Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149514 (bronchitis)
 6,902 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In non-smokers the underlying causes for chronic persistent cough (CPC) e.g. chronic cough without diagnostic chest X-ray or pulmonary function test--are usually as follows: several common upper airways diseases, bronchial (cough type) asthma, gastrooesophageal reflux or treatment with an ACE (angiotensin converting enzyme)--inhibitor. In 10% of CPC however the cause remains uncertain. We report a 30 year old non-smoker with severe coughing and repeated vomiting for two months. No laboratory or technical data could be collected suggestive of a common cause of CPC: Upper airways disease, bronchial flow limitation or hyperresponsiveness, ACE inhibitor medication, B. pertussis infection, gastrooesophageal reflux disease (by 24 hours pH-probe) were ruled out. Fiberbronchoscopic findings remained unremarkable, except for the bronchial biopsy specimen, which showed moderate eosinophilic inflammation of the mucosa and marked thickening of the subepithelial layer. Since the cough was non-productive, sputum induction with 3 ml nebulised 3% NaCl solution was performed. 28% of the granulocytes were eosinophil stained. A low quality morning sputum (< 1 ml) showed 21% eosinophilia. Thus, the diagnosis of eosinophilic bronchitis was established. 400 micrograms budesonide dry powder inhalations b.i.d. for one week resolved the cough, treatment was stopped after three weeks. No recurrence was seen two months later. Both the cough type asthma and the eosinophilic bronchitis could represent a form fruste of classical bronchial asthma beyond wheezing or dyspnoea, but with the common main symptom: cough. Since hyperresponsiveness and cough are phenotypic hallmarks of cough variant asthma, in eosinophilic bronchitis--beside cough--another two features of asthma are present: eosinophilic inflammation of the mucosa along with sputum eosinophilia and subepithelial layer thickening. Not surprisingly, eosinophilic bronchial inflammation could be shown in patients with cough variant asthma as well, who--up to 56% during a four year-period--develop classic asthma. The long-term outcome of eosinophilic bronchitis is not known, however. Thus, asthma, cough variant asthma and cough due to eosinophilic bronchitis can mirror different phenotypes or phases of the same entity. CPC due to either the cough type asthma or the eosinophilic bronchitis is like asthma fast responding to inhalative steroids. (Induced) sputum staining should be added to the diagnostic armamentarium of CPC.
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PMID:[Eosinophilic bronchitis without asthma--an additional rare cause for chronic persistent cough (CPC)? A 30-year old patient with severe CPC due to eosinophilic bronchitis without asthma or hyperreactivity]. 1144 11

Clinico-epidemiological analysis and etiological verification of the outbreak of respiratory infection among school children in a rural district of the Khabarovsk territory, registered in spring 1997, were made. According to clinical signs, one-third of the patients had whooping cough, while the rest of the children exhibited the signs of respiratory infection with the symptoms of longering bronchitis. A half of the children had not been vaccinated against whooping cough, as they had been given injections of adsorbed DT vaccine with reduced antigen content. Etiologically, the diagnosis of whooping cough was confirmed in 57% of the patients with 47.4% of them having Bordetella pertussis monoinfection and 52.6% having mixed infection, mainly in combination with chlamydiosis. Whooping cough took an abnormal course under these circumstances. Treatment with erythromycin produced a good effect.
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PMID:[Etiology, clinical manifestations, and epidemiology in community-acquired respiratory infection in children in the Khabarovsk region]. 1154 56

In countries with high rates of vaccination against pertussis, the incidence of this disease has decreased dramatically compared with the prevaccine era. However, pertussis still occurs in these countries, and severe morbidity and mortality are greatest among infants, particularly those who are unimmunized or incompletely immunized. Pertussis in older children and adults is perceived by many as being a mild disease, but it is a significant health burden in persons of all ages. Infants with pertussis experience the highest rates of hospitalization, complications and death. Severe complications include pneumonia, encephalopathy and meningoencephalitis. In addition, infants may experience weight loss, bronchitis, otitis media, apnea, cyanosis, inguinal hernia and rectal prolapse. It is essential to explore methods to prevent disease transmission to infants in the months before they complete their primary immunization series. The Global Pertussis Initiative was established to assess the true health burden of pertussis in infants and to suggest strategies to combat transmission and infection with Bordetella pertussis, which remains a significant public health concern.
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PMID:Health burden of pertussis in infants and children. 1587 22

