[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Acute bronchitis [Conditions](https://durgical.com/en/conditions/) · [Pulmonology](https://durgical.com/en/conditions/) # Acute bronchitis Acute bronchitis, or chest cold, is inflammation of the large airways, usually from a virus. The cough can last weeks; antibiotics rarely help. Updated 2026-11-01 ## Structures involved Tap one to see what it is and open it in 3D. - [Trachea](https://durgical.com/en/anatomy/trachea/) - [Main bronchi](https://durgical.com/en/anatomy/right-main-bronchus/) - [Lobar bronchi](https://durgical.com/en/anatomy/lobar-bronchus/) - [Segmental bronchi](https://durgical.com/en/anatomy/segmental-bronchus/) - [Right lower lobe](https://durgical.com/en/anatomy/inferior-lobe-of-right-lung/) - [Left lower lobe](https://durgical.com/en/anatomy/inferior-lobe-of-left-lung/) ## In the clinical exam - [Respiratory symptoms: cough, sputum, hemoptysis and dyspnea](https://durgical.com/en/clinical-exam/respiratory-symptoms-cough-sputum-hemoptysis-and-dyspnea/) - [Bronchial obstruction syndrome](https://durgical.com/en/clinical-exam/bronchial-obstruction-syndrome/) ## Why it happens - [Airway defenses, cough and mucociliary clearance](https://durgical.com/en/physiology/airway-defenses-cough-and-mucociliary-clearance/) - [The airway: from nose to bronchioles](https://durgical.com/en/histology/the-airway-from-nose-to-bronchioles/) - [Cilia, microvilli and stereocilia](https://durgical.com/en/histology/cilia-microvilli-and-stereocilia/) ## What it is A self-limited inflammation of the [trachea](https://durgical.com/en/anatomy/trachea/) and large bronchi that causes a cough lasting up to about three weeks, with or without sputum, in a person without pneumonia or chronic lung disease. ## Who gets it One of the most common reasons for primary-care visits and one of the main causes of unnecessary antibiotic prescription worldwide. In Colombia it peaks during the rainy seasons, when respiratory viruses circulate most. ## Causes - Respiratory viruses in about 90% of cases: influenza, rhinovirus, coronaviruses (including SARS-CoV-2), RSV, parainfluenza, adenovirus - Bacteria in a minority: Bordetella pertussis, Mycoplasma pneumoniae, Chlamydia pneumoniae - Irritants: smoke, dust and air pollution ## Risk factors - Active or passive smoking - Exposure to wood smoke or air pollution - Close contact with people who have respiratory infections - Asthma or allergies - Weakened immunity ## Pathophysiology Infection of the bronchial epithelium causes inflammation, mucus hypersecretion and damage to the cilia. The airways become hyper-responsive for weeks, which explains the persistent cough and sometimes wheeze after the infection has cleared. Coloured sputum reflects inflammatory cells, not bacterial infection. ## Symptoms and signs - Cough, dry or productive, lasting 1–3 weeks (the main symptom) - Clear, yellow or green sputum - Chest discomfort or burning when coughing - Mild fever, sore throat, runny nose and fatigue at onset - Mild wheeze or rhonchi on examination ## Red flags - Fast breathing, fast heart rate, high fever or abnormal chest findings (suspect pneumonia) - Shortness of breath or low oxygen saturation - Coughing up blood - Cough lasting more than three weeks - Paroxysmal cough with whoop or post-cough vomiting (suspect pertussis) - Older adults, infants or people with heart or lung disease ## Diagnosis **Clinical** A clinical diagnosis: acute cough with normal vital signs and no signs of consolidation. The main task is to exclude pneumonia, asthma, a COPD exacerbation and pertussis. **Tests** Usually none. Influenza or SARS-CoV-2 testing when it changes management; pertussis testing if suspected; procalcitonin is sometimes used to support withholding antibiotics. **Imaging** [Chest](https://durgical.com/en/anatomy/region/chest/) X-ray only when pneumonia is suspected (abnormal vital signs, focal chest signs, older adults). ## Differential diagnosis - Community-acquired pneumonia - Asthma or COPD exacerbation - Pertussis - Postnasal drip from rhinosinusitis - Gastro-oesophageal reflux - Heart failure ## Goal of treatment Relieve symptoms while the illness resolves on its own, avoid unnecessary antibiotics and recognise pneumonia or other serious illness early. ## Treatment **Conservative** Rest, fluids, warm drinks and honey in children over one year; avoidance of smoke; explanation that the cough often lasts two to three weeks. **Medical** Antipyretics and analgesics for fever and discomfort; inhaled bronchodilators only when there is wheeze. **Medical** Antibiotics are not indicated in uncomplicated acute bronchitis; macrolides only for confirmed or suspected pertussis; antivirals for influenza in high-risk patients. **Lifestyle** Stopping smoking and reducing exposure to wood smoke and pollution. ## Complications - Pneumonia - Post-infectious cough and transient bronchial hyper-responsiveness - Exacerbation of asthma or COPD ## Prognosis Excellent: symptoms usually resolve within three weeks without sequelae. Repeated episodes suggest asthma or chronic bronchitis. ## Prevention - Hand hygiene and covering coughs and sneezes - Influenza, COVID-19 and pertussis vaccination - Avoiding tobacco smoke ## Test yourself Think of the answer, then tap the question to see it. ## What causes most cases of acute bronchitis? Respiratory viruses, in about 90% of cases. ## Does green or yellow sputum in acute bronchitis mean antibiotics are needed? No; sputum colour reflects inflammatory cells, and antibiotics do not shorten uncomplicated acute bronchitis. ## Which findings suggest pneumonia rather than acute bronchitis? Fast heart rate, fast breathing, high fever, low saturation or focal chest signs such as crackles or dullness. ## Which bacterial cause of persistent cough should be suspected with paroxysms and post-cough vomiting? Bordetella pertussis (whooping cough), which is treated with a macrolide. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/conditions/acute-bronchitis/) ## Related conditions - [Community-acquired pneumonia](https://durgical.com/en/conditions/community-acquired-pneumonia/) - [Influenza (flu)](https://durgical.com/en/conditions/influenza/) - [COVID-19](https://durgical.com/en/conditions/covid-19/) - [Pertussis (whooping cough)](https://durgical.com/en/conditions/pertussis/) - [Asthma](https://durgical.com/en/conditions/asthma/) - [Chronic obstructive pulmonary disease (COPD)](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/) - [Bronchiolitis (RSV)](https://durgical.com/en/conditions/bronchiolitis/) - [Acute rhinosinusitis](https://durgical.com/en/conditions/acute-rhinosinusitis/) - [Gastro-oesophageal reflux disease (GERD)](https://durgical.com/en/conditions/gastro-oesophageal-reflux-disease/) Educational information, not medical advice. For any symptom, see a health professional. Sources: [Acute Bronchitis](https://medlineplus.gov/acutebronchitis.html) (MedlinePlus (U.S. National Library of Medicine), 2024); [Chest Cold (Acute Bronchitis) Basics](https://www.cdc.gov/acute-bronchitis/about/index.html) (Centers for Disease Control and Prevention (CDC), 2024). [← All conditions](https://durgical.com/en/conditions/) ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/conditions/acute-bronchitis/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/acute-bronchitis/