|isbn=9780323523714|pages=98}} Mucins thicken mucus, and their concentration has been found to be high in cases of chronic bronchitis, and also to correlate with the severity of the disease.{{Cite web|url=https://www.nhlbi.nih.gov/news/2017/new-insights-chronic-bronchitis-diagnostic-test-and-better-treatments-horizon|title=New Insights on Chronic Bronchitis:Diagnostic Test and Better Treatments on the Horizon|date=September 2017|website=nhlbi.nih.gov|access-date=3 August 2019}} Excess mucus can narrow the airways, thereby limiting airflow and accelerating the decline in lung function, and result in COPD.{{Cite journal|last1=Kim|first1=V|last2=Criner|first2=G|date=Feb 2013|title=Chronic bronchitis and chronic obstructive pulmonary disease|journal=Am J Respir Crit Care Med|volume=187|issue=3|pages=228–237|pmid=23204254|pmc=4951627|doi=10.1164/rccm.201210-1843CI}} Excess mucus shows itself as a chronic productive cough and its severity and volume of sputum can fluctuate in periods of acute exacerbations. In COPD, those with the chronic bronchitic phenotype with associated chronic excess mucus, experience a worse quality of life than those without.{{cite book |title=Global Strategy for Prevention, Diagnosis and Management of COPD: 2021 Report |date=25 November 2020|publisher=Global Initiative for Chronic Obstructive Lung Disease |url=https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf |access-date=3 August 2021|page=106}}

The increased secretions are initially cleared by coughing. The cough is often worse soon after awakening, and the sputum produced may have a yellow or green color and may be streaked with specks of blood.{{cite book|last1=Cohen|first1=Jonathan|first2=William|last2=Powderly|title=Infectious Diseases, 2nd ed|publisher=Mosby (Elsevier)|year=2004|at=Chapter 33: Bronchitis, Bronchiectasis, and Cystic Fibrosis|isbn=978-0323025737}} In the early stages, a cough can maintain mucus clearance. However, with continued excessive secretion mucus clearance is impaired, and when the airways become obstructed a cough becomes ineffective.{{Cite journal|last=Foster|first=W|date=2002|title=Mucociliary transport and cough in humans|journal=Pulm Pharmacol Ther|volume=15|issue=3|pages=277–282|pmid=12099778|doi=10.1006/pupt.2002.0351}} Effective mucociliary clearance depends on airway hydration, ciliary beating, and the rates of mucin secretion. Each of these factors is impaired in chronic bronchitis.{{Cite journal|last=Ghosh|first=A|date=October 2015|title=Airway hydration and COPD|journal=Cell Mol Life Sci|volume=72|issue=19|pages=3637–52|pmid=26068443|pmc=4567929|doi=10.1007/s00018-015-1946-7}} Chronic bronchitis can lead to a higher number of exacerbations and a faster decline in lung function.{{cite journal |last1=Ohar |first1=JA |last2=Donohue |first2=JF |last3=Spangenthal |first3=S |title=The Role of Guaifenesin in the Management of Chronic Mucus Hypersecretion Associated with Stable Chronic Bronchitis: A Comprehensive Review. |journal=Chronic Obstructive Pulmonary Diseases |date=23 October 2019 |volume=6 |issue=4 |doi=10.15326/jcopdf.6.4.2019.0139 |pmid=31647856 |pages=341–349|pmc=7006698 |doi-access=free }} The ICD-11 lists chronic bronchitis with emphysema (emphysematous bronchitis) as a "certain specified COPD".{{cite web |title=ICD-11 - Mortality and Morbidity Statistics |url=https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1948124976 |website=icd.who.int}}{{Cite web |title=ICD-11 - Mortality and Morbidity Statistics |url=https://icd.who.int/browse11/l-m/en#http%3a%2f%2fid.who.int%2ficd%2fentity%2f290835130|website=icd.who.int}}

