Bronchitis, acute

Acute bronchitis: 90% viral infection of the bronchi with cough, fever and headache.

Most often, the trachea is also affected, which is why doctors also from one tracheobronchitis speak. In 10% of cases, bronchitis is bacterial or complicates with viral bronchitis.

Other symptoms include pain behind the sternum when coughing, sometimes muscle and body aches. Symptoms of the upper respiratory tract such as runny nose and sore throat may occur at the same time. Acute bronchitis is very common. In Germany, about 80 new cases per 100,000 inhabitants are assumed every week.


  • to cough
  • Pain behind the sternum when coughing
  • First no sputum, then slimy-glassy and finally whitish-yellowish sputum
  • hoarseness
  • fever
  • Headache, limb and muscle pain.

When to the doctor

After a few days if

  • the fever does not go down or rises again after the fever drops
  • clear breathing noises such as wheezing or rattling or even shortness of breath occur.

The next day if

  • Babies and toddlers suffer from a deep-seated cough or become short of breath
  • Patients with serious underlying conditions such as diabetes, heart failure and chronic lung diseases are affected.

After a few weeks if

  • Stop coughing and / or expectoration for more than 8 weeks.

Show background information

ENT, respiratory system and lungs

The illness


Bronchitis occurs when the immune system is weakened or when humans come into contact with a large number or with particularly contagious pathogens. The local immune system is affected by chronic diseases of the respiratory system such as asthma or COPD, but also by chronic heart, liver and kidney diseases, diabetes, immune deficiencies and alcoholism.

Typical triggers of acute bronchitis:

virus. About 90% of bronchitis are triggered by viruses:

  • most common in children due to RS, Adeno, Coxsackie and ECHO viruses
  • in adults by rhino, influenza and parainfluenza viruses as well as the corona or SARS corona virus.

bacteria. Less often, bacteria cause acute bronchitis. If so, bacterial pathogens often graft on to a pre-existing viral infection (superinfection). The following pathogens are possible in acute bronchitis:

  • pneumococcal
  • staphylococci
  • Haemophilus influenzae
  • Moraxella catarrhalis.

mushrooms. Especially in immunosuppressed patients, fungi such as candida can cause bronchitis.

Irritants in the air we breathe. Acute toxic bronchitis is triggered, for example, by inhaling these substances:

  • sulfur dioxide
  • nitrous
  • ozone
  • hydrocarbons.

Other causes. In addition, acute bronchitis can also develop as part of measles, whooping cough, chickenpox or diphtheria, or be caused by an allergic reaction.


As with the common cold, the pathogens come into the body with the air we breathe. They enter the lower respiratory tract and lead to inflammation of the bronchial mucosa with increased mucus production 1–6 days after infection. In the foreground is the resulting cough, which is often very exhausting and excruciating. to cough is the body’s natural reaction to irritation of the trachea, bronchial tubes or lungs and an attempt to remove disturbing foreign bodies or mucus. In bronchitis, the airways are affected by an infection. Flu-like symptoms such as severe headache, joint and muscle pain can also occur. Diagnostic differentiation from flu is then difficult. Depending on the pathogen and the body’s immune system, fever or an elevated temperature occur. The cough can persist in the actual infection and last up to 8 weeks before it subsides. It is often accompanied by slimy expectoration.

The mucous membrane of the respiratory tract in healthy people – the cells shown in green produce mucus, the blue cells carry cilia. These hairs are constantly moving towards the throat and nose. In this way they transport foreign bodies and mucus and allow coughing up. This self-cleaning mechanism is impaired in respiratory diseases, but also in smokers. Right: Inflamed and swollen mucous membrane after an infection. The cells have partly died and lost their function (shown in brown)., Michael Amarotico, Munich


Existing heart or lung diseases can worsen in the course of acute bronchitis and lead to shortness of breath. If bacteria settle on the inflamed mucous membrane, they lead to a secondary bacterial infection.


As a complication, any bronchitis can spread to the lungs, the doctor then speaks of one bronchopneumonia. Older or defensible patients are particularly at risk. This bronchopneumonia must be treated like pneumonia of another cause.

If the smallest branches of the bronchial system become inflamed, there is a risk, particularly in children, that the bronchi are quickly constricted by swelling of the mucous membrane and shortness of breath arises. As a chronic consequence of such bronchiolitis, permanent narrowing (stenoses) can develop due to scarred changes, which eventually lead to sagging of the bronchi (bronchiectasis) (for more on this, see chronic bronchitis).


