Bronchitis - acute

Alternative names
Acute bronchitis

An inflammation of the main air passages to the lungs (the bronchi).

Causes, incidence, and risk factors

Acute bronchitis is generally caused by viral respiratory infections and typically appears just as the symptoms of the initial infection are waning.

These viral infections may be caused by any number of respiratory viruses including the rhinoviruses which cause the common cold. These viruses produce bronchial inflammation which sets the stage for bronchitis and, in some cases, a secondary bacterial infection.

Early symptoms may include a tickle deep in the throat just above the sternal notch which progresses into an irritating dry cough.

As the infection progresses, the cough may become productive with thick yellow sputum (purulent sputum) which is very rarely blood streaked. Associated symptoms may include fever, malaise, chest pain, and shortness of breath.

When affected, infants generally develop other respiratory complications, such as bronchiolitis or pneumonia, while older children and adolescents develop typical adult symptoms of bronchitis.

Risk factors for bronchitis include recent illnesses that have lowered resistance to infection, a preceding viral respiratory infection, smoking, or chronic lung problems. Acute bronchitis is one of the most common conditions seen in clinical practice..


  • Cough       o May produce pus-like sputum or mucous-like sputum       o Rarely may have episodes of coughing up blood (blood streaked sputum) - though this should always be evaluated by a physician.       o Lasts for less than 6 weeks  
  • Shortness of breath  
  • Wheezing  
  • Rattle in chest  
  • General ill feeling (malaise)  
  • Slight fever  
  • Sore throat  
  • Chest pain, soreness, and constricted feeling in the chest  
  • May cause the individual to awaken at night (paroxysmal nocturnal dyspnea)  
  • Chills (uncommon)

Signs and tests
A physical examination confirms the symptoms and signs of bronchitis, and is most important to help rule out the presence of pneumonia.

Tests performed may include:

  • A chest X-ray to determine if pneumonia has developed  
  • A sputum culture to determine if the inflammation is caused by bacteria


The goal of treatment is to relieve the symptoms with medications and supportive measures. Multiple studies have shown antibiotics do not benefit most patients with acute bronchitis. In otherwise healthy people, antibiotics should rarely be prescribed..

Medications which open constricted air passages in the lungs (bronchodilators), such as albuterol, may be prescribed particularly for patients with wheezing.

Decongestants (such as pseudoephedrine) may also help alleviate the symptoms of bronchitis. Medications that liquefy mucus secretions (mucolytics, like guaifenesin) may also be prescribed.

Supportive treatments include rest, increased humidity (using a cool mist humidifier) to soothe air passages, and increased fluid intake to maintain hydration and to thin mucous lung secretions.

Expectations (prognosis)
Symptoms usually abate within 7 to 10 days in the absence of prior chronicpulmonary disease. Complete resolution of cough commonly takes longer in some patients.


Pneumonia is a possible complication.

Calling your health care provider
Call your health care provider if symptoms suggestive of bronchitis occur.

Call your health care provider if you are being treated for acute bronchitis and breathlessness develops, or if you cough up blood.


Good handwashing is one of the best ways to avoid exposure to viruses and other respiratory infections.

Since influenza viruses have been shown to be a significant cause of bronchitis, yearly ful vaccination may also help prevent acute bronchitis.

Minimize exposure to cold, damp environments which, combined with air pollution or tobacco smoke, may make people more susceptible to bronchitis.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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