Pneumonia vs Bronchitis
A disease in the respiratory tract is one of the commonest causes a patient may seek a doctor and still it can be one of the most lethal conditions. They can afflict children from the smallest infant to the elderly lady in her 80s. The respiratory tract begins from the nostril and end in the alveoli of the lungs, where gas exchange occurs with the capillaries surrounding the alveoli. The respiratory tract is specifically differentiated to handle the traumas from inhaled particulate matter and to promote gas exchange. There are defensive mechanisms, which are physical, biochemical, immunological, and pathological to prevent unnecessary stress upon the tract. The topics for discussion here are two of the most common complaint, and they will be discussed related to the anatomical location, pathophysiology, clinical features and management.
Pneumonia is basically the infection in the lungs. Specifically, it affects the alveoli and the bronchioles, in proximity to the alveoli. It is caused by bacteria, viruses and fungi, and is related to any recent visits to a health care facility and the immunity of the person. When an organism is latched onto the alveoli or the bronchioles it creates an irritation leading to an immunological response, where the bronchioles, alveoli and /or the intermediary spaces are inflamed and congested with fluid. These kinds of patients present with fever, a chesty cough, sputum (white to yellow), fatigue, loss of appetite, headache and confusion. Treatment depends on the level of severity as a low level case will be managed with oral antibiotics, and a high level case will be managed in the intensive care unit with intravenous antibiotics. Usually, the pneumonia gets resolved by 2 weeks duration.
Bronchitis is the inflammation of the main air passages, and it is usually precipitated by a viral infection, or rarely a bacterial infection. Usually, there is an underlying pathology of the air passages like chronic smoking, extremes of age, or long term lung disease. This results in oedema of the air passages and later on scarring. It may be acute or chronic, which is one aspect of chronic pulmonary airway disease (COAD). They present with low fever, fatigue, difficulty in breathing, chest pain, and mucoid cough. Management of the condition includes advising to stop smoking, bed rest, humidified oxygen (if required), fever and pain management, and if infection is suspected, manage with antibiotics. Acute cases get resolved by 1 week duration, but a chronic cough may continue. Chronic bronchitis may require lifelong treatment.
Difference between Pneumonia and Bronchitis
In comparison, both of these conditions are precipitated by infective organisms, and more prone to individuals who have chronic debilitating illnesses and those exposed to noxious elements like cigarette smoke, coal dust, feather particles, soot, etc. Both of these presentations have chest pain, cough with sputum, fatigue, confusion in common. But pneumonia affects the alveoli and the related bronchioles, whilst bronchitis affects the major bronchi and proximal bronchioles. Pneumonia causes the oedema and fluid collection in the alveoli, and bronchitis causes the oedema and scarring of the air passages. Origin of pneumonia is mainly bacterial, while bronchitis is mainly viral. Pneumonia causes high fever with chills, whereas bronchitis causes a mild fever. Management of pneumonia is based on antibiotic treatment, whereas, in bronchitis, it is based on alleviating pain and reducing the oedema. Pneumonia is resolved by 2 weeks duration, but bronchitis may persist as a long term cough for months. Chronic bronchitis may persist throughout the life.
In summary, pneumonia may be lethal but once tackled with antibiotics there are rarely any after effects. On the other hand, bronchitis has a tendency to linger on for some time. This may be related to the immune mediated actions, and damage to the structures in bronchitis, whereas pneumonia is a pure and simple infection.