0
Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles), usually due to a viral infection.
Causes, incidence, and risk factorsBronchiolitis usually affects children under the age of 2, with a peak age of 3 - 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. Other viruses that can cause bronchiolitis include:
- Adenovirus
- Influenza
- Parainfluenza
The virus is transmitted from person to person by direct contact with nasal fluids, or by airborne droplets. Although RSV generally causes only mild symptoms in an adult, it can cause severe illness in an infant.
Bronchiolitis is seasonal and appears more often in the fall and winter months. It is a very common reason for infants to be hospitalized during winter and early spring. It is estimated that by their first year, more than half of all infants have been exposed to RSV.
Risk factors include:
- Exposure to cigarette smoke
- Age younger than 6 months old
- Living in crowded conditions
- Lack of breast-feeding
- Prematurity (being born before 37 weeks gestation)
Some children have infections with few or minor symptoms.
Bronchiolitis begins as a mild upper respiratory infection. Over a period of 2 - 3 days, it can develop into increasing respiratory distress with wheezing and a "tight" wheezy cough.
The infant's breathing rate may increase (tachypnea), and the infant may become irritable or anxious-looking. If the disease is severe enough, the infant may turn bluish (cyanotic), which is an emergency.
As the effort of breathing increases, parents may see the child's nostrils flaring with each breath and the muscles between the ribs retracting (intercostal retractions) as the child tries to breathe in air. This can be exhausting for the child, and very young infants may become so tired that they have difficulty maintaining breathing.
Symptoms include:
- Bluish skin due to lack of oxygen (cyanosis)
- Cough, wheezing, shortness of breath, or difficulty breathing
- Fever
- Intercostal retractions
- Nasal flaring in infants
- Rapid breathing (tachypnea)
Signs include:
- Decreased blood oxygen
- Wheezing and crackling sounds heard through stethoscope exam of chest
Tests include:
- Blood gases
- Chest x-ray
- Nasal fluid cultures (to determine which virus is present)
Sometimes, no treatment is necessary.
Supportive therapy can include:
- Chest clapping
- Drinking enough fluids. Breast milk or formula are okay for children younger than 12 months. Offer warm lemonade or apple juice if your child is over 4 months.
- Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a humidifier to moisten the air your child is breathing. Follow the directions that come with the humidifier.
- Getting plenty of rest
- Do not let anyone smoke in the house, car, or anywhere near your child.
Antibiotics are not effective against viral infections. Most medications have little effect on bronchiolitis. Children in the hospital may need oxygen therapy and fluids given through a vein (IV) to stay hydrated.
In extremely ill children, antiviral medications (such as ribavirin) are used in rare cases.
Expectations (prognosis)Usually, the symptoms get better within a week, and breathing difficulty usually improves by the third day. The mortality rate is less than 1%.
Complications- Airway disease, including Asthma, later in life
- Respiratory failure
- Additional infection, such as pneumonia
Call your health care provider immediately, or go to the emergency room if the child with bronchiolitis:
- Becomes lethargic
- Develops a bluish color in the skin, nails, or lips
- Develops rapid, shallow breathing
- Has a cold that suddenly worsens
- Has difficulty breathing
- Flares nostrils or retracts chest muscles in an effort to breathe
Most cases of bronchiolitis are not easily preventable because the viruses that cause the disorder are common in the environment. Careful attention to hand washing, especially around infants, can help prevent the spread of respiratory viruses.
Family members with an upper respiratory infection should be especially careful around infants. Wash your hands often, especially before handling the child.
At this date, there is no RSV vaccine available. However, there is an effective product, called palivizumab (Synagis), for infants who are at high risk of developing severe disease from RSV. Ask your child's doctor whether this medication is right for your child.
ReferencesWatts KD, Goodman DM. Wheezing, bronchiolitis, and bronchitis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 388.
American Academy of Pediatrics Subcommittee on the Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118:1774-1793.
What else can I help you with?
What Disesae is characterized by paroxysmal wheezing dyspnea and cough?
Bronchiolitis
How is bronchiolitis diagnosed?
Bronchiolitis is usually diagnosed through a physical examination by a pediatrician or family physician. The physician often finds an increased heart rate, rapid, labored breathing, and crackles in the lungs when the child inhales.
What prevention methods are there to avoid bronchiolitis?
The viruses that cause bronchiolitis spread very easily, making prevention difficult. Common sense measures such as frequent hand washing and keeping children away from crowds and sick individuals are only partially effective.
What are the symptoms of bronchiolitis?
The most common signs of bronchiolitis involve the infant's struggle to breathe. The child may take 50-60 breaths per minute and may develop brief periods when they stop breathing (apnea) and begin to turn blue (cyanosis ).
What is the prognosis for patients who have bronchiolitis?
The majority of children who get bronchiolitis, even severe infections, recover without complications in one to two weeks, although fatigue and a light cough may linger longer. About 60% of people develop only cold-like symptoms.
What is the x-ray appearance of a lung affected by rheumatoid arthritis?
I have found a picture of an X ray of a person with pathologically proven respiratory bronchiolitis associated interstitial lung disease. Follow the related links below (Rheumatoid Lung Disease) (bronchiolitis associated interstitial lung disease) below to see it.
When bronchiolitis occurs in children?
Bronchiolitis is most commonly caused by a viral infection, particularly respiratory syncytial virus (RSV), and primarily affects infants and young children. It usually presents with symptoms such as cough, wheezing, breathing difficulties, and fever. Severe cases may require hospitalization for supportive care and monitoring.
What else is respiratory syncytial virus infection called?
RSV infection is also called bronchiolitis, because it is marked in young children by inflammation of the bronchioles.
Is diacetyl bad for your health?
Yes, diacetyl is considered harmful to health when inhaled in high concentrations, as it has been linked to respiratory issues such as bronchiolitis obliterans, also known as "popcorn lung."
What causes children to make grunting sounds?
1-respiratiry distress syndrome 2-pneumonia 3-asthma 4-bronchiolitis 5-heart failure 6-less commonly, constipation
What are the most common symptoms to be aware of if a child has bronchiolitis?
The most common symptoms to be aware if a child may have bronchiolitis is the following: - firstly Bronchiolitis is a virus which forms into a common cold. For the first few days the child may have a runny or stuffy nose. A slight fever which is not always present. Then for one week the child may experience difficult or rapid breathing, maybe a difficult or noisy wheezing. Both types of breathing may also cause rapid heartbeat to take place. The time a doctor is visited when the child vomits, breathes shallowly more than 40 breaths a minute, the skin around the lips and fingernails turns blue and when the child becomes lethargic or exhausted from sitting up all the time to breathe.
If a preemie develops bronchiolitis at 6 months of age what are the long-term effects?
There may be no long-term effects, it depends on the child. Most cases are not severe. The best person to ask is your child's doctor.