The doctor asks the symptoms and examines the lungs. When eavesdropping, the acute bronchitis becomes noticeable through coarse rattling noises. The doctor differentiates the cough of acute bronchitis from the cough caused by physical and chemical stimuli (e.g. cold air, foreign bodies, cigarette smoke and medications such as ACE inhibitors, beta blockers). If necessary, he arranges for laboratory tests and occasionally an X-ray of the lungs.

If the doctor suspects bronchitis in the context of another disease such as whooping cough, blood tests are e.g. on whooping cough makes sense. Incidentally, the color of the sputum is not pioneering in the diagnosis (previously it was thought that yellow or green colored sputum proves that bronchitis is bacterial).



antibiotics. In otherwise healthy patients, antibiotics are not absolutely necessary to treat the secondary bacterial infection. Antibiotic therapy is also recommended for this group of patients if the bacterial infection lasts longer than 1 week. Antibiotics are used earlier in high-risk patients, v. a. to protect against bacterial pneumonia.

corticosteroids. Short-term inhalation therapy with corticosteroids can shorten the course of the disease in some cases.

Bronchodilators. If breathing becomes difficult because the airways are narrowed (bronchial obstruction), bronchospasmolytics can help.


In otherwise healthy people, acute bronchitis heals without complications in most cases, the mucus loosens and can be coughed up after a few days.

The pharmacist recommends

What you can do yourself

bed rest.

As long as you have an elevated temperature, you should take care of yourself and stay in bed. With fever, the body loses fluid through sweating. So drinking frequently (at least 2 l a day) is the top priority. It is good to keep your feet warm and it is best to dress so that you do not sweat or freeze. A pollutant load in the breathing air, e.g. B. by cigarette smoke – active and passive – should be avoided at all costs. Cooking on the gas stove in the kitchen is also unfavorable because the exhaust gases irritate the bronchi. To prevent complications and an unnecessary prolongation of the disease, you should cure the disease and not try to get active again too soon.

Drink a lot.

Dry, irritable cough becomes more bearable if the mouth and throat are well moistened by cough drops and plenty of warm drinks. In particular, tea (sweetened with honey) relieves the urge to cough because it stimulates the formation of bronchial secretions. Known as helpful home remedies Hustentees, Mixtures z. B. from marshmallow, Icelandic moss and ribwort. Steam baths with chamomile flowers or thyme also relieve dry, irritable cough. Beware of asthma or hypersensitive airways! If breathlessness occurs, stop inhaling.

After a few days of illness with a fever, a lot of fluid has been lost. This must be replaced now at the latest in order to be able to remove the stuck mucus from the airways. Herbal teas are also particularly suitable here, but in a slightly different composition, e.g. B. from plantain herb, licorice root, thyme herb and fennel fruits. Fennel honey, which is known for its cough relieving effect, is ideal for sweetening.

chicken soup.

You can also fill up liquid with chicken broth or vegetable soup. There is even evidence for the chicken broth that it not only provides energy and boosts blood circulation through heat, but also has anti-inflammatory and antioxidant effects.


1 tablespoon of honey at bedtime can relieve the nocturnal cough. However, please brush your teeth thoroughly after taking them to prevent tooth decay.

Humidify air.

In winter, the classic cold period, it is also helpful to humidify the mostly very dry heating air, e.g. B. by placed near the heating water tank, hanging wet towels or evaporating a pot of water on the stove. Inhaling hot vapors at around 43 ° C has proven useful for intensely moistening the upper air passages. If you like, you can add sea salt or herbal essences to the hot water.

Appropriate medication

Pain relievers and possibly cough suppressants can relieve the symptoms; if breathing is very restricted, hospitalization is required.


Light pain relievers such as paracetamol (e.g. Benuron®), acetylsalicylic acid (e.g. Aspirin®) or ibuprofen relieve headaches and body aches and promote sleep – taken before going to sleep.

Cough suppressant (antitussive).