Most cases of chronic bronchitis are caused by tobacco smoking.{{cite web |url=http://www.lung.org/lung-disease/bronchitis-chronic/understanding-chronic-bronchitis.html |title=Understanding Chronic Bronchitis |year=2012 |publisher=American Lung Association |access-date=30 December 2012 |url-status=dead |archive-url=https://web.archive.org/web/20121218021056/http://www.lung.org/lung-disease/bronchitis-chronic/understanding-chronic-bronchitis.html |archive-date=18 December 2012 }}{{cite journal | last1= Forey|first1=BA|last2=Thornton|first2=AJ|last3=Lee|first3=PN| title=Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema | journal=BMC Pulmonary Medicine |volume= 11 |issue=36 |pages=36|date=June 2011|pmid=21672193|doi=10.1186/1471-2466-11-36 | pmc=3128042 |doi-access=free }} Chronic bronchitis in young adults who smoke is associated with a greater chance of developing COPD.{{cite book |title=Global Initiative for Chronic Obstructive Lung Disease |date=2019 |page=13 |url=https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf |access-date=25 May 2019}} There is an association between smoking cannabis and chronic bronchitis.{{Cite journal|last=Ribeiro|first=L|date=October 2016|title=Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review|journal=npj Primary Care Respiratory Medicine|volume=26|pages=16071|pmid=27763599|pmc=5072387|doi=10.1038/npjpcrm.2016.71}}{{Cite journal|last=Pfeifer|first=A|date=May 2006|title=Pulmonary consequences of marijuana smoking|journal=Ugeskr Laeger|volume=168|issue=18|pages=1743–6|pmid=16729923}} In addition, chronic inhalation of air pollution, or irritating fumes or dust from hazardous exposures in occupations such as coal mining, grain handling, textile manufacturing, livestock farming,{{cite journal | last1= Szczyrek|first1=M|last2=Krawczyk|first2=P|last3=Milanowski|first3=J|last4=Jastrzebska|first4=I|last5=Zwolak|first5=A|last6=Daniluk|first6=J| title=Chronic obstructive pulmonary disease in farmers and agricultural workers-an overview| journal=Annals of Agricultural and Environmental Medicine |volume= 18 |issue=2 |pages=310–313|year= 2011 |pmid=22216804}} and metal moulding may also be a risk factor for the development of chronic bronchitis.{{cite journal | last1= Fischer|first1=BM|last2=Pavlisko|first2=E|last3=Voynow|first3=JA| title=Pathogenic triad in COPD: oxidative stress, protease-antiprotease imbalance, and inflammation| journal=International Journal of Chronic Obstructive Pulmonary Disease|volume= 6 |pages=413–421|year= 2011 |pmid=21857781|doi=10.2147/COPD.S10770 | pmc=3157944 |doi-access=free }}{{cite web |url=http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi/atrisk.html |title=Who Is at Risk for Bronchitis? |author=National Heart Lung and Blood Institute |year=2009 |publisher=National Institutes of Health |access-date=30 December 2012 |url-status=dead |archive-url=https://web.archive.org/web/20130104000407/http://www.nhlbi.nih.gov/health/health-topics/topics/brnchi/atrisk.html |archive-date=4 January 2013 }}{{cite web |url=https://www.cdc.gov/niosh/programs/resp/risks.html |title=Respiratory Diseases Input: Occupational Risks |author=National Institute of Occupational Safety and Health |year=2012 |website=NIOSH Program Portfolio |publisher=Centers for Disease Control and Prevention |access-date=30 December 2012 |url-status=live |archive-url=https://web.archive.org/web/20121220080104/http://www.cdc.gov/niosh/programs/resp/risks.html |archive-date=20 December 2012 }} Bronchitis caused in this way is often referred to as industrial bronchitis, or occupational bronchitis.{{cite web |title=Industrial bronchitis: MedlinePlus Medical Encyclopedia |url=https://medlineplus.gov/ency/article/000072.htm |website=medlineplus.gov |access-date=28 May 2019 |language=en}} Rarely genetic factors also play a role.{{cite web |title=What Causes COPD |url=https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/symptoms-causes-risk-factors/what-causes-copd.html |website=American Lung Association |access-date=24 February 2019 |language=en}}

