Acute Bronchitis (Chest Cold): Symptoms, Care and When to Be Seen

What it involves

MedlinePlus describes acute bronchitis as swelling and inflamed tissue in the bronchi, the main passages that carry air to the lungs. The swelling causes cough, sometimes with mucus, and may narrow the airways, making it harder to breathe. Acute means the symptoms have been present for a short time, as opposed to chronic bronchitis, which is diagnosed with a cough and mucus on most days for at least 3 months.

Who this is for

• Patients with a cough and mucus that began after a cold or flu-like illness
• Patients whose cough has gone past a week or keeps them up at night
• Patients with chest discomfort, wheezing, or breathlessness with activity
• Patients with heart or lung disease who get chest colds that linger

What to expect

• Questions about the cough, mucus, fever, breathing, and how the illness began
• A listen to your lungs with a stethoscope and a check of your temperature
• A plain explanation of whether this looks viral and whether antibiotics would help
• A referral for a chest x-ray if pneumonia is a concern

How acute bronchitis starts

MedlinePlus says acute bronchitis almost always comes after a cold or flu-like illness. At first it affects the nose, sinuses, and throat, then spreads to the airways that lead to the lungs. It is usually caused by a virus. Sometimes bacteria also infect the airways, which is more common in people with chronic obstructive pulmonary disease. If a stuffy nose and facial pressure are the first signs, the sinus infection or cold guide describes that phase.

Symptoms

MedlinePlus lists the symptoms of acute bronchitis:

• Chest discomfort
• A cough that brings up clear or yellow-green mucus
• Fatigue
• Fever, usually low-grade
• Shortness of breath that gets worse with activity
• Wheezing in people with asthma

Bronchitis or pneumonia

MedlinePlus says it can be hard to know if you have pneumonia or bronchitis. With pneumonia you are more likely to have a high fever and chills, feel sicker, and feel more short of breath. A provider listens to the lungs and may order a chest x-ray if pneumonia is suspected. This practice would arrange the x-ray through a referral. If breathing is the main problem, the shortness of breath guide explains when it is urgent.

Why antibiotics are often not the answer

MedlinePlus says most people do not need antibiotics for acute bronchitis caused by a virus, and that antibiotics only get rid of bacteria, not viruses. The infection almost always goes away on its own within a week, though a mild cough may persist for up to four weeks. If your provider thinks bacteria are also present, they may prescribe an antibiotic. If your symptoms do not improve or you are wheezing, an inhaler may be prescribed.

What helps you feel better

MedlinePlus suggests drinking plenty of fluids, getting rest, and using a humidifier or steaming up the bathroom. Ibuprofen or acetaminophen can help with fever or body aches, and it says not to give aspirin to people under age 18. Over-the-counter products with guaifenesin can help loosen mucus. It also says not to smoke and to avoid secondhand smoke, and to wash hands often. The persistent cough guide covers a cough that outlasts the illness.

Contact your provider if

MedlinePlus says to contact your provider if you have a cough on most days or a cough that keeps returning, are coughing up blood, or have a high fever or shaking chills. Also call for a low-grade fever for three or more days, thick yellow-green mucus with a bad smell, shortness of breath or chest pain, or a chronic illness such as heart or lung disease. Flu symptoms and what separates them from a cold are in the cold versus flu guide.

Sources

• MedlinePlus — Acute bronchitis
• MedlinePlus — Acute Bronchitis health topic