Description

Bronchiolitis is a common lung infection in young children and infants. This causes the inflammation and irritation and accumulation of mucus in the small airways of the lung. These small airways are called bronchioles. Bronchiolitis is almost always caused by a virus.

Bronchiolitis begins with symptoms very similar to those of a common cold. But then it gets worse, causing cough and a high-pitched whistling sound when breathing called wheezing. Sometimes children have difficulty breathing. The symptoms of bronchiolitis may last for 1 to 2 weeks, but sometimes can take more time.

The majority of children improve with home care. A small number of children who need a stay in the hospital.

Symptoms

During the first few days, the symptoms of bronchiolitis are very similar to those of a cold:

  • Runny nose.
  • The congestion of the nose.
  • For cough.
  • At times, a bit of a fever.

Later, your child may have more than a week of work more than usual to breathe, which may include wheezing.

Many infants with bronchiolitis also have an ear infection called otitis media.

When to see a doctor

If the symptoms become severe, call your pediatrician. This is especially important if your child is younger than 12 weeks of age, or have other risk factors for bronchiolitis — for example, being born too early, also called premature, or have a heart condition.

Seek medical attention right away if your child has any of these symptoms:

  • They are blue or gray skin, the lips and fingernails due to low levels of oxygen.
  • Struggle for breath and can't speak or cry.
  • Refuses to drink enough, or breathe too fast to eat or drink.
  • Breathe very fast in babies, this can be more than 60 breaths per minute — with short, shallow breaths.
  • Can't breathe easily, and the ribs seem to sink in when you breathe.
  • Makes a whistling sound when breathing.
  • Making grunting noises with each breath.
  • Appears slow-moving, weak or very tired.

Causes

Bronchiolitis occurs when a virus infects to the bronchioles, which are the smallest airways in the lungs. The infection causes the bronchial tubes are inflamed and irritated. The mucus accumulates in the airways, which makes it difficult for air to flow freely in and out of the lungs.

Bronchiolitis is usually caused by respiratory syncytial virus (RSV). The RSV is a common virus that infects nearly all children 2 years of age. Outbreaks of RSV infection are often produced during the colder months of the year, in some places, or the rainy season in the other. A person can have more than one time. Bronchiolitis can also be caused by other viruses, including those that cause the flu or the common cold.

The viruses that cause bronchiolitis are easily spread. You can get to through droplets in the air when a sick person coughs, sneezes, or speaks. You can also get by touching shared items — such as dishes, doorknobs, towels or toys — and then touching your eyes, nose, or mouth.

Risk factors

Bronchiolitis usually affects children under the age of 2 years. Infants younger than 3 months have the highest risk of contracting bronchiolitis due to your lungs and your ability to fight infections, are not yet fully developed. Rarely, adults can get bronchiolitis.

Other factors that increase the risk of bronchiolitis in infants and young children include:

  • Being born too soon.
  • Have a heart or lungs.
  • Having a weakened immune system. This makes it difficult to fight infections.
  • Being around tobacco smoke.
  • Please get in contact with a lot of other children, as in a child care environment.
  • Spending time in crowded places.
  • Having siblings who go to school or receive child care services and bring into the house of the infection.

Complications

The serious complications of bronchiolitis may include:

  • Low oxygen in the body.
  • Pauses in breathing, which is more likely to occur in babies who are born too early and in infants younger than 2 months of age.
  • Not being able to drink enough fluids. This can cause dehydration, when the excess fluid from the body is lost.
  • Not be able to get the amount of oxygen needed. This is called respiratory failure.

If any of these conditions, your child may need to be in the hospital. Severe respiratory failure may require a tube to be guided into the trachea. This helps your child breathe until the infection improves.

Prevention

Because the virus that causes bronchiolitis is transmitted from person to person, one of the best ways to prevent infection is to wash your hands often. This is especially important before touching your baby when you have a cold, the flu, or another disease that can be transmitted. If you have any of these diseases, use a facial mask.

If your child has bronchiolitis, keep your child at home until the illness has passed, to avoid spreading it to others.