Air quality can also affect the respiratory system with higher levels of nitrogen dioxide and sulfur dioxide contributing to bronchial symptoms. Sulfur dioxide can cause inflammation which can aggravate chronic bronchitis and make infections more likely.{{Cite web|url=https://www.who.int/en/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health|title=Ambient (outdoor) air quality and health|date=2 May 2018|website=who.int|access-date=11 July 2019}}

Air pollution in the workplace is the cause of several non-communicable diseases (NCDs) including chronic bronchitis.{{Cite web|url=https://www.who.int/en/news-room/fact-sheets/detail/protecting-workers'-health|title=Protecting workers' health|date=November 2017|website=who.int|access-date=12 July 2019}}

Decline in lung function in chronic bronchitis may be slowed by stopping smoking.{{cite book|author=Fauci, Anthony S.|author2=Daniel L. Kasper|author3=Dan L. Longo|author4=Eugene Braunwald|author5=Stephen L. Hauser|author6=J. Larry Jameson|title=Chapter 254. Chronic Obstructive Pulmonary Disease Harrison's Principles of Internal Medicine|year=2008|publisher=McGraw-Hill|location=New York|isbn=978-0-07-147691-1|edition=17th }}{{cite journal | last1= Willemse|first1=BW|last2=Postma|first2=DS|last3=Timens|first3=W|last4=ten Hacken|first4=NH| title=The impact of smoking cessation on respiratory symptoms, lung function, airway hyperresponsiveness and inflammation| journal=The European Respiratory Journal |volume= 23 |issue=3|pages=464–476|date=March 2004|pmid=15065840 | doi=10.1183/09031936.04.00012704|doi-access=free}} Chronic bronchitis may be treated with a number of medications and occasionally oxygen therapy. Pulmonary rehabilitation may also be used.

A distinction has been made between exacerbations (sudden worsenings) of chronic bronchitis, and otherwise stable chronic bronchitis. Stable chronic bronchitis can be defined as the normal definition of chronic bronchitis, plus the absence of an acute exacerbation in the previous four weeks. A Cochrane review found that mucolytics in chronic bronchitis may slightly decrease the chance of developing an exacerbation.{{Cite journal|last1=Poole|first1=Phillippa|last2=Sathananthan|first2=K|last3=Fortescue|first3=R|date=May 2019|title=Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease|journal=The Cochrane Database of Systematic Reviews|volume=5|issue=7|pages=CD001287|doi=10.1002/14651858.CD001287.pub6|pmid=31107966|pmc=6527426}} The mucolytic guaifenesin is a safe and effective treatment for stable chronic bronchitis. This has an advantage in that it is available as an extended use tablet which lasts for twelve hours.{{cite journal|pmid=29238574|pmc=5724298|year=2017|last1=Albrecht|first1=H. H.|title=Role of guaifenesin in the management of chronic bronchitis and upper respiratory tract infections|journal=Multidisciplinary Respiratory Medicine|volume=12|pages=31|last2=Dicpinigaitis|first2=P. V.|last3=Guenin|first3=E. P.|doi=10.1186/s40248-017-0113-4 |doi-access=free }} Erdosteine is a mucolytic recommended by NICE.{{cite web |title=Erdosteine |url=https://bnf.nice.org.uk/drug/erdosteine.html |website=NICE |access-date=20 July 2021}} GOLD also supports the use of some mucolytics that are advised against when inhaled corticosteroids are being used, and singles out erdosteine as having good effects regardless of corticosteroid use. Erdosteine also has antioxidant properties. Erdosteine has been shown to significantly reduce the risk of exacerbations, shorten their duration, and hospital stays.{{cite journal |vauthors=Meldrum OW, Chotirmall SH |title=Mucus, Microbiomes and Pulmonary Disease |journal=Biomedicines |volume=9 |issue=6 |date=June 2021 |page=675 |pmid=34199312 |pmc=8232003 |doi=10.3390/biomedicines9060675 |url=|doi-access=free }} In those with the chronic bronchitic phenotype of COPD, the phosphodiesterase-4 inhibitor roflumilast may decrease significant exacerbations.{{cite journal|pmid=22878278|year=2013|last1=Vestbo|first1=J.|title=Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary|journal=American Journal of Respiratory and Critical Care Medicine|volume=187|issue=4|pages=347–65|last2=Hurd|first2=S. S.|last3=Agustí|first3=A. G.|last4=Jones|first4=P. W.|last5=Vogelmeier|first5=C.|last6=Anzueto|first6=A.|last7=Barnes|first7=P. J.|last8=Fabbri|first8=L. M.|last9=Martinez|first9=F. J.|last10=Nishimura|first10=M.|last11=Stockley|first11=R. A.|last12=Sin|first12=D. D.|last13=Rodriguez-Roisin|first13=R.|doi=10.1164/rccm.201204-0596PP|url=http://ajrccm.atsjournals.org/content/187/4/347.full.pdf+html}}

