Tammy is a 33-year-old who presents for evaluation of a coug…

Bronchitis is a common respiratory condition characterized by inflammation of the bronchial tubes, which are responsible for carrying air in and out of the lungs. It can be either acute or chronic. Acute bronchitis is usually caused by a viral infection and typically lasts for a few weeks. Chronic bronchitis, on the other hand, is a long-term condition often caused by smoking and is characterized by a persistent cough that lasts for at least three months in a year for two consecutive years.

In Tammy’s case, she is experiencing symptoms of acute bronchitis. Her initial “really bad cold” with rhinorrhea was most likely a viral upper respiratory infection that has now progressed to involve the lower respiratory tract and cause inflammation of the bronchial tubes. The initial rhinorrhea has resolved but she has developed a deep, mucus-producing cough.

The presence of green sputum indicates the presence of infection. The color is due to the production of neutrophils, a type of white blood cell, which are involved in fighting off bacteria. This suggests that Tammy’s bronchitis may be caused by a bacterial infection, despite the initial viral illness.

Tammy’s scratchy throat is a common symptom of bronchitis, as the inflammation can irritate the throat and cause discomfort. It is important to note that Tammy has not had any fever, which is consistent with viral bronchitis. Bacterial bronchitis is more likely to be associated with fever.

Tammy’s lack of relief from over-the-counter cough medicines is not unexpected. These medications often only provide limited relief and are not very effective in treating the underlying inflammation and infection associated with bronchitis. In some cases, they may even lead to side effects such as drowsiness or dizziness.

The fact that Tammy’s cough is keeping her awake at night and causing her to gag and dry heave suggests that her symptoms are severe and impacting her daily life. This is a common manifestation of bronchitis, as the excessive production of mucus and the coughing fits can cause significant discomfort and disruption.

In order to confirm the diagnosis of bronchitis, Tammy should undergo a thorough evaluation. This may include a physical examination, a review of her medical history, and diagnostic tests such as a chest X-ray or a sputum culture. These tests can help rule out other possible causes of her symptoms, such as pneumonia or asthma.

Once the diagnosis of bronchitis is confirmed, treatment options can be explored. In the case of acute bronchitis, the mainstay of treatment is supportive care. This involves managing symptoms and promoting healing, rather than targeting the underlying cause. Tammy may be advised to rest, drink plenty of fluids, use a humidifier, and take over-the-counter pain relievers such as acetaminophen or ibuprofen to alleviate symptoms.

If bacterial infection is suspected, Tammy may be prescribed antibiotics to help clear the infection. However, it is important to note that antibiotics are not usually recommended for the treatment of uncomplicated acute bronchitis, as they are more likely to be caused by viral infections.

In conclusion, Tammy’s symptoms and presentation are consistent with acute bronchitis. Her initial viral upper respiratory infection has progressed to involve the lower respiratory tract and cause inflammation of the bronchial tubes. The presence of green sputum suggests the presence of infection, possibly bacterial. Treatment for acute bronchitis involves supportive care and managing symptoms, while antibiotics may be considered if a bacterial infection is suspected.