soap Note: Asthmatic Bronchitis Differential Diagnosis

soap Note: Asthmatic Bronchitis Differential Diagnosis

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Assessment: Differential diagnoses

Asthmatic Bronchitis: Bronchitis is an infection of the bronchi by micro-organisms which causes bronchial irritation and inflammation. The bronchus produces mucus that traps dust and other particles from air entering the lungs. When there is inflammation and irritation, the bronchi produce more mucus than usual causing obstruction (Eisner et al., 2016). The body initiates the cough reflex as a mechanism to clear the mucus, a symptom observed in many patients with the condition. Acute bronchitis is a temporary inflammation of the airway causing mucus production and cough (Knutson et al., 2013). The signs manifest from a few days of infection up to three weeks. Asthmatic bronchitis is a condition observed in patients who contract bronchitis in their asthmatic state. The signs and symptoms of bronchitis include cough, fatigue, and production of sputum which can be clear, white or yellowish green. Likewise, the patient complains of cough, with a yellowish green appearance.

Pneumonia: Pneumonia is a common infection of the lungs caused by organisms like bacteria, viruses, and fungi…

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Lung Abscess: Lung abscess is the necrosis of the pulmonary tissue and the formation of cavities containing fluids caused by microbial infection. The condition is caused by gram positive and gram negative micro-organisms such as staph aureus, Pseudomonas and Klebsiella spp (Brown et al., 2017). Most patients present in the healthcare setup with subacute onset of the illness and they do not seek medical attention until three to four weeks of symptom onset. Lung abscess is mostly a secondary infection resulting from conditions like pneumonia or aspiration of gastric contents in hospitalized individuals. There is infection and accumulation of fluid in the pleural cavity. Depending on the causal organisms, lung abscess manifests primarily with cough and production of greenish-yellow purulent sputum (Brown et al., 2017). Chest pain and weight loss are also observed in the patients. This patient presents with a cough that has been persistent for three weeks, and the yellowish-green cough is an indicator of a lung abscess.

Final Diagnosis

The final diagnosis for the patient is Asthmatic Bronchitis…


Asthmatic bronchitis is not a medical emergency unless the patient manifests with airway obstruction (Wenzel et al., 2016)…

Treatment and Alternative therapies


  • Azithromycin 500mg daily for five days
  • Prednisone 40mg for one week

The patient should quit smoking for two weeks to give space for the condition to subside, and she should report back to the facility in case the symptoms persist.

Reflection Notes

From this patient, I was able to establish a good rapport which enabled the success of obtaining a comprehensive history. I was also able to conduct a detailed physical examination and analysis of the medical records of the patient…


Blum, C. A., Nigro, N., Briel, M., Schuetz, P., Ullmer, E., Suter-Widmer, I., … & Arici, B. (2015). Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial. The Lancet385(9977), 1511-1518.

Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2017). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems. Elsevier Health Sciences.

Eisner, M. D., Yelin, E. H., Trupin, L., & Blanc, P. D. (2016). Asthma and smoking status in a population-based study of California adults. Public Health Reports.

Knutson, D., & Braun, C. H. A. D. (2013). Diagnosis and management of acute bronchitis. American family physician65(10), 2039-2048.

Wenzel, R. P., & Fowler III, A. A. (2016). Acute bronchitis. New England journal of medicine355(20), 2125-2130.