Chronic bronchitis affects about 3.4–22% of the general population.{{cite journal | last1=Kim | first1=Victor | last2=Criner | first2=Gerard J. | title=The chronic bronchitis phenotype in chronic obstructive pulmonary disease | journal=Current Opinion in Pulmonary Medicine | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=21 | issue=2 | year=2015 | issn=1070-5287 | doi=10.1097/mcp.0000000000000145 | pages=133–141| pmid=25575367 | pmc=4373868 }} Individuals over 45 years of age, smokers, those that live or work in areas with high air pollution, and anybody with asthma all have a higher risk of developing chronic bronchitis.{{Cite journal|last=Kochanek|first=Kenneth|date=June 2016|title=Deaths: Final Data for 2014|url=https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf|journal=National Vital Statistics Reports|volume= 65| issue = 4|pages=1–122|pmid=27378572}} This wide range is due to the different definitions of chronic bronchitis that can be diagnosed based on signs and symptoms or the clinical diagnosis of the disorder. Chronic bronchitis tends to affect men more often than women. While the primary risk factor for chronic bronchitis is smoking, there is still a 4–22% chance that non-smokers can get chronic bronchitis. This might suggest other risk factors such as the inhalation of fuels, dusts, fumes and genetic factor. In the United States, in 2016, 8.6 million people were diagnosed with chronic bronchitis, and there were 518 reported deaths. Per 100,000 of population the death rate of chronic bronchitis was 0.2.

The condition of bronchitis has been recognised for many centuries, in several different cultures including the Ancient Greek, Chinese, and Indian, with the presence of excess phlegm and cough noted in recognition of the same condition. Early treatments of chronic bronchitis included garlic, cinnamon and ipecac, among others.{{cite journal | vauthors = Ziment I | title = History of the treatment of chronic bronchitis | journal = Respiration; International Review of Thoracic Diseases | volume = 58 | issue = Suppl 1 | pages = 37–42 | year = 1991 | pmid = 1925077 | doi = 10.1159/000195969 }} Modern treatments were developed during the second half of the 20th century.{{cite journal | vauthors = Fishman AP | title = One hundred years of chronic obstructive pulmonary disease | journal = American Journal of Respiratory and Critical Care Medicine | volume = 171 | issue = 9 | pages = 941–8 | date = May 2005 | pmid = 15849329 | doi = 10.1164/rccm.200412-1685OE }}

