When one suffers from chest pain, we automatically jump to the conclusion that it must be something related to our heart; but that is not always the case. Chest pain can occur due to many reasons, such as heart burn/GERD, chest injury, lung infections, fracture ribs etc. One of the reasons a person can suffer from chest pain is bronchitis. In this topic, we are going to discuss about bacterial bronchitis, i.e. bronchitis caused by bacteria; and its symptoms and treatment. Bronchitis is the infection, which causes mucosal inflammation of the airway passages in the lungs leading to cough, chest pain and increased mucus production.
Causes of Acute Bacterial Bronchitis
Bacterial infection of bronchi and lung can occur due to bacterium such as clamydia pneumonia, mycoplasma pneumoniae, streptococcus pneumoniae1, haemophilus influenzae1, and bordetella pertussis (whooping cough), especially in children. Majority of the cases of acute bacterial bronchitis start as viral bronchitis. Isolated bacterial bronchitis is rare. Primary viral infection of the airways (trachea, bronchi and bronchioles) causes mucosal damage of the airways and thus making it more vulnerable to bacterial infiltrations. Individuals suffering from chronic airway diseases like asthma or chronic bronchitis are also at an increased risk for developing bacterial bronchitis.
Risk Factors for Bacterial Bronchitis
- Exposure and inhalation of air irritants and pollutants e.g. chemicals, fumes and dust.
- Chronic sinusitis.
- If the patient has not taken pertussis immunization.
- Dietary deficiency.
- Chest pain and discomfort.
- Persistent cough which produces phlegm. The phlegm appears as thin and clear initially, but later changes to thick, cloudy or greenish-yellow in color.
- High grade fever.
- Patient experiences burning pain with crackling and wheezing in the chest.
- Patient has difficulty in breathing and experiences pain and discomfort when breathing.
- Patient feels very weak and lethargic.
- Patient may also suffer from aches and pain in his body.
Investigations for Bacterial Bronchitis
- Medical history and physical exam.
- A blood test will reveal an increased white count and also increase in polymor-phonuclear leukocytes (PMN). This indicates an infection.
- Gram's stain examines the sputum and helps in detecting white blood cells and bacteria.
- Chest x-ray is done. In bacterial bronchitis there is thickening of the bronchi there are increased markings on the lungs, which is a sign of inflammation.
Treatment for Bacterial Bronchitis
- The main aim of the treatment is to control the infection, as well as the symptoms. Bacterial bronchitis is treated with antibiotics, such as Levaquin, Levofloxacin2, Augmentin, erythromycin, tetracycline, and amoxicillin (in children).
- The antibiotic of choice depends on the type of bacteria causing the infection. Side effects of these antibiotics include: Nausea, vomiting, abdominal pain and diarrhea.
- The antibiotic course is continued for 5 to 7 days. Make sure to continue the entire course even if the symptoms have subsided.
- Medications to keep airways open are called bronchodilators. These will help you breathe easier and help you cough out the infected mucus, and thereby reduce coughing by getting rid of the mucus.
- Usually antihistamines and decongestants are not needed.
- Anti-inflammatory medications such as ibuprofen, aspirin are given for fever and body pains.
- Cough medications containing codeine or dextromethorphan help in relieving cough.
- For persistent cough, bronchodilators such as Atrovent can be used 3 to 4 times a day for 6 weeks. Bronchodilators help in clearing your air ways, easing your breathing, and also help in coughing out the infected mucus thereby decreasing your cough by eliminating the irritant from your airways.
- It's important to take yearly flu shots to prevent viral infections which may lead to bacterial bronchitis.
Preventive Therapy for Bacterial Bronchitis
- Bacterial bronchitis can be prevented after an attack of viral infection, by drinking lots of fluid like hot tea, soup etc. These help in thinning and clearing the mucus from the airways.
- Take plenty of rest.
- Drink lots of fluids to keep your body hydrated and to keep the mucus moist. Drinking lot of fluids also help in flushing out the bacteria.
- Doing saline gargle 2 to 3 times in a day helps with the cough reflex in throat.
- Taking hot showers, especially in the mornings, are beneficial in opening the air passages.
- Use a humidifier especially in night.
1. Bacterial bronchitis caused by Streptococcus pneumoniae and nontypable Haemophilus influenzae in children: the impact of vaccination.
Priftis KN, Litt D, Manglani S, Anthracopoulos MB, Thickett K, Tzanakaki G, Fenton P, Syrogiannopoulos GA, Vogiatzi A, Douros K, Slack M, Everard ML.
Chest. 2013 Jan;143(1):152-7.
2. Levofloxacin for the treatment of respiratory tract infections.
Torres A, Liapikou A.
Expert Opin Pharmacother. 2012 Jun;13(8):1203-12. doi: 10.1517/14656566.2012.688952.