The chronic cough probably just bronchitis (diagnosis of exclusion)

Definition:

Acute bronchitis: Cough and occasionally sputum production more than 3 weeks.

Chronic bronchitis: cough with sputum expectoration at least 3 months a year.

Associated symptoms:

  • Sore throat
  • Runny nose
  • Headache
  • Muscle ache
  • Extreme fatigue

Physical finding:

  • Normal
  • Pharyngeal erythema
  • Localized lymphadenopathy
  • Rhinorrhea
  • Coarse ronchi/wheeze which change location with cough.

Pathophysiology:

The cells of bronchial lining irritated and become hyperemic, edematous, reduced mucociliary function. Then clogged by debris, and cause copious mucus production.

Cause by:

  • Viruses (most common)
  • Cigarette smoking
  • Occupational exposure

Prevention:

  • Avoid smoking and second hand smoke
  • Live in clean environment
  • Influenza vaccine
  • Pneumonia vaccine if >65 year old with comorbid.

Approach:

  1. Symptomatic treatment.
  2. Sputum culture might be helpful.
  3. Antibiotics if bacterial etiology or patient >65 year old.
  4. Mucolytic, expectorant.
  5. NSAIDs for pain.
  6. Short acting beta agonist and corticosteroid if SOB.

Ref:

https://emedicine.medscape.com/article/297108-overview

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