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Issues in Diagnosing Acute Bronchitis

Acute bronchitis is a common respiratory disease that causes inflammation of the bronchial mucosal membranes. Unlike chronic forms of the disease, acute bronchitis has a rapid onset and generates more intense symptoms. However, acute bronchitis doesn’t have a recurrent character and thus its generated symptoms don’t persist in time. Due to the fact that the clinical manifestations of acute bronchitis are unspecific, pointing to various types of respiratory diseases, sometimes it can be difficult for doctors to quickly find the correct diagnosis. Thus, doctors usually perform additional tests in order to confirm the presumptive diagnosis. However, even laboratory tests can sometimes fail to reveal conclusive evidence of acute bronchitis. Considering this fact, the majority of patients with suspected acute bronchitis are commonly diagnosed after they receive elaborate physical examinations.

Most symptoms of acute bronchitis are outwardly visible. The disease generates symptoms such as mucus-producing cough, chest pain and discomfort (intensifying with deep breaths), wheezing, difficult, shallow and accelerated breathing. Sometimes, these manifestations of acute bronchitis can be accompanied by mild or moderate fever. The presence of high fever is an indicator of complications, suggesting severe infection with bacteria or mycoplasmas. Prolonged, intense fever may point to spreading of the respiratory infection at the level of the lungs (pneumonia).

Mucus-producing cough is usually the most revealing symptom of acute bronchitis. Although the presence of cough is not sufficient for diagnosing acute bronchitis, the intensity and the frequency of this symptom are major indicators of respiratory diseases such as bronchitis. Cough is usually the first symptom to occur among people with acute bronchitis, intensifying within the first days after the period of incubation. Some patients with acute bronchitis may have this symptom for less than two weeks, while others may be confronted with cough for more than six weeks. If this symptom persists for more than 8 weeks, it may point to chronic bronchitis.

The texture and the color of the expectorated mucus are major indicators for the seriousness of the disease. For instance, the expectoration of clear, colorless mucus may disclose infectious forms of acute bronchitis. By contrast, abundant expectoration of yellowish or dark-colored mucus may point to bacterial infection of the bronchial membranes. Blood-producing cough usually points to severe forms of acute bronchitis, suggesting that the lungs are also affected by the disease. The majority of patients with acute bronchitis may experience an exacerbation of cough during the night or in the first hours of the morning.

Although doctors often perform laboratory analyses of mucus samples, tests such as Gram staining aren’t very accurate in revealing traces of bacterial infection. Even in the cases of serious infection, most laboratory tests may only reveal the presence of benign bacterial flora at the level of the respiratory tract. In spite of medical progress and the wide range of medical techniques available nowadays, the presence of acute bronchitis in patients is rarely revealed by routine laboratory tests. Thus, acute bronchitis is usually diagnosed according to the results of more elaborate physical examinations.

Radiography, spirometry and pulse oximetry are rarely used in the process of diagnosing acute bronchitis. These tests are recommended to patients with complicated forms of acute bronchitis that involve spreading of the disease at pulmonary level.

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