Bronchitis causes

Bronchitis Main page

Patient Information

Overview

Causes

Classification

Acute bronchitis
Chronic bronchitis

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Seyedmahdi Pahlavani, M.D. [2]; Nate Michalak, B.A.

## Overview

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Virus are thought to be the most common cause of acute bronchitis. Influenza A and B, parainfluenza, respiratory syncytial virus, coronavirus are the most commonly involved pathogens. Bacteria, such as mycoplasma, chlamydiae and bordetella pertussis, are also found to cause acute bronchitis. Smoking, occupational exposures, air pollutants, and genetic factors are etiologies of chronic bronchitis.

## Causes

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* Acute Bronchitis: may be caused by either viruses, bacteria or environmental factors.

Viruses: Influenza virus, parainfluenza virus, respiratory syncytial virus, coronavirus, adenovirus, enterovirus, rhinovirus, coxsackievirus, and human metapneumovirus[1][2][3]
Bacteria: Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Bordetella pertussis[4]
Environmental factors: Toxic fume inhalation, tobacco, dust, and aerosols[5]

* Chronic Bronchitis: may be caused by smoking, air pollutants, occupational exposures, and genetic factors

Smoking

The primary risk factor for COPD is chronic tobacco smoking. In the United States, 80 to 90% of cases of COPD are due to smoking.[6][7] Exposure to cigarette smoke is measured in pack-years, the average number of packages of cigarettes smoked daily multiplied by the number of years of smoking.[8] The likelihood of developing COPD increases with age and cumulative smoke exposure. Almost all life-long smokers will develop COPD.[9]

Occupational Exposures

Intense and prolonged exposure to workplace dusts found in coal mining, gold mining, and the cotton textile industry, and chemicals such as cadmium, isocyanates, and fumes from welding, have been implicated in the development of airflow obstruction, even in nonsmokers.[10] Workers who smoke and are exposed to these particles and gases are even more likely to develop COPD. Intense silica dust exposure causes silicosis, a restrictive lung disease distinct from COPD; however, less intense silica dust exposures have been linked to a COPD-like condition.[11] The effect of occupational pollutants on the lungs appears to be substantially less important than the effect of cigarette smoking.[12]

Air Pollution

Studies in many countries reveal that people who live in large cities have a higher rate of COPD compared to people who live in rural areas.[13] Urban air pollution may be a contributing factor for COPD, as it is thought to slow the normal growth of the lungs, although the long-term research needed to confirm the link has not been performed. Studies of the industrial waste gas and COPD/asthma-aggravating compound, sulfur dioxide, and the inverse relation to the presence of the blue lichen Xanthoria (usually found abundantly in the countryside, but never in towns or cities) suggest that combustive industrial processes do not aid COPD sufferers. In many developing countries, indoor air pollution from cooking fire smoke (often using biomass fuels such as wood and animal dung) is a common cause of COPD, especially in women.[14]

Genetics

Some factor in addition to heavy smoke exposure is required for a person to develop COPD. This factor is probably a genetic susceptibility. COPD is more common among relatives of COPD patients who smoke than unrelated smokers.[15] The genetic differences that make some peoples' lungs susceptible to the effects of tobacco smoke are mostly unknown. Alpha 1-antitrypsin deficiency is a genetic condition that is responsible for approximately 2% of cases of COPD. In this condition, the body does not make enough of the protein alpha 1-antitrypsin. Alpha 1-antitrypsin protects the lungs from damage caused by protease enzymes, such as elastase and trypsin, that can be released as a result of an inflammatory response to tobacco smoke.[16]

### Common Causes

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* Adenovirus
* Air pollution
* Bordetella pertussis
* Coal dust
* Coronavirus
* Influenza
* Mycoplasma pneumoniae
* Parainfluenza
* Respiratory syncytial virus
* Rhinovirus
* Tobacco smoking

