These episodes are often precipitated by viral infections and may occur for more than a year following pertussis. Thus, whatever acute bronchitis is, it certainly is being diagnosed frequently. Children who are brought in because of cough must be evaluated to determine their management even if we have difficulty assigning a diagnosis. A cough is common to all of these children. Signs of upper respiratory infection are usually present together with transmitted rhonchi.
Fever is a variable sign and when present is usually low grade.
There may be lassitude, which can be secondary to loss of sleep, fatigue from severe cough or decreased oral intake. Roentgenographic studies are rarely indicated unless one has reason to suspect a foreign body, tuberculosis, cystic fibrosis or another conditions which might be responsible. In preschool children, antibiotics are rarely indicated. They may be useful if pertussis or parapertussis is suspected. In older children, particularly those with productive coughs and low-grade fever, one might suspect Mycoplasma pneumoniae or Chlamydia pneumoniae as the etiologic agent.