The British physician Charles Badham was the first person to describe the condition and name the acute form as acute bronchitis in his book Observations on the inflammatory affections of the mucous membrane of the bronchiæ, published in 1808. In this book, Badham distinguished three forms of bronchitis, including acute and chronic. A second, expanded edition of the book was published in 1814 with the title An essay on bronchitis. Badham used the term catarrh to refer to the cardinal symptoms of chronic cough and mucus hypersecretion of chronic bronchitis, and described chronic bronchitis as a disabling disorder.{{cite journal |last1=Petty |first1=TL |title=The history of COPD. |journal=International Journal of Chronic Obstructive Pulmonary Disease |date=2006 |volume=1 |issue=1 |pages=3–14 |pmid=18046898|pmc=2706597 |doi=10.2147/copd.2006.1.1.3 |doi-access=free }}

In 1901 an article was published on the treatment of chronic bronchitis in the elderly. The symptoms described have remained unchanged. The cause was thought to be brought on by dampness, cold weather, and foggy conditions, and treatments were aimed towards various cough mixtures, respiratory stimulants, and tonics. It was noted that something other than the weather was thought to be at play.{{cite journal |title=Chronic Bronchitis. |journal=The Hospital |date=19 October 1901 |volume=31 |issue=786 |pages=48–49 |pmid=29819251|pmc=5211570 }} Exacerbations of the condition were also described at this time. Another physician Harry Campbell was referred to who had written in the British Medical Journal a week before. Campbell had suggested that the cause of chronic bronchitis was due to toxic substances, and recommended pure air, simple food, and exercise to remove them from the body.

A joint research programme was undertaken in Chicago and London from 1951 to 1953 in which the clinical features of one thousand cases of chronic bronchitis were detailed. The findings were published in the Lancet in 1953.{{cite journal |last1=Oswald |first1=NC |last2=Harold |first2=JT |last3=Martin |first3=WJ |title=Clinical pattern of chronic bronchitis. |journal=Lancet |date=26 September 1953 |volume=265 |issue=6787 |pages=639–43 |doi=10.1016/s0140-6736(53)90369-9 |pmid=13098028}} It was stated that since its introduction by Badham, chronic bronchitis had become an increasingly popular diagnosis. The study had looked at various associations such as the weather, conditions at home, and at work, age of onset, childhood illnesses, smoking habits, and breathlessness. It was concluded that chronic bronchitis invariably led to emphysema, particularly when the bronchitis had persisted for a long time.

In 1957 it was noted that at the time there were many investigations being carried out into chronic bronchitis and emphysema in general, and among industrial workers exposed to dust.{{cite journal |last1=Meiklejohn |first1=A |title=A house-surgeon's observations on bronchitis in North Staffordshire pottery workers in 1864. |journal=British Journal of Industrial Medicine |date=July 1957 |volume=14 |issue=3 |pages=211–2 |doi=10.1136/oem.14.3.211 |pmid=13446354|pmc=1037807 }} Excerpts were published dating from 1864 in which Charles Parsons had noted the occurring consequence of the development of emphysema from bronchitis. This was seen to be not always applicable. His findings were in association with his studies on chronic bronchitis among pottery workers.

A CIBA (now Novartis) meeting in 1959, and a meeting of the American Thoracic Society in 1962, defined chronic bronchitis as a component of COPD, in the terms that have not changed.{{cite journal |title=Terminology, Definitions, and Classification of Chronic Pulmonary Emphysema and Related Conditions: A Report of the Conclusions of a Ciba Guest Symposium. |journal=Thorax |date=December 1959 |volume=14 |issue=4 |pages=286–299 |pmc=1018516|doi=10.1136/thx.14.4.286 }}

{{Main|Eosinophilic bronchitis}}

Eosinophilic bronchitis is a chronic dry cough, defined by the presence of an increased number of a type of white blood cell known as eosinophils. It has a normal finding on X-ray and has no airflow limitation.{{Cite book|title=Harrison's Principles of Internal Medicine|last=Longo|first=Dan|publisher=McGraw Hill|year=2012|isbn=9780071748896|pages=284}}