### Causes by Organ System

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Cardiovascular | Heart disease

|

Chemical / poisoning | Acenaphthene, acetaldehyde, acetic acid, acetic anhydride, biphenyl, chlorine dioxide, ethyleneamine, hexamethylene diisocyanate, nitric acid, phosphine, polychlorinated dibenzofurans, selenium poisoning, silver, sulfuric acid, toluene diisocyanate, vanadium poisoning
Dermatologic | Yellow nail syndrome
Drug Side Effect | Albuterol, alferon N, alfuzosin, artemether and lumefantrin, belimumab, benazepril, budesonide, butorphanol, candesartan, captafol, cardura, cevimeline, ciclesonide, citalopram, clopidogrel, crofelemer, doxazosin, enalapril maleate, escitalopram, exemestane, febuxostat, felodipine, fingolimod, fluoxetine, fluvoxamine, goserelin, ibandronate, infliximab, interferon, ipratropium, irbesartan, isosorbide dinitrate, isosorbide mononitrate, itraconazole, lamotrigine, latanoprost, leflunomide, lumigan, methotrexate, metipranolol, metronidazole topical, minoxidil, moexipril, mycophenolate, mycophenolic acid, nateglinide, nitisinone, oseltamivir, oxcarbazepine, paroxetine, pentamidine isethionate, pirbuterol, pramipexole, repaglinide, risedronate, ropinirole, rosuvastatin, sertraline, sibutramine, simvastatin, tacrolimus, tamsulosin, tarka (medication), telmisartan, thalidomide, tiagabine, tobramycin, tolterodine, topiramate, trandolapril, travoprost, unoprostone, zanamivir
Ear Nose Throat | Pharyngitis, sinusitis
Endocrine | No underlying causes
Environmental | Air pollution, aluminium lung, anthracosis, coal dust, coal worker's pneumoconiosis, farmer's lung, mesothelioma, pneumoconiosis, silicosis, smoking
Gastroenterologic | Alpha 1-antitrypsin deficiency, cystic fibrosis, gastroesophageal reflux disease, inflammatory bowel disease
Genetic | Alpha 1-antitrypsin deficiency, ataxia telangiectasia, cystic fibrosis, Gulf War syndrome, Klinefelter syndrome
Hematologic | No underlying causes
Iatrogenic | Lung transplantation
Infectious Disease | Acute viral nasopharyngitis (common cold), adenovirus, aspergillosis, bordetella pertussis, chickenpox, chlamydia pneumonia, common cold, coronavirus, coxsackievirus, echovirus, encephalitozoon cuniculi infection, enterovirus, flu, group A streptococcal infection, HIV, influenza, measles, moraxella catarrhalis, mycoplasma pneumonia, orthomyxovirus, paragonimiasis, parainfluenza, paramyxovirus, pharyngitis, pneumococcus, respiratory syncytial virus, rhinovirus, trichinellosis
Musculoskeletal / Ortho | Prune belly syndrome
Neurologic | Ataxia telangiectasia, Gulf War syndrome
Nutritional / Metabolic | Hypoglycemia
Obstetric/Gynecologic | No underlying causes
Oncologic | Lung cancer, mesothelioma
Opthalmologic | No underlying causes
Overdose / Toxicity | Marijuana abuse, nicotine addiction
Psychiatric | No underlying causes
Pulmonary | Acute viral nasopharyngitis (common cold), alpha 1-antitrypsin deficiency, aluminium lung, anthracosis, aspergillosis, asthma, blue and bloated syndrome, bronchiectasis, bronchiolitis, coal worker's pneumoconiosis, common cold, COPD, farmer's lung, flu, influenza, lung cancer, lung transplantation, mesothelioma, yellow nail syndrome
Renal / Electrolyte | No underlying causes
Rheum / Immune / Allergy | Asthma, Felty's syndrome, Gulf War syndrome, IgG deficiency, Immunoglobulin G subclass deficiency, MHC class I deficiency, primary immunodeficiency, Sjogren's syndrome
Sexual | No underlying causes
Trauma | No underlying causes
Urologic | Prune belly syndrome
Miscellaneous | Tobacco smoking

