From the Guidelines
Fever and productive cough are common symptoms of acute viral bronchitis, with approximately 30-40% of patients experiencing fever and 60-80% having a productive cough, as noted in studies such as 1 and 1.
Symptoms of Acute Viral Bronchitis
The symptoms of acute viral bronchitis include:
- Fever, typically low-grade (below 101°F or 38.3°C) and lasting for the first few days of illness
- A wet, productive cough that occurs in most cases (about 60-80% of patients) and typically develops after an initial dry cough phase
- The cough often starts within the first few days of infection and may persist for 2-3 weeks, sometimes even longer
- The wet cough produces mucus that may be clear, white, yellow, or green in color These symptoms occur because viral infection causes inflammation of the bronchial tubes, leading to increased mucus production and the body's immune response triggering fever, as discussed in 1.
Treatment and Management
Treatment focuses on symptom relief with:
- Rest
- Adequate hydration
- Over-the-counter medications like acetaminophen or ibuprofen for fever and discomfort
- Expectorants such as guaifenesin (400mg every 4 hours) may help loosen mucus Antibiotics are not effective for viral bronchitis and should be avoided unless a secondary bacterial infection develops, as recommended in 1 and 1. It is essential to distinguish acute bronchitis from pneumonia, as pneumonia requires different management, and the presence of purulent sputum or a change in its color does not signify bacterial infection, as noted in 1.
From the Research
Symptoms of Acute Viral Bronchitis
- Fever and productive cough are common symptoms in patients with acute viral bronchitis, although the presence or absence of colored sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections 2.
- Cough is the most common symptom bringing patients to the primary care physician's office, and acute bronchitis is usually the diagnosis in these patients 2.
- The cough associated with acute bronchitis typically lasts about two to three weeks 3.
- Symptoms of bronchitis typically last about three weeks 2.
Diagnosis and Treatment
- Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia 3.
- Acute bronchitis should be differentiated from other common diagnoses, such as pneumonia and asthma, because these conditions may need specific therapies not indicated for bronchitis 2.
- Viruses are responsible for more than 90 percent of acute bronchitis infections 2.
- Antibiotics are generally not indicated for bronchitis, and should be used only if pertussis is suspected to reduce transmission or if the patient is at increased risk of developing pneumonia 2.
- Treatment of acute bronchitis is symptomatic, with a focus on relieving symptoms such as cough and sore throat 4.