Bronchitis (Chest Cold), Acute

Presentation

The patient’s symptoms generally begin with 1 to 5 days of fever, malaise, and myalgias that are often indistinguishable from other acute upper respiratory tract infections (URIs). With acute bronchitis, the acute phase is followed by a second phase characterized by persistent cough, often accompanied by phlegm production or wheezing. This second phase usually lasts 1 to 3 weeks but may last as long as 2 months in some patients. The cough may produce hoarseness or may be accompanied by difficulty breathing and chest tightness. The patient may be fearful about developing pneumonia, is seeking relief from the symptoms, and is frequently seeking antibiotics that are errantly believed to improve the condition.

The patient’s vital signs are within normal limits and they do not appear toxic. They commonly produce sputum, which may be clear, white, yellow, brown, or green, and lung sounds may be clear or reveal rhonchi or wheezes. The presence or absence of purulent sputum is a poor predictor of bacterial infections.