### Causes in Alphabetical Order

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* Acenaphthene
* Acetaldehyde
* Acetic acid
* Acetic anhydride
* Acute viral nasopharyngitis (common cold)
* Adenovirus
* Air pollution
* Albuterol
* Alferon N
* Alfuzosin
* Alpha 1-antitrypsin deficiency
* Aluminium lung
* Anthracosis
* Artemether and lumefantrin
* Aspergillosis
* Asthma
* Ataxia telangiectasia
* Belimumab
* Benazepril
* Biphenyl
* Blue and bloated syndrome
* Bordetella pertussis
* Bronchiectasis
* Bronchiolitis
* Budesonide
* Butorphanol
* Candesartan
* Captafol
* Cardura
* Cevimeline
* Chickenpox
* Chlamydia pneumonia
* Chlorine dioxide
* Ciclesonide
* Citalopram
* Clopidogrel
* Coal dust
* Coal worker's pneumoconiosis
* Common cold
* COPD
* Coronavirus
* Coxsackievirus
* Crofelemer
* Cystic fibrosis
* Doxazosin
* Echovirus
* Enalapril maleate
* Encephalitozoon cuniculi infection
* Enterovirus
* Escitalopram
* Ethyleneamine
* Exemestane
* Farmer's lung
* Febuxostat
* Felodipine
* Felty's syndrome
* Fingolimod
* Flu
* Fluoxetine
* Fluvoxamine
* Gastroesophageal reflux disease
* Goserelin
* Group A streptococcal infection
* Gulf War syndrome
* Heart disease
* Hexamethylene diisocyanate
* HIV
* Hypoglycemia
* Ibandronate
* IgG deficiency
* Immunoglobulin G subclass deficiency
* Inflammatory bowel disease
* Infliximab
* Influenza
* Interferon
* Ipratropium
* Irbesartan
* Isosorbide dinitrate
* Isosorbide mononitrate
* Itraconazole
* Klinefelter syndrome
* Lamotrigine
* Latanoprost
* Leflunomide
* Lumigan
* Lung cancer
* Lung transplantation
* Marijuana abuse
* Measles
* Mesothelioma
* Methotrexate
* Metipranolol
* Metronidazole topical
* MHC class I deficiency
* Minoxidil
* Moexipril
* Moraxella catarrhalis
* Mycophenolate
* Mycophenolic acid
* Mycoplasma pneumonia
* Nateglinide
* Nicotine addiction
* Nitisinone
* Nitric acid
* Orthomyxovirus
* Oseltamivir
* Oxcarbazepine
* Paragonimiasis
* Parainfluenza
* Paramyxovirus
* Paroxetine
* Pentamidine isethionate
* Pharyngitis
* Phosphine
* Pirbuterol
* Pneumococcus
* Pneumoconiosis
* Polychlorinated dibenzofurans
* Pramipexole
* Primary immunodeficiency
* Prune belly syndrome
* Repaglinide
* Respiratory syncytial virus
* Rhinovirus
* Risedronate
* Ropinirole
* Rosuvastatin
* Selenium poisoning
* Sertraline
* Sibutramine
* Silicosis
* Silver
* Simvastatin
* Sinusitis
* Sjogren's syndrome
* Smoking
* Sulfuric acid
* Tacrolimus
* Tamsulosin
* Tarka (medication)
* Telmisartan
* Thalidomide
* Tiagabine
* Tobacco smoking
* Tobramycin
* Tolterodine
* Toluene diisocyanate
* Topiramate
* Trandolapril
* Travoprost
* Trichinellosis
* Unoprostone
* Vanadium poisoning
* Yellow nail syndrome
* Zanamivir

### Causes Based on Classification

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#### Acute Bronchitis

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* The cause of acute bronchitis depends on several factors including season of the year (winter and fall), vaccination level, age and immune status of the patient.
* Viruses are considered to be the most common cause of acute bronchitis. Common viruses include influenza A and B, parainfluenza, respiratory syncytial virus, coronavirus, adenovirus and rhinovirus.
* Human metapneumovirus is also found to cause bronchitis.
* Some atypical bacteria are also found to act as causative factors for bronchitis namely bordetella pertussis, Chlamydia pneumonia and mycoplasma pneumonia.

The following factors exacerbate bronchitis:

* Air pollution
* Allergens
* Certain occupations (such as coal mining, textile manufacturing, or grain handling)

#### Chronic Bronchitis

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Chronic bronchitis is a long-term condition. People have a cough that produces excessive mucus. To be diagnosed with chronic bronchitis, a patient must have a cough with mucus most days of the month for at least 3 months.

