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Acute bronchitis: symptoms, therapy, course

by Josephine Andrews
Published: Last Updated on 391 views

Bronchitis (acute bronchitis) is an inflammation of the mucous membrane in the bronchi . Viruses are usually the cause of the disease. Bronchitis often clears up on its own within a few days, but sometimes causes complications. Here you can read everything you need to know about the disease, which symptoms are typical of bronchitis and how the symptoms can be treated.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.


quick overview

  • Symptoms: Cough (dry at first, later with sputum), possibly fever, headache, sore throat and body aches, runny nose , hoarseness
  • Treatment: Take it easy, drink enough, inhale, possibly cough suppressant, in the case of a strong dry cough (without sputum) possibly cough suppressant (only in the evening); in certain cases antibiotics and/or cortisone
  • Causes and risk factors: pathogens such as viruses and bacteria , rarely fungi, inhaled irritants (such as ammonia, gastric acid) and radiation in cancer therapy; Pollutants such as tobacco smoke or cold increase the risk
  • Examinations and diagnosis: Physical examination with listening to the lungs and tapping on the chest, nasopharynx swab, if necessary blood test , chest X-ray , lung function test
  • Prognosis: usually heals easily without medical treatment; sometimes leads to complications such as pneumonia , bacterial superinfection, spastic bronchitis or becomes chronic ( COPD )
  • Prevention: careful washing of hands, abstinence from tobacco consumption, social distancing, if necessary wearing a respirator; to further support the immune system e.g. E.g. getting enough sleep, regular exercise, gargling , taking or adequate intake of vitamins and probiotics

What is acute bronchitis?

Acute bronchitis is an inflammation of the mucous membranes in the bronchi (air-conducting “ducts” from the trachea to the air sacs in the lungs), which develops quickly and is usually accompanied by inflammation of the upper airways in the nose and throat.

Acute bronchitis is one of the most common respiratory diseases in children and adolescents and occurs mainly in the winter months.

What are the symptoms of acute bronchitis?

Acute bronchitis is usually triggered by cold viruses. Therefore, it often occurs together with or after a cold . One of the most important bronchitis symptoms is a cough : most patients initially have a dry, hacking cough . It is often accompanied by a runny nose .

In about half of the cases, the virus spreads throughout the body. Then, with bronchitis, fever develops . Cold symptoms such as a sore throat, headache and body aches, hoarseness and a burning sensation behind the breastbone often appear . Those affected feel sick and unwell.

Acute bronchitis
In acute bronchitis, the mucous membrane in the bronchi is inflamed. The disease is usually caused by viruses, rarely bacteria.

Bronchitis without a cough is very rare. However, fever does not always occur. It only occurs when the whole body is affected by the viral infection.

As the disease progresses, the symptoms change: after a few days, bronchitis patients develop a ” productive cough “, which means that mucus is released in the lower respiratory tract (bronchi), which the affected person then coughs up. A cough with sputum develops from the dry, irritating cough .

The expectorated phlegm is usually viscous and clear to whitish . This is typical for the acute viral infection of the bronchial mucosa. In some patients, the sputum turns yellowish or greenish. Then additional bacteria have settled on the inflamed mucous membranes. Physicians call this a bacterial superinfection or bacterial secondary infection : a bacterial infection has “sat on top” of the viral infection.

Bronchitis: signs of complications

In severe cases, bronchitis patients cough up mucus mixed with blood . The blood usually comes from small injuries to the mucous membrane. This is generally not dangerous. Bloody sputum should still be taken seriously, as it sometimes has a serious cause. You should therefore always clarify this with a doctor.

When the mucous membrane produces more mucus, swells and narrows, complicated bronchitis has developed. Doctors then speak of obstructive or spastic bronchitis . There are audible breathing sounds (rattling, wheezing). Some patients also have difficulty breathing ( shortness of breath ).

Sometimes acute bronchitis turns into pneumonia .

If bronchitis triggers the following symptoms, you should definitely see a doctor:

  • Cough lasts more than eight weeks
  • Very high fever or rising fever after afebrile phase
  • Strong feeling of illness, chills and night sweats
  • Coughed up phlegm contains blood
  • Increased shortness of breath
  • Unusual, wheezing breath sounds

Doctors recommend people with a weakened immune system to have a doctor examine them even if they have mild bronchitis symptoms. The same applies to people with chronic heart or lung diseases (such as heart failure, asthma , COPD – English: chronic obstructive pulmonary disease).

