Bronchiolitis - Symptoms, Causes, Diagnosis and Treatment

Overview

Bronchiolitis is an illness of the respiratory tract. It happens when tiny airways called bronchioles get infected with a virus. These airways become inflamed, then swell and fill with mucus, which can make breathing hard.

Bronchiolitis starts out with symptoms similar to those of a common cold but then progresses to coughing, wheezing and sometimes difficulty breathing. Symptoms of bronchiolitis can last for several days to weeks, even a month.

Symptoms

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

  • Runny nose
  • Stuffy nose
  • Cough
  • Fatigue
  • Slight fever (not always present)

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

Causes

Bronchiolitis usually affects children under the age of 2, with a peak age of 3 to 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. More than half of all infants are exposed to this virus by their first birthday.

Other viruses that can cause bronchiolitis include:

  • Adenovirus
  • Influenza
  • Parainfluenza

The virus is spread to infants by coming into direct contact with nose and throat fluids of someone who has the illness. This can happen when another child or an adult who has a virus:

  • Sneezes or coughs nearby and tiny droplets in the air are then breathed in by the infant
  • Touches toys or other objects that are then touched by the infant

Bronchiolitis occurs more often in the fall and winter than other times of the year. It is a very common reason for infants to be hospitalized during winter and early spring. Risk factors of bronchiolitis include:

  • Being around cigarette smoke
  • Being younger than 6 months old
  • Living in crowded conditions
  • Not being breastfed
  • Being born before 37 weeks of pregnancy

Diagnosis

Tests and X-rays are not usually needed to diagnose bronchiolitis. The doctor can usually identify the problem by observing your child and listening to his or her lungs with a stethoscope. However, it may take more than one or two visits to distinguish the condition from a cold or the flu.

If your child is at risk of severe bronchiolitis, if symptoms are worsening or if another problem is suspected, your doctor may order tests, including:

  • Chest X-ray. Your doctor may request a chest X-ray to look for signs of pneumonia.
  • Viral testing. Your doctor may collect a sample of mucus from your child to test for the virus causing bronchiolitis. This is done using a swab that’s gently inserted into the nose.
  • Blood tests. Occasionally, blood tests might 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 level of oxygen has decreased in your child’s bloodstream.

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

Treatment

Bronchiolitis typically lasts for two to three weeks. The main focus is to relieve symptoms, such as difficulty breathing and wheezing. Some children may need to stay in the hospital if their breathing problems do not improve after being observed in the clinic or emergency room.

The most common treatments for bronchiolitis are usually prescription medications to help control specific symptoms. For instance, cough medications are used to suppress the cough and inhalers are used to help with shortness of breath.

Other treatments for bronchiolitis usually depend on what is causing the injury to the airways. When bronchiolitis is caused by medication or inhaling a toxic substance, sometimes limiting exposure is enough. When bronchiolitis is the result of specific disease, such as arthritis, treatment might include medications against those diseases.

When symptoms are severe, steroids may be prescribed. Steroids are strong medications used to fight inflammation. They work by suppressing the immune system. While often effective, steroids may also have side effects, including increased appetite, increased blood sugar levels and weight gain.

Lifestyle and home remedies

Although it may not be possible to shorten the duration of your child’s illness, you may be able to make your child more comfortable. Here are some tips to try:

  • Humidify the air. If the air in your child’s room is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing. Be sure to keep the humidifier clean to prevent the growth of bacteria and molds.
  • Keep your child upright. Being in an upright position usually makes breathing easier.
  • Have your child drink. To prevent dehydration, give your child plenty of clear fluids to drink, such as water or juice. Your child may drink more slowly than usual, because of the congestion.
  • Try saline nose drops to ease congestion. You can purchase these drops over-the-counter (OTC). They’re effective, safe and nonirritating, even for children. To use them, instill several drops into one nostril, then immediately bulb suction that nostril (but don’t push the bulb too far in). Repeat the process in the other nostril. If your child is old enough, teach your child how to blow his or her nose.
  • Use OTC pain relievers. For treatment of fever or pain, consider giving your child infants’ or children’s over-the-counter fever and pain medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) as a safer alternative to aspirin. Use caution when giving aspirin to children or teenagers. Although aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children.
  • Maintain a smoke-free environment. Smoke can aggravate symptoms of respiratory infections. If a family member smokes, ask him or her to smoke outside of the house and outside of the car.

Keyword: bronchiolitis.

Related Posts:

What is Obliterative Bronchiolitis?

What is Follicular Bronchiolitis?

Is Bronchiolitis Contagious?

Do You Know RSV in Infants?

Can RSV Lead to Pneumonia?

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.