Before the middle of the 19th century urban life was hazardous, life expectancy in big cities was shorter than in the countryside, it was half as high as it is today. Cities used to be called "the graves of mankind"; they were unhygienic, since their inhabitants lived under crowded, unhealthy conditions. In German cities infant mortality was extremely high, one out of three new-born children died within its first year. In most big cities more people died in any given year than were born. In 1806, when the Imperial City of Nuremberg was absorbed by the Kingdom of Bavaria, it had 25 000 inhabitants, fewer than around the year 1600. In the following decades Nuremberg grew quickly, up to 50000 in 1846 and 100000 in 1881, 330000 in 1910. Its population was living extremely crowded within the medieval city-walls, up to 58 000 (1885) in the old parts of the city, more than twice as many as in 1806. Mortality was bound to increase, as more and more people moved to Nuremberg. Mortality rose from 25.5 per thousand in the 1820's to 29.4 in the 1850's and 32.8 in the 1860's. This increase of population was mainly due to migration from outside, from the countryside. New industries settled down in Nuremberg and provided new jobs, the new factories produced lots of smoke and dangerous dust. The general living conditions of the workers were poor, people were much smaller than nowadays. During the industrialisation labor was backbreaking, working hours were extremely long, and annual working hours were more than twice as long as today. New and better legislation was written by the Northern German Confederation, founded in 1867. Now the magistrate of Nuremberg recognised that something had to be done. In the following years physicians began to collect information as to morbidity and mortality in various parts of Nuremberg. Very many people still died of infectious diseases, esp. of tubercolosis, typhoid fever, diphtheria, pertussis, scarlet fever and other infectious diseases. There were many cases of bronchitis and deadly pneumonia. Even suicide was an important cause of death. In 1886 mortality at Nuremberg peaked for the last time above 30. Nuremberg had fewer doctors than other big cities in Germany. The city-fathers noticed that the public wells and the drinking water were dirty--they were getting more and more contaminated as time went by. It proved extremely difficult to provide this fast growing population with "free goods" like clean water and air. In the 1870's Nuremberg began to build a new water supply and a modern municipal sewer system. Cases of typhoid fever declined quickly thereafter. The magistrate did not provide new apartment-houses, but it took care that the new houses were more hygienic, with toilets and other necessary facilities. After 1880 new vaccinations were developed by modern medicine, these and other methods of preventive medicin proved to be more important for prolonging human lifes than therapeutic medicine. In the 1880's a steep rise of income can be registered, it brought more and better food, more meat, and better living and working conditions--and fewer working-hours per year. At the eve of World War I, Nuremberg was one of the ten or twelve biggest cities in Germany, an industrialized city with a hard-working population, people with little education and income. Urban mortality in Nuremberg declined rather slowly. In 1867 35.7 percent of all deceased persons were infants, less than one year old, in 1913 that percentage had declined to 30.7. In 1867 only 9.3 per cent of the deceased were older than 70, in 1913 the elderly constituted 14.2 per cent. Very many people still died in their forties or fifties.
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PMID:[Mortality in Nuremberg in the 19th century (about 1800 to 1913)]. 1733 66

In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which was conducted from 2003 to 2006, data on acute/infectious and chronic diseases were collected from a population-based sample of 17,641 subjects aged 0 to 17 years. The annual prevalence rates among acute diseases vary widely. Children and adolescents are most frequently affected by acute (infectious) respiratory conditions. 88.5 % of the surveyed children and adolescents experienced at least one episode of common cold within the last 12 months. Among the other acute respiratory infections, bronchitis and tonsillitis were the most frequently encountered conditions with 19.9 % and 18.5 %, respectively. The 12-month prevalence of otitis media and pseudocroup was 11 % and 6.6 %, respectively. 1.5 % of the children and adolescents experienced an episode of pneumonia. Apart from respiratory infections, gastrointestinal infections were very frequently stated as reasons for acute illness. Furthermore, 12.8 % of the children and adolescents experienced a herpetic infection, 7.8 % a conjunctivitis and 4.8 % a urinary tract infection. Lifetime prevalence rates of infectious diseases were as follows: pertussis 8.7 %, measles 7.4 %, mumps 4.0 %, rubella 8.5 %, varicella 70.6 %, scarlet fever 23.5 %. The various chronic somatic diseases in children and adolescents had different lifetime prevalence rates. Most frequently, children and adolescents were affected by obstructive bronchitis (13.3 %), neurodermatitis/atopic eczema (13.2 %) and hay fever (10.7 %). Scoliosis and asthma had been diagnosed by a doctor in 5.2 % and 4.7 % of subjects aged 0-17 years, respectively. The lifetime prevalence rates of the remaining diseases varied between 0.14 % for diabetes mellitus and 3.6 % for convulsions/epileptic fits. For the first time ever, these survey results provide nationwide representative information on the prevalence rates of acute/infectious and chronic diseases in children and adolescents which is based on a population-representative sample.
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PMID:[Prevalence of somatic diseases in German children and adolescents. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. 1751 53

Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. Cough that is misdiagnosed as asthma can occur with pertussis, cystic fibrosis, primary ciliary dyskinesia, airway abnormalities such as tracheomalacia and bronchomalacia, chronic purulent or suppurative bronchitis in young children, and habit-cough syndrome. The respiratory sounds that occur with the upper airway obstruction caused by the various manifestations of the vocal cord dysfunction syndrome or the less common exercise-induced laryngomalacia are often mischaracterized as wheezing and attributed to asthma. The perception of dyspnea is a prominent symptom of hyperventilation attacks. This can occur in those with or without asthma, and patients with asthma may not readily distinguish the perceived dyspnea of a hyperventilation attack from the acute airway obstruction of asthma. Dyspnea on exertion, in the absence of other symptoms of asthma or an unequivocal response to albuterol, is most likely a result of other causes. Most common is the dyspnea associated with normal exercise limitation, but causes of dyspnea on exertion can include other physiologic abnormalities including exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, and exercise-induced supraventricular tachycardia. A careful history, attention to the nature of the respiratory sounds that are present, spirometry, exercise testing, and blood-gas measurement provide useful data to sort out the various causes and avoid inappropriate treatment of these pseudo-asthma clinical manifestations.
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PMID:Pseudo-asthma: when cough, wheezing, and dyspnea are not asthma. 1816 77