Bronchitis & Pregnancy

If you are pregnant, it is advisable to see a doctor if you have bronchitis-like symptoms. He is then able to rule out more serious causes of the symptoms (such as whooping cough ). It also makes sense to have a doctor monitor the course of bronchitis during pregnancy – especially if there are complications. The doctor also advises the pregnant woman on the selection of suitable medication for the symptoms of bronchitis.

How can acute bronchitis be treated?

“What to do with bronchitis?” Many people turn to the doctor, pharmacist or health website with this question, especially during the cold season. The answer: There are no specific bronchitis medications. In most cases, however, this would not be necessary. Simple bronchitis, while uncomfortable, is not dangerous. Simple measures such as taking it easy, drinking enough and inhaling are sufficient . This usually relieves the symptoms and supports the healing process.

Clearing mucus is especially important

The fact that the lower respiratory tract produces more mucus in bronchitis is an important defense mechanism: together with the secretion, the patient coughs up pathogens and dead cells. Treating acute bronchitis therefore means above all drinking enough. This will help loosen the mucus and make it easier to cough up. This supports the defense against infection.

Inhaling also helps to liquefy and loosen the mucus. You can do the same if you gently tap the chest .

Many patients rely on expectorant drugs (” cough relievers “). They contain N-acetylcysteine ​​or ambroxol as the active ingredient. So far, however, it has not been scientifically proven that such preparations are actually helpful in acute bronchitis therapy.

Cough suppressants only work if you also drink a lot of liquid (tea, clear soup, etc.).

Do not suppress coughing!

With a nagging, non-productive cough (without sputum), many patients do not sleep well. In addition, the constant hard coughing irritates the attacked mucous membrane. Many patients then take medication that suppresses the urge to cough (antitussives such as codeine) – also known colloquially as “ cough suppressants ” or “ cough blockers ”. Some require a prescription and are more effective. Other cough suppressants are available over-the-counter (such as those containing clobutinol). However, their effectiveness has not been scientifically proven.

Cough suppressants are particularly helpful when violent, dry coughing attacks disturb sleep at night. The purpose of coughing is to clear the germs from the airways. This defense mechanism should therefore only be suppressed for a short time, for example in order to be able to sleep peacefully again. After all, restful and sufficient sleep is extremely important in order to strengthen the body’s own defences.

In the case of prescription cough suppressants in particular, it is advisable to only use them for a short time. They contain opiates like codeine. These harbor a certain potential for dependency and addiction. In addition, they often make you very tired, limit your ability to react and sometimes cause constipation.

Cough suppressants are not recommended for productive coughs (cough with sputum), as they prevent mucus from being coughed up. Also, do not combine cough suppressants with expectorants: otherwise, the liquefied mucus will build up in the bronchi.

Bronchitis: antibiotics only for bacterial infection

Many patients want to take antibiotics for bronchitis in order to get well again quickly. But this is rarely useful, because bronchitis is a viral infection. Antibiotics don’t help. These are only effective against bacteria.

That is why the doctor only prescribes an antibiotic for bronchitis if bacteria have also spread to the affected mucous membrane (bacterial superinfection). This can be recognized, for example, by the fact that the coughed-up mucus is discolored yellowish or greenish by pus.

Cortisone for bronchitis

The effect of antibiotics in bronchitis with bacterial superinfection can be increased if you also take cortisone tablets for a short time. Cortisone has an anti-inflammatory effect. Cortisone is particularly useful for obstructive (spastic) bronchitis. Cortisone causes the mucous membrane in the airways to decongest. The body then transports the bronchial mucus, which contains plenty of germs and waste materials, better. Doctors often recommend cortisone inhalations for obstructive bronchitis.

More tips

If bronchitis is accompanied by a cold or flu , fever, sore throat, headache and body aches often also occur. If necessary, painkillers such as ibuprofen or paracetamol can help . They bring down the fever and relieve the pain. Ibuprofen also has an anti-inflammatory effect.

Doctors primarily recommend physical protection for bronchitis. Sport is therefore not advisable during the acute illness, especially not with a fever. Better keep bed rest then .

Overheated rooms are rather unfavorable for bronchitis patients . It is also important that the air is not too dry . For example, hang damp cloths over the heater and air regularly, preferably intermittently . A certain level of humidity is good for the mucous membranes.

Home remedies for bronchitis

Many people use home remedies for bronchitis. They sometimes support the treatment and help to liquefy the stuck mucus from the bronchi and cough it up more easily. These include, among others:

  • inhalations
  • chest wrap
  • medicinal plant teas
  • Baths with herbal additives

You can read how to use these home remedies for bronchitis treatment correctly in the article Bronchitis – home remedies .

