Acute bronchitis in the community: clinical features, infective factors, changes in pulmonary function and bronchial reactivity to histamine.
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.
Boldy
D A
DA
Department of Respiratory Medicine, East Birmingham Hospital, U.K.
Skidmore
S J
SJ
Ayres
J G
JG
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001985:Bronchial Provocation Tests; D001991:Bronchitis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D003371:Cough / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume; D006632:Histamine; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification; D010366:Peak Expiratory Flow Rate; D012229:Rhinovirus / Q000302:isolation & purification; D014797:Vital Capacity
D000900:Anti-Bacterial Agents; D006632:Histamine