respiratory health

A.Griguolo Without Fever Bronchitis

Generality

Bronchitis without fever is a peculiar form of inflammation of the bronchi, which is not associated with any alteration in body temperature.

Bronchitis without fever never has an infectious origin; in fact, it may depend on conditions such as: sporadic or continuous exposure to irritating substances to the bronchial tree, chronic pulmonary diseases (eg, asthma or chronic obstructive pulmonary disease) and gastroesophageal reflux.

Bronchitis without fever can cause several symptoms, including: cough, chest pain, wheezing and breathing characterized by wheezing or rattling.

The diagnosis of bronchitis without fever always starts from the physical examination and from the anamnesis.

Bronchitis without fever requires causal therapy, where possible, and symptomatic therapy.

Short review of the Bronchial Tree

Following the trachea and preceding the pulmonary alveoli, the bronchial tree is the complex section of the lower airways (or lower respiratory tract ), which includes, in order, the primary bronchi, secondary bronchi, tertiary bronchi, bronchioles, the terminal bronchioles and respiratory bronchioles .

According to the most common anatomical vision relating to the bronchial tree, the latter can be divided into two sections: the extrapulmonary tract (ie, external to the lungs), to which only the primary bronchi belong, and the intrapulmonary tract (ie, inside the lungs) which include the secondary bronchi, the tertiary bronchi, the bronchioles, the terminal bronchioles and the respiratory bronchioles.

What is Bronchitis Without Fever?

Bronchitis without fever is a particular form of inflammation of the bronchi, whose symptomatology does not include any alteration of body temperature.

Generally, bronchitis without fever corresponds to non-infectious bronchitis, ie bronchitis not due to infectious agents; non-infectious bronchitis contrasts with infectious bronchitis, namely bronchitis sustained by the action of a virus or a bacterium and has among its distinctive symptoms fever.

Bronchitis Without Fever: Acute Type and Chronic Type

Bronchitis without fever may have the characteristics of an acute condition (therefore intense in symptoms, but of limited duration) and may be an example of acute bronchitis, or it may possess the characteristics of a chronic condition (therefore mild to moderate in symptoms, but of long duration) and be an example of chronic bronchitis .

Causes

The causes of bronchitis without fever include:

  • Sporadic or continuous inhalation of irritating substances for the bronchial tree ;
  • Some pulmonary diseases of a chronic nature ;
  • Other special conditions .

Irritants that cause Feverless Bronchitis

The irritants capable of causing bronchitis without fever are: cigarette smoke, cigar, pipe etc. (in other words, tobacco smoke ), the substances that make up the so-called environmental pollution, some chemical fumes and some toxic dusts .

In addition to attacking the bronchial tree and causing bronchitis without fever, the aforementioned irritants could also ignite the trachea, giving rise to a condition known as tracheitis .

Chronic Lung Diseases That Cause Bronchitis Without Fever

Asthma and chronic obstructive pulmonary disease ( COPD ) stand out in the list of chronic lung diseases potentially capable of causing bronchitis without fever.

Generally, fever-free bronchitis resulting from chronic lung disease is a form of chronic bronchitis.

Bronchitis without chronic fever is a persistent condition that is difficult to treat.

ASTHMA

Asthma is a chronic pulmonary disease of an inflammatory nature, which determines, usually due to allergens (eg: pollen and animal hair), respiratory infections, medicines (eg NSAIDs), physical exertion, excessive emotions, stress and smoking, the temporary narrowing of intrapolmonary bronchi and bronchioles, thus resulting in an obstacle to the passage of inhaled air.

According to the most reliable hypotheses, asthma would have a genetic origin.

COPD

Chronic obstructive pulmonary disease (or COPD) is an inflammatory lung disease, which causes a permanent narrowing (which is why it is called chronic and obstructive) of the bronchial tree inside the lungs.

COPD is a very serious condition, which recognizes as main causative factors: smoking (the habit of smoking tobacco), passive smoking and constant exposure to certain powders or toxic substances.

COPD has a devious behavior; in fact, it begins as an asymptomatic condition becomes responsible for serious symptoms (such as dyspnea, cough with phlegm, exhaustion etc.) only in the most advanced stages (when by now the patient's health is already irretrievably compromised).

COPD permanently affects the health of the lungs and the bronchial tree.

Other Conditions That Cause Bronchitis Without Fever

Among the causes of bronchitis without fever labeled as "other special conditions", gastroesophageal reflux disease is worth mentioning.

