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Internal Medicine Conspectus for 5 year 2016-2017 Vol. 1

Internal Medicine Conspectus for 5 year 2016-2017 Vol. 1

Сумата се прибавя директно в кошницата

Acute bronchitis & Tracheobronchitis & Broncheolitis
Acute bronchitis is inflammation of the tracheobronchial tree, commonly following a URI, that occurs in patients without chronic lung disorders. The cause is almost always a viral infection. The pathogen is rarely identified. The most common symptom is cough, with or without fever, and possibly sputum production. Diagnosis is based on clinical findings. Treatment is supportive; antibiotics are usually unnecessary. Prognosis is excellent.

Acute bronchitis is frequently a component of a URI caused by rhinovirus, parainfluenza, influenza A or B virus, respiratory syncytial virus, coronavirus, or human metapneumovirus. Less common causes may be Mycoplasma pneumoniae, Bordetella pertussis, and Chlamydia pneumoniae. Less than 5% of cases are caused by bacteria, sometimes in outbreaks.

Bronchiolitis is an acute viral infection of the lower respiratory tract affecting infants < 24 mo and is characterized by respiratory distress, wheezing, and crackles. Diagnosis is suspected by history, including presentation during a known epidemic; the primary cause, respiratory syncytial virus, can be identified with a rapid assay. Treatment is supportive with oxygen and hydration. Prognosis is generally excellent, but some patients develop apnea or respiratory failure.

Bronchiolitis often occurs in epidemics and mostly in children < 24 mo, with a peak incidence between 2 mo and 6 mo of age. The annual incidence in the first year of life is about 11 cases/100 children. In the temperate northern hemisphere, most cases occur between November and April, with a peak incidence during January and February.

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