eMedicine Specialties > Pediatrics: General Medicine > Pulmonology

Bronchitis, Acute and Chronic: Follow-up

Author: Patrick L Carolan, MD, Adjunct Associate Professor, Departments of Pediatrics, Family Practice, and Community Health, University of Minnesota Medical School; Medical Director of Minnesota Sudden Infant Death Center; Attending Staff, Department of Emergency Services, Children's Hospitals and Clinics of Minnesota
Coauthor(s): Charles Callahan, DO, Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center
Contributor Information and Disclosures

Updated: Mar 19, 2009

Follow-up

Further Outpatient Care

  • If anti-inflammatory therapy has been started in a child with bronchitis, continue therapy until the child is asymptomatic for at least 1 week. Bronchodilators can be used as needed.
  • Resolution of symptoms, normal findings on physical examination, and normal pulmonary function findings indicate the end of acute treatment.
  • Patients in whom asthma is diagnosed may be candidates for "controller" therapy, which consists of daily inhaled corticosteroid therapy, antihistamines, or leukotriene inhibitors.
  • Patients with defined hypogammaglobulinemia may need periodic immunoglobulin replacement treatments. These are best coordinated with the assistance of pediatric allergy and immunology or pulmonary specialist.

Complications

Complications are extremely rare and should prompt evaluation for anomalies of the respiratory tract, including immune deficiencies. Complications may include the following:

  • Bronchiectasis
  • Bronchopneumonia
  • Acute respiratory failure

Prognosis

  • Acute bronchitis usually completely heals, with excellent prognosis.
  • Patients with chronic bronchitis and established diagnoses of asthma, structural airway disease, or immunodeficiency need careful periodic monitoring to minimize further lung damage and progression to chronic irreversible lung disease.

Patient Education

  • Prevention
    • Instruct patients regarding the need for immunization against pertussis, diphtheria, and influenza, which reduces the risk of bronchitis due to the causative organisms.
    • Instruct patients to avoid passive environmental tobacco smoke.
    • Instruct patients to avoid air pollutants, such as wood smoke, solvents, and cleaners.
    • Instruct patient to obtain medical attention for prolonged respiratory infections.
  • Attendance at school or daycare facilities
    • Instruct parents that children may attend school or daycare without restrictions except during episodes of acute bronchitis with fever.
    • Instruct parents that children may return to school or daycare when signs of infection have decreased, appetite returns, and alertness, strength, and a feeling of well being allow.
  • For excellent patient education resources, see eMedicine's Asthma Center and Procedures Center. Also, visit eMedicine's patient education articles Asthma and Bronchoscopy.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Christine D Dittmer, MD, to the development and writing of this article.



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Multimedia: Bronchitis, Acute and Chronic
References
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Further Reading

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Keywords

bronchitis, acute bronchitis, chronic bronchitis, tracheobronchitis, COLD, chronic obstructive lung disease, OAD, obstructive airway disease, COPD, chronic obstructive pulmonary disease, respiratory tract infection, asthma, viral respiratory tract infection, bacterial respiratory tract infection, CB, acute bronchitis, chronic bronchitis, bronchitis, cough, viral infection, adenovirus, influenza, parainfluenza, respiratory syncytial virus, RSV, rhinovirus, coxsackievirus, herpes simplex virus, HSV, Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae, Chlamydia pneumoniae, Mycoplasma species, air pollution, air pollutants, smoking, second-hand smoke, allergies, chronic aspiration, gastroesophageal reflux, GER, fungal infection, treatment, diagnosis

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Contributor Information and Disclosures

Author

Patrick L Carolan, MD, Adjunct Associate Professor, Departments of Pediatrics, Family Practice, and Community Health, University of Minnesota Medical School; Medical Director of Minnesota Sudden Infant Death Center; Attending Staff, Department of Emergency Services, Children's Hospitals and Clinics of Minnesota
Patrick L Carolan, MD is a member of the following medical societies: American Academy of Pediatrics and International Society of SIDS Researchers
Disclosure: Nothing to disclose.

Coauthor(s)

Charles Callahan, DO, Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center
Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, and Christian Medical & Dental Society
Disclosure: Nothing to disclose.

Medical Editor

Thomas Scanlin, MD, Chief, Division of Pediatric Pulmonary & Cystic Fibrosis, Assistant Professor, Department of Pediatrics, Robert Wood Johnson University Medical Group
Thomas Scanlin, MD is a member of the following medical societies: American Thoracic Society and Society for Pediatric Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Charles Callahan, DO, Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center
Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, and Christian Medical & Dental Society
Disclosure: Nothing to disclose.

CME Editor

Mary E Cataletto, MD, Associate Director, Division of Pediatric Pulmonology, Winthrop University Hospital; Professor of Clinical Pediatrics, State University of New York at Stony Brook; Director of Children's Sleep Services, Winthrop University Hospital
Mary E Cataletto, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Chest Physicians
Disclosure: Shering Plough Pharmaceuticals Honoraria Consulting

Chief Editor

Michael R Bye, MD, Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center
Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society
Disclosure: Merck Honoraria Speaking and teaching

 
 
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