Gastroesophageal reflux disease is the medical condition characterized by the continuous repetition of the abnormal rising phenomenon towards the esophagus of gastric contents, whose acidic nature makes it irritating to any other organ other than the stomach.

Gastroesophageal reflux disease can assume the role of a cause of bronchitis without fever in the most serious situations, that is when the ascent of the gastric contents goes beyond the esophagus, reaching first the larynx and then the airways.

Who is more at Risk of Bronchitis Without Fever

The subjects most at risk of bronchitis without fever are:

  • Smokers. Smoking is the main cause of bronchitis without fever;
  • Who lives in particularly polluted urban centers;
  • Who practices a job that exposes daily to irritants to the bronchial tree;
  • People with asthma or COPD

Is Feverless Bronchitis Contagious?

Bronchitis without fever is not a contagious condition, as it has no infectious nature.

Symptoms and Complications

The typical symptoms of bronchitis without fever are:

  • Cough . Depending on the severity of the cause, the cough may be either a passing phenomenon (lasting a few weeks) or chronic (therefore a constant) and may or may not be accompanied by expectoration (ie production of phlegm);
  • Breath difficulties ( dyspnea ). In the more tenuous forms of bronchitis without fever, dyspnea appears only during physical efforts; in the more severe forms of bronchitis without fever, however, dyspnea is also present at rest (dyspnea at rest);
  • Breath with wheezing or gasps ;
  • Sense of malaise in the chest, in less serious cases, and real pain in the chest, in the most severe cases.

Other Symptoms of Bronchitis Without Fever

Depending on the cause, coughing, wheezing and chest pain, bronchitis without fever may accompany ailments such as:

  • Sense of recurrent exhaustion ;
  • Ankle swelling ;
  • Decreased appetite and consequent weight loss .

Did you know that ...

Exhaustion, ankle swelling and decreased appetite associated with cough, dyspnea and chest discomfort is typical of bronchitis without fever due to COPD.

When should I go to the doctor?

Among the reasons that should induce an individual with bronchitis without fever to contact the treating physician immediately or to go as soon as possible to the nearest hospital are:

  • The addition to the classical symptomatology (cough, dyspnea and chest pain) of a sudden drop in body weight;
  • Worsening of cough;
  • The appearance of severe respiratory problems (dyspnea at rest);
  • The presence of real pain in the chest;
  • Cough permanence.

Complications

In its most severe forms, bronchitis without fever can profoundly impair respiratory function.

Furthermore, when it depends on a very serious cause such as COPD, it can cause serious complications, including: acute forms of pneumonia, heart problems (eg heart attack), lung cancer, pulmonary hypertension and depression (resulting in the need to continuous care and assistance).

Diagnosis

In general, an accurate physical examination and scrupulous medical history are sufficient for the diagnosis of bronchitis without fever. However, very often, doctors believe it is essential to investigate the situation considered with further investigations, for at least two reasons: to go back to the precise cause and to establish the severity of bronchitis without fever present.

Physical examination

The physical examination is the set of maneuvers and tests, which the diagnostic doctor performs in order to ascertain the symptoms and signs of a pathology which he suspects is present.

During the physical examination to a person with a presumed bronchitis without fever, the evaluation of the breath (which, in the case of a positive test, will present wheezing or wheezing) and cough (which, in the case of a positive test, will be catarrhose).

Did you know that ...

In a person with a disease of the bronchial tree or of the lungs (such as bronchitis without fever), the evaluation of the breath takes place through the so-called auscultation .

history

The anamnesis is the particular study of the symptomatology with a view to identifying its triggering / favoring factors; the anamnesis, in fact, consists of an examination of the symptoms, combined with an investigation regarding elements such as the age of the patient, his clinical history, his work activity, his habits, his family history etc.

In a context of presumed bronchitis without fever, the anamnesis allows us to identify the possible causal factors of the condition in progress (eg, cigarette smoke, in a smoking patient; exposure to irritants, in a patient with work at risk, etc. .).

In-depth examinations

To go back to the precise causal factor and outline the characteristics of a bronchitis without fever, the physician may follow the physical examination and anamnesis:

  • A chest radiograph (or RX-thorax ) and / or a thoracic CT scan . These radiological tests provide detailed images of the lungs and bronchial tree, so that the diagnostic doctor can thoroughly assess their state of health;
  • Oximetry . is the measurement of oxygen saturation in the blood. As simple and immediate as spirometry, for its execution you need an instrument called an oximeter, which is applied to a finger or to one of the two ear lobes;
  • Spirometry . It is used to measure the inspiratory and expiratory capacity of the lungs; furthermore, it provides information regarding the patency (or opening) of the pulmonary airways;
  • The stress test . It consists of recording how an individual's heart rate, blood pressure and breathing vary, while the latter is practicing more or less intense physical activity.

