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nchitis
Bronchitis
Acute bronchitis
A n acute inflam m ation of th e bronch ial m ucosa, m ost com m only of v iral orig in. I n
old er ch ild ren it can be caused by Mycoplasma pneumoniae. In ch ild ren ov er 2 years of
ag e w ith repetitiv e acute bronch itis or „w h eezing ‟ bronch itis, consid er asth m a
( see Asthma, pag e 7 4 ) . I n ch ild ren und er 2 years of ag e, consid er bronch iolitis
(see Bronchiolitis, pag e 6 4 ).
Clinical features
O ften beg ins w ith a rh inoph aryng itis th at d escend s prog ressiv ely: ph aryng itis,
laryng itis, trach eitis.
– H eav y coug h , d ry at th e beg inning th en becom ing prod uctiv e
– L ow -g rad e fev er
– N o tach ypnoea, no d yspnoea
– O n pulm onary auscultation: bronch ial w h eezing
Treatment
– F ev er: paracetam ol P O (see Fever, pag e 2 6 ).
– K eep th e patient h yd rated , h um id ify air (w ith a bow l of w ater or a w et tow el).
– C h ild ren: nasal irrig ation w ith 0 .9 % sod ium ch lorid e or R ing er L actate, 4 to
6 tim es/ d ay to clear th e airw ay.
– A ntibiotic treatm ent is not useful for patients in g ood ov erall cond ition w ith
rh inoph aryng itis or influenza.
– A ntibiotic treatm ent is ind icated only if:
• th e patient is in poor g eneral cond ition: m alnutrition, m easles, rickets, sev ere
anaem ia, card iac d isease, eld erly patient etc.
• if th e patient h as d yspnoea, fev er g reater th an 3 8 .5 °C and purulent expectorations:
a second ary infection w ith Haemophilus influenzae or w ith pneum ococcus is
probable.
amoxicillin P O
C h ild ren: 1 0 0 m g / kg / d ay in 3 d iv id ed d oses for 5 d ays
A d ults: 3 g / d ay in 3 d iv id ed d oses for 5 d ays
or
chloramphenicol P O
A d ults: 3 g / d ay in 3 d iv id ed d oses for 5 d ays
62
Bronchitis
Acute bronchitis
A n acute inflam m ation of th e bronch ial m ucosa, m ost com m only of v iral orig in. I n
old er ch ild ren it can be caused by Mycoplasma pneumoniae. In ch ild ren ov er 2 years of
ag e w ith repetitiv e acute bronch itis or „w h eezing ‟ bronch itis, consid er asth m a
( see Asthma, pag e 7 4 ) . I n ch ild ren und er 2 years of ag e, consid er bronch iolitis
(see Bronchiolitis, pag e 6 4 ).
Clinical features
O ften beg ins w ith a rh inoph aryng itis th at d escend s prog ressiv ely: ph aryng itis,
laryng itis, trach eitis.
– H eav y coug h , d ry at th e beg inning th en becom ing prod uctiv e
– L ow -g rad e fev er
– N o tach ypnoea, no d yspnoea
– O n pulm onary auscultation: bronch ial w h eezing
Treatment
– F ev er: paracetam ol P O (see Fever, pag e 2 6 ).
– K eep th e patient h yd rated , h um id ify air (w ith a bow l of w ater or a w et tow el).
– C h ild ren: nasal irrig ation w ith 0 .9 % sod ium ch lorid e or R ing er L actate, 4 to
6 tim es/ d ay to clear th e airw ay.
– A ntibiotic treatm ent is not useful for patients in g ood ov erall cond ition w ith
rh inoph aryng itis or influenza.
– A ntibiotic treatm ent is ind icated only if:
• th e patient is in poor g eneral cond ition: m alnutrition, m easles, rickets, sev ere
anaem ia, card iac d isease, eld erly patient etc.
• if th e patient h as d yspnoea, fev er g reater th an 3 8 .5 °C and purulent expectorations:
a second ary infection w ith Haemophilus influenzae or w ith pneum ococcus is
probable.
amoxicillin P O
C h ild ren: 1 0 0 m g / kg / d ay in 3 d iv id ed d oses for 5 d ays
A d ults: 3 g / d ay in 3 d iv id ed d oses for 5 d ays
or
chloramphenicol P O
A d ults: 3 g / d ay in 3 d iv id ed d oses for 5 d ays
62