## References

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1. ↑ Jonsson JS, Sigurdsson JA, Kristinsson KG, Guthnadóttir M, Magnusson S (1997). "Acute bronchitis in adults. How close do we come to its aetiology in general practice?". Scand J Prim Health Care. 15 (3): 156–60. PMID 9323784.
2. ↑ Boivin G, Abed Y, Pelletier G, Ruel L, Moisan D, Côté S, Peret TC, Erdman DD, Anderson LJ (2002). "Virological features and clinical manifestations associated with human metapneumovirus: a new paramyxovirus responsible for acute respiratory-tract infections in all age groups". J. Infect. Dis. 186 (9): 1330–4. doi:10.1086/344319. PMID 12402203.
3. ↑ Louie JK, Hacker JK, Gonzales R, Mark J, Maselli JH, Yagi S, Drew WL (2005). "Characterization of viral agents causing acute respiratory infection in a San Francisco University Medical Center Clinic during the influenza season". Clin. Infect. Dis. 41 (6): 822–8. doi:10.1086/432800. PMID 16107980.
4. ↑ Wenzel RP, Fowler AA (2006). "Clinical practice. Acute bronchitis". N. Engl. J. Med. 355 (20): 2125–30. doi:10.1056/NEJMcp061493. PMID 17108344.
5. ↑ Irwin RS, Madison JM (2000). "The diagnosis and treatment of cough". N. Engl. J. Med. 343 (23): 1715–21. doi:10.1056/NEJM200012073432308. PMID 11106722.
6. ↑ MedicineNet.com - COPD causes
7. ↑ Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD (2009). "COPD prevalence is increased in lung cancer, independent of age, sex and smoking history". Eur. Respir. J. 34 (2): 380–6. doi:10.1183/09031936.00144208. PMID 19196816. Unknown parameter `|month=` ignored (help)CS1 maint: Multiple names: authors list (link)
8. ↑ "Definition of pack year - NCI Dictionary of Cancer Terms".
9. ↑ Template:Cite doi
10. ↑ Devereux, Graham (2006). "Definition, epidemiology, and risk factors". BMJ. 332 (7550): 1142–4. doi:10.1136/bmj.332.7550.1142. PMC 1459603. PMID 16690673. Unknown parameter `|month=` ignored (help)
11. ↑ Hnizdo E, Vallyathan V (2003). "Chronic obstructive pulmonary disease due to occupational exposure to silica dust: a review of epidemiological and pathological evidence". Occup Environ Med. 60 (4): 237–43. doi:10.1136/oem.60.4.237. PMC 1740506. PMID 12660371. Unknown parameter `|month=` ignored (help)
12. ↑ Loscalzo, Joseph; Fauci, Anthony S.; Braunwald, Eugene; Dennis L. Kasper; Hauser, Stephen L; Longo, Dan L. (2008). Harrison's Principles of Internal Medicine (17th ed.). McGraw-Hill Professional. ISBN 0-07-146633-9.CS1 maint: Multiple names: authors list (link)
13. ↑ Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM (2006). "Global burden of COPD: systematic review and meta-analysis". Eur. Respir. J. 28 (3): 523–32. doi:10.1183/09031936.06.00124605. PMID 16611654. Unknown parameter `|month=` ignored (help)CS1 maint: Multiple names: authors list (link)
14. ↑ Kennedy SM, Chambers R, Du W, Dimich-Ward H (2007). "Environmental and occupational exposures: do they affect chronic obstructive pulmonary disease differently in women and men?". Proceedings of the American Thoracic Society. 4 (8): 692–4. doi:10.1513/pats.200707-094SD. PMID 18073405. Unknown parameter `|month=` ignored (help)CS1 maint: Multiple names: authors list (link)
15. ↑ Silverman EK, Chapman HA, Drazen JM; et al. (1998). "Genetic epidemiology of severe, early-onset chronic obstructive pulmonary disease. Risk to relatives for airflow obstruction and chronic bronchitis". Am. J. Respir. Crit. Care Med. 157 (6 Pt 1): 1770–8. PMID 9620904. Unknown parameter `|month=` ignored (help)CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
16. ↑ MedlinePlus Encyclopedia 000091

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