Home remedies can at best complement conventional medical treatment, but cannot replace it. Talk to your doctor about how you can best support the therapy yourself.

What leads to acute bronchitis?

Acute bronchitis is usually caused by viruses . Often these are cold viruses: The common cold is an infection and inflammation of the upper respiratory tract. It often spreads down into the bronchi, which then leads to acute bronchitis.

There are other viruses that sometimes cause acute bronchitis. These include, for example, rhino, flu, herpes , corona and parainfluenza viruses. Viral bronchitis in children is often caused by the RS virus (respiratory syncytial virus).

Rarely, bacteria are the cause of bronchitis. The main triggers are mycoplasma or chlamydia. But other bacteria are also possible, such as streptococci, staphylococci, pneumococci and Haemophilus influenzae. These are mainly responsible for acute bronchitis in immunocompromised people, pulmonary patients and hospital patients.

What is known as bacterial superinfection in viral bronchitis is more common than purely bacterial bronchitis: the mucous membrane attacked by the virus is then also colonized by bacteria.

Very rarely, fungi cause acute bronchitis. This happens especially in people whose immune systems are weakened.

Other rare causes of bronchitis are substances such as ammonia, hydrochloric acid, sulfur dioxide and nitrous gases. When inhaled, they damage the mucous membrane of the bronchi and thus trigger inflammation. Radiation ( radiation therapy ) in the context of cancer is sometimes the reason for acute bronchitis.

In allergy sufferers, contact with the allergy trigger may cause acute allergic bronchitis .

Pollutants such as smog, smoking and tobacco smoke from passive smoking and extreme cold are considered risk factors that promote acute bronchitis.

Incubation period for bronchitis

Doctors call the period of time between infection with a pathogen (viruses, bacteria, fungi, etc.) and the appearance of the first symptoms the incubation period. The different germs trigger bronchitis at different speeds. Viruses are particularly fast: the incubation period for viral bronchitis is only one day. The additional settlement of bacteria on the mucous membranes in viral bronchitis lasts up to ten days.

Is bronchitis contagious?

Acute bronchitis is contagious if pathogens (viruses, bacteria, fungi) are the cause. For example, when the patient coughs, it spreads tiny liquid droplets containing the germs into the surrounding air. If someone inhales these, they may also become ill.

However, not every infection leads to the outbreak of the disease: bronchitis pathogens often only make you ill if the infected person is weak (e.g. due to a cold).

How is acute bronchitis diagnosed?

Acute bronchitis can usually be treated at home without medical help. Have severe bronchitis examined by your family doctor at least once. He is able to assess possible dangers and risks. Specialists in respiratory diseases are pulmonologists and ENT doctors. In the case of acute bronchitis, however, it is usually only very rarely necessary to consult them.

A doctor’s visit is advisable in the following cases:

  • Difficulty breathing, shortness of breath and chest pain
  • coughing up blood
  • High fever
  • Yellowish or greenish sputum
  • Symptoms that last longer than seven days
  • Previous illnesses such as COPD, bronchial asthma or cardiac insufficiency
  • Immune deficiency in HIV infection, cancer or cortisone therapy
  • Acute bronchitis in the elderly or children

Doctor-patient interview and physical examination

The doctor will first ask you exactly what your symptoms are – what symptoms you have, what color the sputum is, how severe the symptoms are and how long they have existed. Inform him of any previous or underlying illnesses (cold, flu, asthma, etc.). Through this conversation, the doctor collects your medical history ( anamnesis ). It provides him with important information about the cause of your symptoms and possible complications.

After that, the doctor examines you physically. Above all , he listens to the heart and lungs with a stethoscope . In bronchitis, a rattling, whistling or buzzing sound is noticeable in addition to the normal breathing sounds. These sounds are caused by the mucus vibrating in the bronchi when the air blows past. In children, a so-called tube breathing is noticeable.

The doctor taps the chest to assess the percussion sound. This provides indications of possible accumulation of secretions or effusions in the lungs. The doctor also feels the lymph nodes in the neck and takes a look at the mouth , throat and ears. He often also measures body temperature, pulse and blood pressure.

blood test is usually not necessary. It is only an option if the doctor suspects pneumonia: the direct connection between the bronchi and the airways deep into the lungs sometimes turns bronchitis into pneumonia in severe cases.

