A 34-year-old woman with no known underlying lung disease has had a 12-day history of cough that has become productive of sputum. Initially she was not short of breath, but now she becomes short of breath with exertion. She initially had nasal congestion and a mild sore throat, but now her symptoms are all related to a productive cough without paroxysms. She denies any sick contacts. On physical examination she is not in respiratory distress and is afebrile with normal vital signs. No signs of upper respiratory tract infection are noted. Scattered wheezes are present diffusely on lung auscultation.
Acute bronchitis can also present as wheezing that resembles asthma with minimal cough, or as a nocturnal cough only. While most patients with acute bronchitis will have a productive cough, patients in later phases of the illness may have a nonproductive cough.
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