BRONCHIOLITIS

 Basic information

description

Bronchiolitis is an inflammation and infection of the smallest airways (bronchioles) of the respiratory tract. These airways normally carry air from the large bronchial tubes to tiny air sacs in the lungs. Bronchiolitis mainly affects infants and young children. Boys are affected more often than girls.

FREQUENT SIGNS & SYMPTOMS

• Often there is a mild common cold and cough before symptoms of bronchiolitis appear.
• Sudden trouble with breathing and wheezing.
• Rapid, shallow breathing.
• Chest and stomach are pulled in and out in seesaw movements with breathing.
• Grunting sounds while breathing in infants.
• Fever may occur or dehydration may develop.
• Blue skin or nails in severe cases.

causes

Usually a viral infection. Respiratory syncytial virus (RSV) is the most common. Other viral infections may sometimes be the cause. Germs are spread by sneezing, coughing, or by contact of hands to nose, mouth, or eyes. Symptoms start 2 to 5 days after the exposure.

risk increases with

• Young children (usually under age 2).
• Winter and early spring seasons.
• Daycare centers.
• Crowded living conditions.
• Exposure to cigarette smoke.
• Children who were born premature, had low birth weight, were born with health problems (neurologic, heart, or lung), or have developed a lung disorder.
• Bottle fed baby slightly more so than breastfed baby.

PREVENTIVE MEASURES

• No specific preventive measures.
• Wash hands carefully to prevent spread of any germs.
• Avoid exposure to infected persons.
• Don't allow any smoking around a baby or child.
• Children at risk for complications of RSV infections may be given therapy to prevent the infection.

expected outcomes

Mild cases may last for one or two days. Other cases may take 5 to 12 days for recovery. A few children with other health problems may be at risk for complications.

possible complications

• Respiratory failure.
• Chronic lung disease.
• Heart disorders.
• Bronchiolitis obliterans (collapse of part of the lung).
• Other infections.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about the symptoms and activities. Medical tests are usually not needed, but may be done to confirm the diagnosis.
• There is no specific treatment for this disorder. Mild cases may be treated at home. Extra rest and drinking plenty of fluids is usually all that is needed.
• Use an ultrasonic, cool-mist humidifier if recommended by your health care provider. Clean the humidifier daily.
• A blocked-up nose may be suctioned with a rubber suction device.
• If the symptoms are more severe, hospital care may be required. Oxygen may be provided through a face-mask. Some patients require breathing support with a ventilator (a device to help the lungs). Treatment to help remove lung secretions may be needed.

medications

• Hospital care may include drugs to relieve breathing problems, treat infections, and prevent complications.
• Acetaminophen may be used for fever.

activity

Rest until symptoms have improved for 48 hours. Then gradually return to normal activities.

diet

Offer a child clear fluids often. These include water, clear juice, clear broth, or others. Infants should continue to nurse or drink formula.

 notify our office if

• You or a family member has bronchiolitis symptoms.
• Cold symptoms become worse.
• Temperature rises to 101°F (38.3°C) or higher.
• Breathing becomes more difficult.
• A cough begins that produces colored mucus.
• The skin, lips, or nails turn bluish in color.
• The child becomes drowsy and lacks energy.

Special Notes: