Onset of a distressing cough usually signals onset of bronchitis. Frankly purulent sputum suggests superimposed bacterial infection. Some patients have burning substernal chest pain, which is aggravated by coughing. Persistent fever suggests complicating pneumonia. Dyspnea may occur secondary to airway obstruction.
Pulmonary signs are few in uncomplicated acute bronchitis.
Wheezing, especially after cough, is common. Persistent localized signs noted during chest examination suggest development of bronchopneumonia. Serious complications usually occur only in patients with an underlying chronic respiratory disorder. Diagnosis Diagnosis is usually based on the symptoms and signs, but a chest x-ray to rule out other diseases or complications is indicated if symptoms are severe or prolonged. Arterial blood gases should be monitored when serious underlying chronic respiratory disease is present.