Tammy is a 33-year-old who presents for evaluation of a cough

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Tammy is a 33-year-old who presents for evaluation of a cough

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Tammy, a 33-year-old woman, comes in for a cough evaluation. She says she got a “really bad cold” with rhinorrhea about three weeks ago. The cold seemed to go away, but then she developed a severe, mucus-producing cough. There is no longer any rhinorrhea or rhinitis; the main issue is the cough. She gets these coughing fits that are long, deep, and produce a lot of green sputum. She isn’t feverish, but she does have a scratchy throat. Tammy has tried over-the-counter cough medicines with little success. Her cough keeps her awake at night and can cause her to gag and dry heave. She is diagnosed with bronchitis after a thorough examination.

What is the cause of bronchitis?
Describe the pathophysiology of bronchitis in detail.
Identify the hallmark signs and symptoms identified during the physical exam.
Describe the pathophysiology of bronchitis complications.
What advice would you give her in light of her diagnosis?

There are two kinds of Bronchitis: Acute Bronchitis, that is caused by “Infections or lung irritants,” and Chronic Bronchitis, that is

Tammy is a 33-year-old who presents for evaluation of a cough

Tammy is a 33-year-old who presents for evaluation of a cough

caused by “repeatedly breathing in fumes that irritate and damage lung and airway tissues” (National Heart, Lung, and Blood Institute, 2018). This could be like smoking or inhaling second-hand smoke. The etiology of bronchitis is the same that causes upper respiratory infections. The names of the viruses that cause bronchitis are coronavirus, rhinovirus, respiratory syncytial virus, and adenovirus. Most cases of bronchitis come from a virus instead of bacteria. Current smoking is associated with a more goblet cell hyperplasia and number, and chronic bronchitis is associated with more goblet cells, independent of the presence of airflow obstruction. This provides clinical and pathologic correlation for smokers with and without COPD (Kim et al., 2015)….

I enjoyed reading your post. I can relate to your teaching about ensuring that individuals with bronchitis wear a mask when around fumes and individuals with cold or flu symptoms. I was once diagnosed with bronchitis when I moved to West Virginia in 2009. I remember having a cold and I was very congested. Right after the cold subsided I started coughing like crazy every day all day. I coughed non-stop and would throw up from coughing too much for two months, I kept thinking it will go away. Every time I would fly I would be so embarrassed because I would cough non-stop on the plane. I took every over the counter cough suppressant and none of them worked. I finally went to the doctor and they prescribe bronchial dilator inhalers, but none of them worked. I went to the doctor the second time and she prescribed codeine which finally cleared my cough. I have learnt to wear a mask whenever I go outside due to high levels of pollen, once I moved Georgia and I sleep with a cool mist Humidifier. The doctors did not prescribe antibiotics because they told me it was a viral infection. They did some blood work and the blood work came back negative.

According to Smith (2017), a systematic review shows that there was limited evidence of clinical benefit to support the utilization of antibiotics for acute bronchitis. Some patients treated with antibiotics recovered a bit more quickly with reduced cough-related outcomes. Unfortunately surveys show that 80% of patients with acute bronchitis receive antibiotics. Antibiotic overuse contributes to emergence of drug-resistant organisms.

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