Version July 2025
ACE: angiotensin converting enzyme; bpm: beats per minute; COPD: chronic obstructive pulmonary disease; GERD: gastroesophageal reflux disease; URI: upper respiratory infection.
* By definition, acute bronchitis occurs in the absence of COPD. Similar symptoms in a patient with COPD would be considered a COPD exacerbation.
¶ Each of these features increases suspicion for pneumonia. The decision to obtain a chest radiograph should take the full clinical picture into account. Additional factors that may raise the likelihood of pneumonia include moderate/severe dyspnea, hemoptysis, older age, and dementia.
Δ Most pathogens that cause acute bronchitis do not require specific treatment; thus, testing is not needed. Circumstances that might warrant testing include suspicion for pertussis (based on characteristic cough or known exposure), influenza (in a high-risk patient early in the course of illness), or COVID-19 (in a patient at risk for severe illness). Refer to UpToDate text for additional detail on when to suspect specific pathogens.
◊ Refer to UpToDate content for detail on when additional testing is needed for patients with known or suspected pneumonia.
