Bronchiolitis is a viral infection of the lungs. It causes the small airways of the lungs (bronchioles) to swell. This makes breathing difficult.
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Bronchiolitis is caused by one of several of viruses that spread from person to person, such as respiratory syncytial virus (RSV) and influenza.
Bronchiolitis is most common in premature babies and children under 2 years of age. It is also more common in the winter. Other things that may raise the risk are:
- Attending childcare or having older siblings who attend childcare or school
- Exposure to environmental pollution including secondhand smoke
- Birth defects of the heart or lungs
- Cardiopulmonary disease
- A weak immune system
- Severe neuromuscular disease
The first symptoms will be the same as a common cold. This may include stuffy or runny nose, cough, and mild fever. After a few days, the cough will worsen and breathing will be faster.
Symptoms may be:
- Rapid breathing
- Wheezing or crackling noises when breathing out
- Changes in breathing patterns, such as using the belly muscles to help move air, widening nostrils, or grunting while breathing
- Periods of no breathing
- A chest that sinks in between the ribs or under the ribcage with each breath
- Poor feeding
- Blue skin color around the lips or fingertips
The doctor will ask about the child's symptoms and past health. A physical exam will be done. This is enough to make the diagnosis.
Viral infections cannot be cured with medicine. The virus often goes away in 2 to 3 weeks.
The goal of treatment is supportive care while the child heals. This may include:
- Acetaminophen to lower a fever
- Suctioning any fluids blocking the airway
- Oxygen therapy
- Nutrition therapy with an IV or a feeding tube
Babies who are at high risk for bronchiolitis by RSV may be given medicine to lower the risk.
Viruses cannot always be prevented. They are common and spread easily. To lower the risk:
- Avoid contact with people who are sick.
- Practice good hand hygiene.
- Avoid exposure to secondhand smoke.
- Babies over 6 months of age should get the influenza vaccine.
- Breastfeed for the first 6 months of life when possible.
- Bronchiolitis. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Bronchiolitis.aspx.
- Bronchiolitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/bronchiolitis.
- Treating bronchiolitis in infants. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/chest-lungs/pages/Treating-Bronchiolitis-in-Infants.aspx.
- Kari Kuenn, MD
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