The main clinical manifestations of chronic bronchitis are cough, sputum. Asthma and recurrent whistling infections. (1) Cough
Long-term, recurrent and gradually worsening cough is the prominent manifestation of this disease. In mild cases, the onset is only in winter and spring, especially in the early morning before and after waking up, with less coughing during the day. In summer and autumn, the cough decreases or disappears. In severe cases, the cough is present in all seasons, intensifying in winter and spring, and is particularly intense in the morning and evening. (2) Coughing sputum
Generally, sputum is white mucus foamy, more in the morning, and often not easy to cough out because of its stickiness. After infection or cold, the symptoms are rapidly aggravated, the sputum volume increases, viscosity increases, or the sputum is yellow and purulent or accompanied by wheezing. Occasionally there is blood in the sputum due to severe coughing. (3) Asthma
When combined with whistling tract infection, shortness of breath (wheezing) symptoms can occur due to congestion and edema of the fine bronchial mucosa, sputum obstruction and narrowing of the bronchial lumen. A wheezing sound occurs in the patient’s throat during whistling, and a croup is present on auscultation of the lungs. This type with wheezing as the prominent manifestation is clinically called wheezing bronchitis; however, its attack condition is not like typical bronchial asthma. (4) Recurrent infections
During the cold season or sudden changes in temperature, recurrent whistling infections are likely to occur. At this time, the patient’s shortness of breath worsens, sputum volume increases significantly and is purulent, accompanied by general malaise, chills, fever and so on. Wet sounds in the lungs and increased blood leukocyte counts are seen. Repeated whistling infections are particularly likely to worsen the condition of elderly patients and must be given due attention. In the early stages of the disease, there are no specific signs, but in most patients, a few wet or dry glottal sounds can be heard at the base of the lungs. Sometimes they may disappear temporarily after coughing or sputum production. During an attack of wheezing laryngitis, a widespread croup may be heard, “which disappears again after the wheezing has subsided. Signs of emphysema may be found in cases of prolonged exacerbations.