Acute bronchitis in the community: clinical features, infective factors, changes in pulmonary function and bronchial reactivity to histamine

Respir Med. 1990 Sep;84(5):377-85. doi: 10.1016/s0954-6111(08)80072-8.

Abstract

A descriptive study of acute bronchitis in patients without pre-existing pulmonary disease was undertaken in the community during the winter months of 1986-87. Forty-two episodes were investigated in 40 individuals. The cardinal symptom was the acute onset of cough (100%), usually productive (90%). Wheezing was noted by 62% of patients, but heard on auscultation in only 31%. A potential pathogen was isolated in 29% of cases with a virus (eight cases) being identified more frequently than either Mycoplasma pneumoniae (three cases) or a bacterium (three cases). The acute illness was associated with significant reductions in forced expired volume in 1 second (P less than 0.02) and peak expiratory flow (P less than 0.001) but not forced vital capacity compared to 6 weeks later. Ten of the 27 (37%) patients who had a histamine challenge test performed at 6 weeks had a PD20 of less than 7.8 mumol histamine. Thirty-nine episodes (93%) were treated with antibiotics by the general practitioner, the clinical course being unremarkable apart from one patient who developed a lingular pneumonia despite antibiotic therapy. Further studies are required to assess whether acute bronchitis causes an acute increase in bronchial hyperresponsiveness and whether either antibiotics or inhaled bronchodilators or anti-inflammatory therapy has a useful role in the management of this predominantly viral illness.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bronchial Provocation Tests
  • Bronchitis / drug therapy
  • Bronchitis / microbiology
  • Bronchitis / physiopathology*
  • Cough / etiology
  • Female
  • Forced Expiratory Volume
  • Histamine
  • Humans
  • Influenza A virus / isolation & purification
  • Male
  • Middle Aged
  • Mycoplasma pneumoniae / isolation & purification
  • Peak Expiratory Flow Rate
  • Rhinovirus / isolation & purification
  • Vital Capacity

Substances

  • Anti-Bacterial Agents
  • Histamine