Bronchitis natural history, complications and prognosis

Overview
Acute Bronchitis usually presents with cough with or without sputum. The symptoms generally gets well within 10 days but may last for 4 weeks or more. Patients with recurrent episodes of acute bronchitis should be tested to rule out asthma.

Natural history
Acute bronchitis usually presents with cough with or without sputum. Since, acute bronchitis has similar presentation as many other respiratory infections it is difficult to distinguish it from upper respiratory tract infection initially. However, unlike other upper respiratory tract infections the cough usually lasts for more than 5 days in acute bronchitis. It usually last for more than 10-20 days and occasionally more than one month. If the symptoms persist it may also give difficulties in abnormal pulmonary function tests (forced expiratory volume in 1 second and bronchial provocation test). Some studies have found that patients presenting with recurrent episodes of bronchitis were later as diagnosed to have asthma.

Complications
Pneumonia can develop from either acute or chronic bronchitis. If you have chronic bronchitis, you are more likely to develop recurrent respiratory infections. You may also develop:
 * Emphysema
 * Right-sided heart failure or cor pulmonale
 * Pulmonary hypertension

Prognosis
Acute bronchitis usually lasts approximately 20 or 30 days. It may accompany or closely follow a cold or the flu, or may occur on its own. Bronchitis usually begins with a dry cough, including waking the sufferer at night. After a few days it progresses to a wetter or productive cough, which may be accompanied by fever, fatigue, and headache. The fever, fatigue, and malaise may last only a few days; but the wet cough may last up to several weeks.

Should the cough last longer than a month, some doctors may issue a referral to an otolaryngologist (ear, nose and throat doctor) to see if a condition other than bronchitis is causing the irritation. It is possible that having irritated bronchial tubes for as long as a few months may inspire asthmatic conditions in some patients.

In addition, if one starts coughing mucus tinged with blood, one should see a doctor. In rare cases, doctors may conduct tests to see if the cause is a serious condition such as tuberculosis or lung cancer.