Describe the general diagnostic approach.
Acute bronchitis is a clinical diagnosis based on typical clinical features and auscultation findings
Diagnostic studies are usually only required to:
Rule out alternative diagnoses: e.g., CBC, CXR, nasopharyngeal swab
Evaluate for complications (e.g., pneumonia, AECOPD) in patients with:
Atypical clinical findings
Increased risk of bacterial infection: e.g., smokers, patients > 75 years old, patients with lung disease
List routine laboratory and imaging studies with their respective findings.
CBC: may show mild leukocytosis
Chest x-ray
Indication: to evaluate for pneumonia in patients with abnormal examination findings or atypical clinical presentation
Findings: often normal or nonspecific, e.g., peribronchial thickening
In which circumstances can further diagnostic testing be performed?
Consider targeted testing for alternate diagnoses or complications in patients with the following:
High fevers: Consider a diagnosis of pneumonia or influenza
Prominent coughing fits: Consider pertussis testing.
Worsening symptoms or cough lasting > 3 weeks: Consider adding sputum culture, spirometry, or other laboratory studies (e.g., CRP) depending on clinical suspicion.
Recurrent episodes of bronchitis: Consider diagnostic testing for asthma or COPD.
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