    The exercise test is especially useful when bronchitis without fever is due (or appears to be) to COPD;

  • Blood gas analysis . It allows to measure three important parameters of an individual's blood: circulating oxygen levels, circulating carbon dioxide levels and pH;
  • Cardiac tests (echocardiogram, electrocardiogram, etc.). These are useful tests, when heart problems have emerged from a previous exercise test.

Why is it important to investigate the causes?

The diagnosis of the causes of bronchitis without fever is important, because it is based on the triggers that any therapeutic choice is based.

Therapy

Generally speaking, the presence of bronchitis without fever requires causal therapy, where possible, and symptomatic therapy .

Causal therapy is the set of treatments aimed at eliminating the factor responsible for a certain situation.

Symptomatic therapy, on the other hand, is the set of treatments aimed at alleviating the symptoms and preventing / postponing complications.

Causal therapy

The causal therapy varies according to what the doctor has identified as a trigger for bronchitis without fever; this means, for example, that a fever-free bronchitis related to sporadic exposure to irritants will require a causal therapy other than bronchitis without fever due to COPD.

EXAMPLES OF CAUSAL THERAPY

  • Bronchitis without fever due to inhalation of irritating substances: the causal therapy for this situation consists in avoiding exposure to the triggering factor; in practical terms, this means, for example:
    • Quit smoking, if the cause is tobacco smoke;
    • Do not circulate to the most polluted urban sectors, if the cause is environmental pollution;
    • Stop working until recovery, if the cause is inhalation of toxic substances or fumes.
  • Bronchitis without fever associated with COPD: COPD is a disease for which there is no causal therapy; this means that those suffering from COPD are forced to live with this condition, without being able to count on treatments capable of restoring the airways.

    This is why bronchitis without fever due to COPD is a chronic condition.

  • Bronchitis without fever associated with asthma: as with COPD, asthma is also an incurable disease in the causes.
  • Bronchitis without fever related to gastroesophageal reflux: for this circumstance, the causal therapy involves all those treatments useful to prevent the anomalous phenomenon of ascent towards the esophagus of the acid content of the stomach; specifically, these treatments may consist of:
    • Ad hoc diet (abolition of fried foods, fatty foods, beverages that promote production in the stomach, etc.);
    • Drugs (prokinetics, proton pump inhibitors and H2 receptor antagonists);
    • Surgery aimed at restoring the function of the gastroesophageal sphincter.

For two conditions such as COPD and asthma (for which causal therapy does not exist), symptomatic therapy is essential.

Symptomatic therapy

Fundamental to alleviating the patient's suffering, the symptomatic therapy of bronchitis without fever varies in relation to the clinical severity of the triggering cause and its repercussions on the health of the lungs and the bronchial tree.

Indeed:

  • Bronchitis without fever due to a clinically irrelevant and resolvable cause (eg: sporadic inhalation of irritants) could include very simple symptomatic treatments, such as taking an NSAID against chest pain, taking a drug against the cough and / or air humidification of the domestic environment (to improve breathing);
  • Bronchitis without fever due to COPD or asthma involves a series of important symptomatic treatments, to be taken permanently or in the presence of an acute disturbance.

    In the case of COPD, these treatments include: oxygen therapy, respiratory rehabilitation, taking bronchodilator drugs, taking mucolytic drugs and taking corticosteroid drugs .

    In the case of asthma, on the other hand, the aforementioned symptomatic treatments include all those drugs that, taken by inhalation or by the oral route, mitigate or prevent the consequences of so-called asthma crises (eg: long-lasting beta-agonists, corticosteroids, leukotriene, etc.).

Some advices

Anyone suffering from a form of bronchitis without fever benefits from certain behaviors such as:

  • No smoking . Not smoking is good behavior both when it causes bronchitis without fever and when it is not directly responsible;
  • Eat in a healthy and balanced way ;
  • Practice physical exercise regularly.

Prognosis

The prognosis in the case of bronchitis without fever is all the more benevolent, the more treatable the cause triggering the inflammation of the bronchi.

This means that a bronchitis without fever due to COPD has a non-positive, if not even poor prognosis in the most serious cases.

Prevention

Not smoking, minimizing exposure to air pollution and toxic dusts / fumes, and finally, managing chronic lung disease is the main medical indication, when the topic of discussion is the prevention of bronchitis without fever.