Acute bronchitis
A medical diagnosis of acute bronchitis is not usually required unless your symptoms are particularly severe, or they last longer than three weeks.
If you do see your doctor, they will usually be able to make a diagnosis by asking about your symptoms and listening to your chest using a stethoscope (a piece of medical equipment that is used to listen to the heart and lungs).
Ruling out other conditions
In confirming a diagnosis of acute bronchitis, your doctor may need to rule out other lung infections, such as pneumonia, which has similar symptoms to bronchitis.
If your doctor thinks that you may have pneumonia, you will probably need to have a chest X-ray. They may also take a sample of mucus for testing.
If an undiagnosed underlying condition is suspected, such as asthma, or emphysema (damage to the small airways in your lungs) your doctor may suggest that you have a pulmonary function test.
If you have a pulmonary function test, your doctor will ask you to take a deep breath before blowing into a device called a spirometer, which measures the volume of air in your lungs. A decreased lung capacity may indicate that you have an underlying health problem.
Pneumonia
To help make a diagnosis, your doctor will ask you about your symptoms. For example, they may ask you:
- whether you are breathing faster than usual (respiratory rate)
- whether you feel breathless
- how long you have had your cough
- whether you are coughing up phlegm (thick mucus) and what colour it is
- whether the pain in your chest is worse when you breathe in or out
Your doctor will probably use a stethoscope to listen to the back and front of your chest in order to check for any crackling or rattling sounds. They may also tap your chest and listen to the sound that is produced. If your lungs are filled with fluid, it will produce a different sound compared with normal, healthy lungs.
Your blood pressure will also be checked as well because an unusually low blood pressure (hypotension) may be a sign that you have a more serious type of pneumonia.
Your doctor may also carry out a test called a pulse oximetry test. This test is used to measure how much oxygen your lungs are able to breathe in. A sensor is put on your fingertip, ear, or toe. The sensor sends out light waves and a computer that is connected to the sensor measures how the light waves are being absorbed.
Oxygen can affect how the light waves are being absorbed. Therefore, by analysing the results, the computer can quickly determine how much oxygen is present in your blood. Unusually low levels of oxygen may be a sign that you have a more serious type of pneumonia.
Further testing
Further testing is usually only required if your chest infection symptoms are severe. A chest X-ray can highlight the extent to which pneumonia has affected your lungs. Other tests that your doctor may suggest include:
- sputum test – where you cough up some phlegm (mucus) into a container so that it can be tested in a laboratory
- blood tests
The samples that are taken during sputum and blood tests will be analysed in a laboratory to help identify the germ that is causing your infection.
If the tests identify the germ that is causing the infection, your doctor may decide to adjust your treatment. Delaying treatment until the results of the test are known could be dangerous, so in most cases chest infections are initially treated with broad-spectrum antibiotics, which are antibiotics that are known to be effective against a wide range of bacteria). Once the exact germ that is causing your infection has been identified, your doctor may adjust your treatment accordingly.
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