A cough suppressant promise remedies for dry cough: medications with different modes of action that reduce the urge to cough. There are more effective prescription and less effective over-the-counter cough suppressants. Herbal products are also used to line the upper respiratory tract with a protective film that relieves the cough. The use of cough suppressants is particularly useful in the evening to achieve a peaceful night’s sleep. at "loose", So already "productive" Cough, however, has to be weighed up whether it is still worth it. Because mucus is a good breeding ground for bacteria, it is better to cough up as much of it as possible instead of suppressing the urge to cough.

  • The prescription cough suppressant work the strongest and are usually well tolerated. They should be used if the cough is very excruciating, painful and prevents sleep: Codeine and dihydrocodeine suppress the cough that emanates from the brain, but also dampen the respiratory drive, which is why they are not used in lung diseases (e.g. asthma) allowed to. They are chemically related to opium and must therefore be prescribed by a doctor, but do not cause dependence. They make you tired, can limit your ability to react and should not be combined with alcohol, antihistamines or sleeping pills. In higher doses they cause constipation.
  • The over-the-counter cough suppressant are significantly inferior in their potency to prescription cough suppressants. Whether they are effective at all from a scientific point of view is assessed differently. However, many sufferers have a good experience with them. Dextromethorphan is comparatively effective and is often recommended, but can only be used from the age of 12. It is chemically similar in structure to the prescription cough suppressant, but does not impair the reactivity so much because it does not lack opioid >Plantain or Icelandic moss have a calming effect by placing a protective film of mucus over the irritated airway mucosa. In the form of lozenges, they envelop the cough receptors of the throat in a mixture of saliva and syrup, thus effectively dampening the cough stimulus while they are in the mouth.

complementary medicine


Cineol (e.g. Soledum® capsules), a natural ingredient made from limonene, also has an expectorant and bactericidal effect. In vitro studies have also shown antiviral activity.

The effectiveness of combined phytotherapy with thyme plus ivy and thyme plus primrose for acute cough has been demonstrated in two controlled studies.

According to a controlled study, the mixture of myrtol, eucalyptus oil, sweet orange and lemon oil (Gelomyrtol®forte) reduced acute cough more than treatment with placebo both during the day and at night in acute bronchitis.


Homeopathy knows numerous acute agents for the relief of acute bronchitis. B. Aconite, Apis mellifica, Bellis perennis, Bryonia, Conium, Echinacea, Hepar sulfuris, Lachesis, Spongia or Sulfur .

onion syrup.

A homemade onion syrup has a good expectorant effect: Slowly boil a chopped onion with a cup of water, let it cool slightly and add two tablespoons of honey. Allow to steep for half an hour, drain and drink in sips throughout the day. A good home remedy is also a cough syrup, which is formed from a mixture of freshly cut onion and rock candy in a closed container after about a day. Two teaspoons are taken three times a day.


Disinfected ginger, stimulates blood circulation and is not only helpful for prevention, but also during bronchitis. For tea, the ginger is crushed with hot water poured over and let go for a while. If it is still too hot to drink, you can inhale it well. To do this, bend over the cup, put a cloth over your head and inhale the vapors deeply. If you want, you can also suck small pieces of ginger to dissolve the mucus.

radish syrup.

You need a tuber of black radish and sugar candy. A cap is cut off from the radish and hollowed out to a wall thickness of approximately 1 cm. Then you put the radish on a glass and drill a few holes with a toothpick through the bottom of the radish. Now fill it with sugar candy, put the radish lid back on and let it steep overnight. A mixture of sugar and radish juice drips into the glass. You can drink this syrup in small portions throughout the day. If you want, you can warm it up.

breast wrap.

Breast wraps with onions, thyme or curd cheese can provide relief for children and adults, as can a warm full bath with a handful of thyme as an additive.

vibration massage.

Regular vibration or tapping massages on the back help some patients to loosen the mucus in the bronchi.


Always keep your feet and hands warm! When the feet are cold, the mucous membranes of the respiratory tract are poorly perfused. This promotes the development of respiratory infections. Rooms in which you are staying should be well ventilated. During the heating season, increased humidity prevents the mucous membranes from drying out. Zinc can also be used preventively, e.g. B. before the main cold periods in autumn and spring, the intake of 15 mg zinc twice a day is recommended in addition to the consumption of plenty of fruits and vegetables.

Respiratory infections occur less often if harmful substances such as active or passive cigarette smoke are avoided.

Hardening measures such as regular visits to the sauna, cold water and alternating showers improve the immune system and thus help to prevent colds and bronchitis.


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