Protracted bacterial bronchitis in children, is defined as a chronic productive cough with a positive bronchoalveolar lavage that resolves with antibiotics.{{cite journal |last1=Goldsobel|first1= AB|last2= Chipps |first2=BE |title=Cough in the pediatric population |journal=The Journal of Pediatrics |volume=156 |issue=3 |pages=352–358.e1 |date=March 2010 |pmid=20176183 |doi=10.1016/j.jpeds.2009.12.004}} Protracted bacterial bronchitis is usually caused by Streptococcus pneumoniae, non-typable Haemophilus influenzae, or Moraxella catarrhalis.{{cite journal |last1=Craven|first1=V|last2=Everard|first2=ML |title=Protracted bacterial bronchitis: reinventing an old disease |journal=Archives of Disease in Childhood |volume=98 |issue=1 |pages=72–76 |date=January 2013 |pmid=23175647 |doi=10.1136/archdischild-2012-302760|s2cid=34977990}} Protracted bacterial bronchitis (lasting more than 4 weeks) in children may be helped by antibiotics.{{cite journal |last1=Marchant |first1=JM |last2=Petsky |first2=HL |last3=Morris |first3=PS |last4=Chang |first4=AB |title=Antibiotics for prolonged wet cough in children |journal=The Cochrane Database of Systematic Reviews |date=31 July 2018 |volume=2018 |issue=7 |pages=CD004822 |doi=10.1002/14651858.CD004822.pub3 |pmid=30062732|pmc=6513288 }}

File:Plastic_bronchitis_casts.png bronchial casts{{Cite journal|last1=Kamaltynova|first1=E. M.|last2=Krivoshchekov|first2=E. V.|last3=Yanulevich|first3=O. S.|last4=Kavardakova|first4=E. S.|date=2017-08-11|title=Plastic bronchitis associated with corrected cardiac anomaly in a child|url=https://bulletin.tomsk.ru/jour/article/view/888/689|journal=Bulletin of Siberian Medicine|volume=16|issue=2|pages=180–186|doi=10.20538/1682-0363-2017-2-180-186|issn=1819-3684|doi-access=free}}]]

Plastic bronchitis is a rarely found condition in which thickened secretions plug the bronchi.{{Cite book|last1=Kotloff|first1=Robert|url=https://books.google.com/books?id=vozeDAAAQBAJ&pg=PA405|title=Rare and Orphan Lung Diseases, An Issue of Clinics in Chest Medicine, E-Book|last2=McCormack|first2=Francis X.|date=2016-08-16|publisher=Elsevier Health Sciences|isbn=978-0-323-46274-7|pages=405–408|language=en}} The plugs are rubbery or plastic-feeling (thus the name). The light-colored plugs take the branching shape of the bronchi that they fill, and are known as bronchial casts. When these casts are coughed up, they are firmer in texture from typical phlegm or the short, softer mucus plugs seen in some people with asthma. However, some people with asthma have larger, firmer, and more complex plugs. These differ from the casts seen in people whose plastic bronchitis is associated with congenital heart disease or lymphatic vessel abnormalities mainly because eosinophils and Charcot–Leyden crystals are present in the asthma-associated casts but not in the others.