In addition, a blood analysis is sometimes helpful to clarify the suspicion of a bacterial infection in bronchitis: If the blood sedimentation rate and the number of white blood cells are greatly increased, bacteria have probably settled on the mucous membranes of the airways. Treatment with antibiotics is then usually advisable.

However, there are also bronchitis patients with a bacterial infection whose blood values ​​are all normal. Then the doctor examines the sputum or has a nasal or throat swab examined in the laboratory. This enables the exact causative agent of bronchitis to be determined. If necessary, the doctor initiates targeted antibiotic therapy.

An X-ray of the chest (X-ray chest) is necessary if pneumonia is suspected. In addition, more serious causes of the symptoms can be ruled out, such as lung cancer with bloody sputum and worsening symptoms. In such a case, further examinations may be indicated, for example a bronchoscopy.

In complicated bronchitis, the doctor performs a lung function test (spirometry). This is how he determines whether the airways are narrowed (e.g. in spastic bronchitis).

How successful is the treatment of acute bronchitis?

The prognosis of acute bronchitis is very good. In most patients, it heals without any medical treatment. The duration of bronchitis varies: In uncomplicated cases, it usually subsides after a few days up to a maximum of four weeks. A dry, dry cough may last for a long time (up to eight weeks). Go to the doctor if the illness lasts longer. Bronchitis is then perhaps not the right diagnosis, or the acute bronchitis has developed into chronic bronchitis.

Complications of bronchitis

Caution should be exercised in elderly or immunocompromised patients and those with pre-existing pulmonary disease. In them, acute bronchitis leads more easily to complications, such as pneumonia . This is especially true if the bronchitis is delayed or not properly cured. As a result , bronchitis develops into a chronic form .

In COPD patients, acute bronchitis sometimes triggers a flare -up: the COPD symptoms then worsen acutely.

Pneumonia and bacterial superinfection are among the most common complications of acute bronchitis. A so-called ” bronchiolitis obliterans” develops more rarely . The smallest bronchial branches (bronchioles) in the lungs become inflamed and scar as a result. They then remain permanently closed, which means: This part of the airways narrows. Young children in particular are prone to bronchiolitis obliterans.

Spastic bronchitis

Acute obstructive or spastic bronchitis occurs primarily in infants and young children. It arises as a complication of acute viral bronchitis. In spastic bronchitis, the mucous membrane of the bronchi produces a lot of mucus and is swollen at the same time, i.e. narrowed. This makes breathing difficult. The shortness of breath is sometimes even threatening. In addition, wheezing, whistling and/or humming can be heard when exhaling .

The little patients are given special medication to relieve shortness of breath, so-called sympathomimetics. These active ingredients are available as a spray or inhalation. They dilate the airways. The patient then finds it easier to breathe again. In certain cases, other medications are added to this particular acute bronchitis.

You can read more about this special form of acute bronchitis in the article Spastic bronchitis .

Can acute bronchitis be prevented?

There are only a few preventive measures, since acute bronchitis is usually caused by an infection with pathogens that you take in with the air, with droplets or through direct contact. These pathogens are usually not visible and it is therefore difficult to identify a risk of infection.

Prevent effectively

The only and most effective protection against this disease is careful hygiene and sufficient distance from other people or animals. Wash hands regularly with soap, especially after touching potentially contaminated objects. Avoid putting your fingers in your mouth or touching your face. Keep your distance from other people (“social distancing”) and, if necessary, wear a respirator in closed, narrow rooms with a high risk of infection . Such rooms are, for example, waiting rooms in medical practices, public bars or small shops.

Other precautionary options

There are other preventive measures, but their effectiveness has not been medically proven. For example, regular sport or physical training should contribute to strengthening the immune system and thus also prevent acute bronchitis. However, there is no evidence for this.

The same applies to the subject of “sleep”. In general, a sleep duration of between six and nine hours is recommended. Initial evidence suggests that sleep duration may have an impact on the risk of developing respiratory diseases.

There is also evidence that certain vitamins ( vitamins C , D and E) have a positive effect on the risk of disease. However, since the effect has not been clearly confirmed here either, experts advise you to always consult a doctor first if, for example, you want to take vitamin preparations as a dietary supplement as a precaution.

The same applies to so-called probiotics (products with viable microorganisms). They usually contain lactic acid bacteria such as Lactobacillus or Bifidobacterium, which are particularly active in the intestinal tract. These bacteria are contained, for example, in fermented foods such as sauerkraut or in dairy products such as yoghurt. A few studies have shown that certain strains of bacteria have a positive effect on the duration of respiratory disease and reduce its frequency. But the effect was very weak.

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