Bronchitis - Uncomplicated Acute Công cụ chẩn đoán

Laboratory Tests and Ancillaries

No available test can provide a definitive diagnosis of acute bronchitis. In patients presumed to have acute bronchitis, viral cultures, serologic assays, and sputum analyses should not be done routinely because the organism responsible is rarely identified in clinical practice. Gram stain or sputum culture in a healthy adult with acute bronchitis is not helpful, as most cases are caused by a virus. Transient pulmonary function abnormalities, which are very similar to those of mild asthma, may occur in acute bronchitis, and peak expiratory flow rate may be measured in these patients.

Imaging

Chest X-ray is typically unnecessary and primarily done to rule out pneumonia, However, consider performing a chest X-ray if vital signs show a heart rate of more than 100 beats per minute, respiratory rate of more than 24 breaths per minute, or an oral temperature of more than 100.4°F (38°C), or if signs of focal pulmonary consolidation are present on chest exam, or if there is mental status or behavioral changes in a patient older than 75 years old as these raise the suspicion for pneumonia. Other factors, such as moderate or severe dyspnea, hemoptysis, immunocompromise, older age and/or dementia may also increase the likelihood of pneumonia or having underlying pulmonary disorders thus warrant chest X-ray. Purulent sputum is not an indication for a chest X-ray.