Bronchiolitis – What it is, Causes, Symptoms and Treatments

Bronchiolitis – What it is, Causes, Symptoms and Antibiotic Treatments. Also, Bronchiolitis is a common lung infection in young children and children. It causes inflammation and congestion in the small airways (bronchioles) of the lung. Bronchiolitis is almost always caused by a virus. Typically, the peak time for Bronchiolitis is during the winter months. Bronchiolitis starts with symptoms similar to a common cold, but then progresses to coughing , wheezing, and sometimes difficulty breathing . Symptoms of Bronchiolitiscan last several days to weeks, even a month. Most children get better with care at home. A very small percentage of children require hospitalization.

Causes of Bronchiolitis:  Bronchiolitis occurs when a virus infects the bronchioles, which are the smallest airways in your lungs. The infection makes the bronchioles swollen and inflamed. Mucus collects in these airways, which makes it difficult for air to flow freely in and out of the lungs.

Most cases of bronchiolitis are caused by respiratory syncytial virus (RSV). RSV is a common virus that infects almost all children up to the age of 2. Outbreaks of RSV infection occur every winter. Bronchiolitis can also be caused by other viruses, including those that cause the flu or the common cold. Babies can be reinfected with RSV because there are at least two strains.

The viruses that cause bronchiolitis are easily spread. You can catch them through droplets in the air when someone is sick, coughs, sneezes, or talks. You can also get them by touching shared objects — like utensils, towels, or toys — and then touching their eyes, nose, or mouth.

Symptoms  of Bronchiolitis:  In the first few days, the signs and symptoms of bronchiolitis are similar to those of a cold:

• coryza
• Stuffy nose
• cough
• Mild fever (not always present)

After that, there may be a week or more of difficulty breathing or a whistling noise when the child exhales (wheezing). Many babies will also have an ear infection (otitis media).

When to See a Doctor:  If it is difficult for your child to eat or drink and his breathing  becomes faster or labored, talk to your child’s doctor. This is especially important if your child is younger than 12 weeks old or has other risk factors for bronchiolitis – including premature birth or a heart or lung condition. The following signs and symptoms are reasons to seek immediate medical attention:

• vomit
• Audible sleepy sounds
• Breathing very fast – more than 60 breaths  per minute (tachypnea) – and shallowly
• labored breathing  – the ribs seem to suck in when the baby inhales
• Slow or lethargic appearance
• Refusing to drink enough, or breathing too fast to eat or drink
• Skin turning blue, especially lips and nails (cyanosis)

Bronchiolitis Risk Factors:  Babies younger than 3 months of age are at the highest risk of getting bronchiolitis because their lungs and immune systems are not yet fully developed. Other factors associated with an increased risk of bronchiolitis in infants, or more serious bronchiolitis illness , include:

• premature birth
• An underlying heart or lung condition
• A depressed immune system
• Exposure to tobacco smoke
• Never been breastfed – breastfed babies receive immunological benefits from the mother
• Contact with multiple children, such as in a childcare setting
• Living in a crowded environment
• Having siblings who attend school or childcare and bring home the infection

Complications of Bronchiolitis:  Complications of severe bronchiolitis can include:

• Blue lips or skin (cyanosis). Cyanosis is caused by a lack of oxygen.
• Pause in breathing  (apnea). Apnea is more likely to occur in premature infants and in infants in the first two months of life.
• Dehydration.
• Low oxygen levels and respiratory failure.

If they occur, your child may need hospitalization. Severe respiratory failure may require a tube to be inserted into the windpipe to help the child breathe until the infection has run its course. If your baby was born prematurely, has a heart or lung condition, or has a compromised immune system, watch carefully for early signs of bronchiolitis . The infection can quickly become serious. In these cases, your child will usually need hospitalization.

Diagnosis of Bronchiolitis:  Tests and X-rays are usually not necessary to diagnose Bronchiolitis . The doctor can usually identify the problem by looking at your child and listening to their lungs with a stethoscope. However, it may take more than one or two visits to distinguish the condition from a cold or flu. If your child is at risk for severe bronchiolitis , if symptoms are getting worse, or if another problem occurs, your doctor may order tests, including:

• Chest X-ray: Your doctor may order a chest X-ray to look for signs of pneumonia.
• Viral Test: Your doctor may take a mucus sample from your child to test for the virus that causes bronchiolitis . This is done using a cotton swab that is gently inserted into the nose.
• Blood Tests: Occasionally, blood tests may be used to check your child’s white blood cell count. An increase in white blood cells is usually a sign that the body is fighting an infection. A blood test can also determine whether the oxygen level has decreased in your child’s bloodstream.

Your doctor may also ask you about signs of dehydration, especially if your child has refused to drink or eat or has vomited. Signs of dehydration include sunken eyes, dry mouth and skin, sluggishness and little or no urination.

Bronchiolitis Treatments:  Bronchiolitis typically lasts for two to three weeks. Most children with bronchiolitis can be cared for at home with supportive care. It is important to be aware of changes in breathing difficulties, such as struggling for each breath , being unable to speak or cry from difficulty breathing, or making grunting noises with each breath .

Because viruses cause bronchiolitis , antibiotics — which are used to treat infections caused by bacteria — are not effective against it. If your child has an associated bacterial infection, such as pneumonia, your doctor may prescribe an antibiotic for this. Drugs that open the airways (bronchodilators) have not been routinely found to be helpful.

But your doctor may choose to try a nebulized albuterol treatment to see if it helps. Oral corticosteroid medications and tapping the chest to loosen mucus (chest physiotherapy) have not been shown to be effective treatments for bronchiolitis and are not recommended.

Hospital Care:  A small percentage of children need hospital care to manage their condition. At the hospital, your child may be given humidified oxygen to keep enough oxygen in the blood, and perhaps fluids through a vein (intravenously) to prevent dehydration. In severe cases, a tube may be inserted into the windpipe (windpipe) to help the  child breathe .