Overview
Definition
An acute, self-limiting inflammation of the tracheobronchial tree, usually following an upper respiratory tract infection.
Epidemiology
One of the most common diagnoses in primary care and urgent care.
Etiology & Risk Factors
- Viral (90% of cases): Influenza, Parainfluenza, Adenovirus, Rhinovirus, RSV
- Bacterial (Rare, <10%): Bordetella pertussis, Mycoplasma pneumoniae, Chlamydia pneumoniae
Clinical Symptoms
- Cough (often productive) lasting 1-3 weeks
- Sputum production (clear, yellow, or green - color DOES NOT reliably indicate bacterial infection)
- Mild dyspnea or wheezing
- Chest wall pain (from coughing)
Clinical Approach
Diagnosis
- Clinical diagnosis based on history and physical exam
- Chest X-ray is NOT routinely indicated unless pneumonia is suspected (e.g., abnormal vitals: HR > 100, RR > 24, Temp > 38°C, or focal consolidation on exam)
Management
- Reassurance and symptom control ONLY
- Cough suppressants (Dextromethorphan), Expectorants (Guaifenesin), NSAIDs/Acetaminophen for discomfort
- ANTIBIOTICS ARE NOT INDICATED in the vast majority of cases (due to viral etiology)
Complications
- Pneumonia (rare)
- Reactive airway disease / Bronchospasm