Pertussis carries a high risk of mortality in very young infants. The mechanism of refractory cardio-respiratory failure is complex and not clearly delineated. We aimed to examine the clinico-pathological features and suggest how they may be related to outcome, by multi-center review of clinical records and post-mortem findings of 10 patients with fulminant pertussis (FP). All cases were less than 8 weeks of age, and required ventilation for worsening respiratory symptoms and inotropic support for severe hemodynamic compromise. All died or underwent extra corporeal membrane oxygenation (ECMO) within 1 week. All had increased leukocyte counts (from 54 to 132 x 10(9)/L) with prominent neutrophilia in 9/10. The post-mortem demonstrated necrotizing bronchitis and bronchiolitis with extensive areas of necrosis of the alveolar epithelium. Hyaline membranes were present in those cases with viral co-infection. Pulmonary blood vessels were filled with leukocytes without well-organized thrombi. Immunodepletion of the thymus, spleen, and lymph nodes was a common feature. Other organisms were isolated as follows; 2/10 cases Para influenza type 3, 2/10 Moraxella catarrhalis, 1/10 each with respiratory syncytial virus (RSV), a coliform organism, methicillin-resistant Staphylococcus aureus (MRSA), Haemophilus influenzae, Stenotrophomonas maltophilia, methicillin-sensitive Staphylococcus aureus (MSSA), and candida tropicalis. We postulate that severe hypoxemia and intractable cardiac failure may be due to the effects of pertussis toxin, necrotizing bronchiolitis, extensive damage to the alveolar epithelium, tenacious airway secretions, and possibly leukostasis with activation of the immunological cascade, all contributing to increased pulmonary vascular resistance. Cellular apoptosis appeared to underlay much of these changes. The secondary immuno-compromise may facilitate co-infection.
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PMID:Fulminant pertussis: a multi-center study with new insights into the clinico-pathological mechanisms. 1972

Cough is a common and important respiratory symptom that can produce significant complications for patients and be a diagnostic challenge for physicians. An organized approach to evaluating cough begins with classifying it as acute, subacute, or chronic in duration. Acute cough lasting less than 3 weeks may indicate an acute underlying cardiorespiratory disorder but is most commonly caused by a self-limited viral upper respiratory tract infection (eg, common cold). Subacute cough lasting 3 to 8 weeks commonly has a postinfectious origin; among the causes, Bordetella pertussis infection should be included in the differential diagnosis. Chronic cough lasts longer than 8 weeks. When a patient is a nonsmoker, is not taking an angiotensin-converting enzyme inhibitor, and has a normal or near-normal chest radiograph, chronic cough is most commonly caused by upper airway cough syndrome, asthma, nonasthmatic eosinophilic bronchitis, or gastroesophageal reflux disease alone or in combination.
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PMID:Cough: a worldwide problem. 2017 52

To prospectively investigate the incidence and clinical findings of "postinfectious cough" among adult patients with prolonged cough, enrolled from July 2006 to June 2008, we studied the serum antibodies of Mycoplasma pneumoniae, Chlamydophila pneumoniae and Bordetella pertussis in those who complained of cough lasting 3-8 weeks but with no abnormalities on their chest X-ray films. Mycoplasma pneumoniae bronchitis, Chlamydophila pneumoniae bronchitis, and pertussis were diagnosed based on serological criteria in 5.5%, 4.1%, 9.2% of the cases, respectively. Postinfectious cough including "post-common cold cough" comprised 39.4% of all prolonged cough cases. The above diseases lacked specific clinical findings, making it difficult to differentiate between diseases causing postinfectious cough. Postinfectious cough is thought to be a common clinical entity, however further definitions of the diagnostic criteria and rapid diagnostic procedures are desirable, first to prevent familial transmission, and secondly to differentiate from allergic diseases that cause chronic cough.
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PMID:[Clinical investigation of postinfectious cough among adult patients with prolonged cough]. 2038 20

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. 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. Symptoms of bronchitis typically last about three weeks. The presence or absence of colored (e.g., green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections. Viruses are responsible for more than 90 percent of acute bronchitis infections. 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 (e.g., patients 65 years or older). The typical therapies for managing acute bronchitis symptoms have been shown to be ineffective, and the U.S. Food and Drug Administration recommends against using cough and cold preparations in children younger than six years. The supplement pelargonium may help reduce symptom severity in adults. As patient expectations for antibiotics and therapies for symptom management differ from evidence-based recommendations, effective communication strategies are necessary to provide the safest therapies available while maintaining patient satisfaction.
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PMID:Diagnosis and treatment of acute bronchitis. 2112 19


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