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2. Respiratory diseases
Chronic bronchitis
A ch ronic inflam m ation of th e bronch ial m ucosa d ue to irritation (tobacco, pollution), 2
allerg y (asth m a) or infection (repetitiv e acute bronch itis). It m ay d ev elop into ch ronic
obstructiv e pulm onary d isease.
Clinical features
– P rod uctiv e coug h for 3 consecutiv e m onth s per year for 2 successiv e years.
– N o d yspnoea at onset. D yspnoea d ev elops after sev eral years, first on exertion, th en
becom ing persistent.
– O n pulm onary auscultation: bronch ial w h eeze (alw ays exclud e tuberculosis).
A patient w ith an acute exacerbation of ch ronic bronch itis presents w ith :
– O nset or increase of d yspnoea
– Increased v olum e of sputum
– P urulent sputum
Treatment
– A ntibiotic treatm ent is not useful in treating sim ple ch ronic bronch itis.
– A ntibiotic treatm ent m ay be useful, for patients in a poor g eneral cond ition only, for
acute exacerbations of ch ronic bronch itis (see Acute bronchitis, prev ious pag e).
– D iscourag e sm oking and oth er irritating factors.
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Chronic bronchitis
A ch ronic inflam m ation of th e bronch ial m ucosa d ue to irritation (tobacco, pollution), 2
allerg y (asth m a) or infection (repetitiv e acute bronch itis). It m ay d ev elop into ch ronic
obstructiv e pulm onary d isease.
Clinical features
– P rod uctiv e coug h for 3 consecutiv e m onth s per year for 2 successiv e years.
– N o d yspnoea at onset. D yspnoea d ev elops after sev eral years, first on exertion, th en
becom ing persistent.
– O n pulm onary auscultation: bronch ial w h eeze (alw ays exclud e tuberculosis).
A patient w ith an acute exacerbation of ch ronic bronch itis presents w ith :
– O nset or increase of d yspnoea
– Increased v olum e of sputum
– P urulent sputum
Treatment
– A ntibiotic treatm ent is not useful in treating sim ple ch ronic bronch itis.
– A ntibiotic treatm ent m ay be useful, for patients in a poor g eneral cond ition only, for
acute exacerbations of ch ronic bronch itis (see Acute bronchitis, prev ious pag e).
– D iscourag e sm oking and oth er irritating factors.
63