Casts obstruct the airflow, and can result in the overinflation of the opposite lung. Plastic bronchitis usually occurs in children. Some cases may result from abnormalities in the lymphatic vessels. Advanced cases may show imaging similarities to bronchiectasis.{{cite journal |last1=Panchabhai |first1=TS |last2=Mukhopadhyay |first2=S |last3=Sehgal |first3=S |last4=Bandyopadhyay |first4=D |last5=Erzurum |first5=SC |last6=Mehta |first6=AC |title=Plugs of the Air Passages: A Clinicopathologic Review. |journal=Chest |date=November 2016 |volume=150 |issue=5 |pages=1141–1157 |doi=10.1016/j.chest.2016.07.003 |pmid=27445091 |pmc=6026239}}

Eosinophilic plastic bronchitis is a subtype of plastic bronchitis that is more often found in children. Symptoms may include a cough, and wheezing, and imaging may reveal a lung that is completely collapsed.{{cite journal |last1=Gipsman |first1=AI |last2=Feld |first2=L |last3=Johnson |first3=B |title=Eosinophilic plastic bronchitis: Case series and review of the literature. |journal=Pediatric Pulmonology |date=November 2023 |volume=58 |issue=11 |pages=3023–3031 |doi=10.1002/ppul.26650 |pmid=37606213|pmc=10928548 }} Depending on the size of the casts, and the location the condition may present with mild symptoms, or prove fatal.

Aspergillus bronchitis is a type of aspergillosis, a fungal infection caused by Aspergillus a common mold that affects the bronchi. Unlike other types of pulmonary aspergillosis, it can affect individuals who are not immunocompromised.{{cite web |title=Aspergillus bronchitis {{!}} Aspergillus & Aspergillosis Website |url=https://www.aspergillus.org.uk/content/aspergillus-bronchitis |website=www.aspergillus.org.uk}}{{cite journal |last1=Kosmidis |first1=Chris |last2=Denning |first2=David W. |date=1 March 2015 |title=The clinical spectrum of pulmonary aspergillosis |url=https://thorax.bmj.com/content/70/3/270 |journal=Thorax |language=en |volume=70 |issue=3 |pages=270–277 |doi=10.1136/thoraxjnl-2014-206291 |pmid=25354514 |access-date=8 November 2019 |doi-access=free}} In immunocompetent individuals, Aspergillus bronchitis may manifest as persistent respiratory infections or symptoms that do not respond to antibiotics, but may improve with antifungals.{{cite journal |last1=Chrdle |first1=Ales |last2=Mustakim |first2=Sahlawati |last3=Bright-Thomas |first3=Rowland J. |last4=Baxter |first4=Caroline G. |last5=Felton |first5=Timothy |last6=Denning |first6=David W. |title=Aspergillus bronchitis without significant immunocompromise |journal=Annals of the New York Academy of Sciences |date=December 2012 |volume=1272 |issue=1 |pages=73–85 |doi=10.1111/j.1749-6632.2012.06816.x |pmid=23231717 |bibcode=2012NYASA1272...73C }}

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{{Reflist}}

{{Medical condition classification and resources

| DiseasesDB = 29135

| ICD10 = {{ICD10|J|20||j|20}}-{{ICD10|J|21||j|20}}, {{ICD10|J40}}, {{ICD10|J41}}, {{ICD10|J|42||j|40}}

| ICD9 = {{ICD9|466}}, {{ICD9|491}}, {{ICD9|490}}

| ICDO =

| OMIM =

| MedlinePlus = 001087

| eMedicineSubj = article

| eMedicineTopic = 807035

| eMedicine_mult = {{eMedicine2|article|297108}}

| MeshID = D001991

| MeshNumber = I

}}

• NIH entry on [https://www.nhlbi.nih.gov/health/bronchitis Bronchitis]
• MedlinePlus entries on [https://medlineplus.gov/acutebronchitis.html Acute bronchitis] and [https://medlineplus.gov/chronicbronchitis.html Chronic bronchitis]
• Mayo Clinic [https://www.mayoclinic.org/diseases-conditions/bronchitis/symptoms-causes/syc-20355566?p=1 factsheet on bronchitis]

{{Respiratory pathology}}

{{Authority control}}

Category:Chronic lower respiratory diseases

Category:Bronchus disorders

Category:Wikipedia medicine articles ready to translate

Category:Wikipedia emergency medicine articles ready to translate