Acute Bronchitis, Chronic Bronchitis and Pneumonia

Bronchitis is an inflammation of the trachea, bronchus and bronchioles which are tubes that lead to the lung tissues. This may be caused by an infection or a chemical irritant. Pneumonia is an infection of the lung tissue itself. Acute bronchitis may be bacterial, viral in origin or chemically mediated by noxious chemicals from a variety of sources. Chronic bronchitis is more likely due to a longer term exposure to noxious chemicals usually tobacco based or chemical pollution.  Pneumonia may be caused by viruses, bacteria or various other ways. All three have some similar characteristics and also have differences.  Acute bronchitis patients often have no fever or minimal fever, a normal respiratory rate and diffuse rales or chest sounds on auscultation (listening) with a stethoscope (DC Maldonado, 2006).  Chronic bronchitis is usually due to a long term exposure to chemicals such as tobacco, fumes, and other irritants. Chronic bronchitis is one of 5 main types of conditions that make up the category of chronic obstructive pulmonary disease (COPD), along with emphysema and cystic fibrosis, brochiectasis and asthma (AJ Cropp, 2012). Most types of bronchitis early on have a nonproductive cough that later turns into a productive cough of phlegm, mucus and purulent materials or pus. The treatment of bronchitis whether  the acute or chronic form depends on the cause and needs specific treatments directed hopefully at getting rid of the cause of the problem.

Pneumonia is an infection or irritation of the pulmonary parenchymal tissues or the actual end organ lung soft tissues themselves. This is the area of the lung where oxygen and carbon dioxide exchange places, one going in and the other coming out of the body and this fact results in difficulty with the exchange. Pneumonia is thus a deeper infection or site of inflammation than bronchitis of either type. Patients with pneumonia present with fever, difficulty breathing, high respiratory rate and abnormal sounds over the affected area of the lung with a stethoscopic exam. Viral pneumonia onset is slow onset and a bacterial pneumonia is usually a more rapid onset of sickness.

Questions to ask are “has the person been around any sick people?”, because most infectious causes of these tissues are viral in origin. Another important question is, “is the person able to drink oral fluids?, because if unable they may need to have intravenous (IV)  fluids due to likelihood of dehydration occurring, and that will need done in a facility that has that capability. Another question is to inquire about any recent travel, living or work environments that could be involved (DC Maldonado, 2006).

The treatments of all of these three conditions are different. Often a patient with one of the 5 general forms of COPD will have a greater likelihood of developing acute bronchitis or pneumonia. These two conditions will need to have powerful antibiotics (unless viral) prescribed to cure them. The more disease issues or comorbidities involved such as diabetes, high blood pressure, heart disease, heart failure, kidney disease etc will mean they need to be evaluated earlier.

If you or a friend, neighbor, coworker or other person that you know has any of these symptoms, they should be evaluated as soon as able so that the proper treatment can be started especially if they have other underlying chronic diseases. We would of course be happy to help with these potentially problematic and life changing conditions. Call us at 817-274-2343 for an immediate appointment.

  1. COPD, the 5 Minute Clinical Consult 2012, AJ Cropp ,pp 276-277.
  2. Acute bronchitis, SOAP for Family Medicine, DC Maldonado, C Zuniga, PS Uzelac, pp 14-15