In the given scenario with Lou who is 35 and otherwise healthy, non-smoker with acute onset of tracheitis and a productive cough producing green sputum, it appears that it is acute bronchitis (Lefebvre, 2020). Acute bronchitis is a self-limiting respiratory infection that causes inflammation of the large airways distinguished by a cough (Lefebvre, 2020). The epithelial lining of the bronchi become thickened and inflamed (Lefebvre, 2020). As a result, it causes an interruption in airflow and bronchial hypersensitivity which leads to coughing, wheezing, and shortness of breath (Lefebvre, 2020). Sputum may or may not be present although it may appear as yellow or green from cellular debris (Lefebvre, 2020).
The presentation of acute bronchitis typically exhibits generalized fatigue, fever, mild shortness of breath, and either a productive or nonproductive cough which can last from five days and lasting up to three to four weeks (Lefebvre, 2020; McCance & Huether, 2019). Further, a cough can be exacerbated by cold, dry or dusty air (Lefebvre, 2020; McCance & Huether, 2019). Despite the presentation of yellow or green sputum, it may not indicate bacterial infection as it may be present with viral bronchitis (Lefebvre, 2020; McCance & Huether, 2019).
In a majority of cases, acute bronchitis is caused by respiratory viruses such as influenza A and B, parainfleunza, respiratory syncytial, corona, adeno and rhino (Lefebvre, 2020; McCance & Huether, 2019). In 6-15% of cases, bacteria are detected with haemophilus influenza and streptoccus pneumonia being the most prevalent (Lefebvre, 2020). In addition to these bacteria, less common or atypical bacteria include mycoplasma pneumoniae, bordetella pertussis and chlamydia pneumoniae have also been identified as causative agents (Lefebvre 2020). Common risk factors may include smoking, asthma, allergies, older adults, childhood respiratory diseases and environmental exposures to pollutants (Lefebvre, 2020.
Factors influencing bronchitis
In consideration of the patient’s age and she does not have any chronic respiratory issues such as chronic obstructive pulmonary disease or emphysema which would put her at greater risk of pneumonia, her acute bronchitis should be resolve on its own (Grigoryan et al., 2017). Research has shown that up to 70% of acute bronchitis cases result in treatment with antibiotics (Grigoryan et al., 2017). In the 18–39-year-old age group, antibiotics were prescribed the most frequently in this population (Grigoryan et al., 2017). Antibiotics for otherwise healthy adults do provide any major benefit and may experience adverse effects of antibiotic treatment (Grigoryan et al., 2017; Lefebvre, 2020.