To help prevent infection:

  • Limit contact with people who have fever or cold. If your child is a newborn, especially a premature baby, avoid being around people with colds. This is especially important in the first two months of life.
  • Clean and disinfect surfaces. Clean and disinfect surfaces and items that people often touch, such as toys and doorknobs. This is especially important if a family member is sick.
  • Wash your hands often. Frequently wash their own hands and the hands of his son. Wash with soap and water for at least 20 seconds. Keep an alcohol-based hand sanitizer on hand to use when you're away from home. Make sure that contains at least 60% alcohol.
  • Cover coughs and sneezes. Cover your mouth and nose with a tissue. Throw the handkerchief. Then wash your hands. If soap and water are not available, use a hand sanitizer. If you don't have a tissue, cough or sneeze into your elbow, not your hands.
  • Use your own glass. Do not share vessels with others, especially if someone in your family is sick.
  • Breastfeeding, when possible. Respiratory infections are less common in breastfed babies.

Vaccines and medicines

In the united states, the respiratory syncytial virus (RSV) is the most frequent cause of bronchiolitis and pneumonia in children under one year of age. Two options for vaccination can help prevent babies from getting severe RSV. Both are recommended by the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and others.

You and your healthcare provider should discuss which is the best option to protect your child:

  • Antibody product called nirsevimab (Beyfortus). This antibody is a product of a single dose of vaccine is administered in the month before or during the RSV season. It is for newborn babies and children under 8 months of age during or entering their first RSV season. In the united states, the RSV season is usually from November to March, but varies in Florida, Alaska, Hawaii, Puerto Rico, Guam and other territories of the Pacific islands of the united states.
  • Nirsevimab should also be given to children of 8 months through 19 months of age who are at increased risk of severe rsv disease through their second RSV season. Higher risk conditions include: Children with active chronic lung disease of being born too early (before time).Children with a severely weakened immune system.Children with severe cystic fibrosis.American indian or Alaska Native children.
  • Children with active chronic lung disease of being born too early (before time).
  • Children with a severely weakened immune system.
  • Children with severe cystic fibrosis.
  • American indian or Alaska Native children.
  • The vaccine for pregnant people. The FDA approved a vaccine for RSV called Abrysvo for pregnant people to prevent RSV in infants from birth to 6 months of age. A single dose of vaccine Abrysvo can be given at any time of the week 32 to 36 weeks of pregnancy during the months of September to January in the united states Abrysvo not recommended for infants or young children.
  • Children with active chronic lung disease of being born too early (before time).
  • Children with a severely weakened immune system.
  • Children with severe cystic fibrosis.
  • American indian or Alaska Native children.

On rare occasions, when nirsevimab is not available or that a child is not eligible for it, another antibody product called palivizumab may be given. But palivizumab requires monthly injections given during the RSV season, while nirsevimab is only one shot. Palivizumab is not recommended for healthy children or adults.

Other viruses that can cause bronchiolitis too. These include COVID-19 and the flu (influenza). Get season COVID-19 and the flu vaccine each year is recommended for all persons 6 months and older.

Diagnosis

Your doctor can usually diagnose bronchiolitis symptoms and listen to your child's lungs with a stethoscope.

The tests and X-rays are not usually needed for the diagnosis of bronchiolitis. But your child's provider may recommend testing if your child is at risk of bronchiolitis serious, if the symptoms get worse, or if the physician believes that there may be another problem.

Tests may include:

  • X-ray of the chest. A chest x-ray can show if there are signs of pneumonia.
  • Viral tests. A sample of the mucus in the nose of your child can be used to test for the virus causing bronchiolitis. This is done using a swab, which is inserted gently into the nose.
  • Blood tests. Sometimes, blood tests can be used to check your child's white blood cell count. An increase in the white cells of the blood is usually a sign that the body is fighting an infection. A blood test can also show if the level of oxygen in your bloodstream is low.

Your child's provider may search the symptoms of dehydration, especially if your child has been refusing to eat or drink, or has been vomiting. Signs of dehydration include dry mouth and skin, extreme fatigue, and make little or no urine.

Treatment

Bronchiolitis usually lasts 1 to 2 weeks, but the symptoms occasionally last longer. The majority of children with bronchiolitis can be treated at home with comfort measures. It is important to be aware of the breathing problems that are getting worse. For example, fighting for every breath, not being able to speak or cry because of the difficulty breathing, or making grunting noises with each breath.

Due to a virus that causes bronchiolitis, antibiotics used to treat infections caused by bacteria — not work against viruses. Bacterial infections such as pneumonia or an ear infection may occur along with bronchiolitis. In this case, the health care provider may give you an antibiotic for bacterial infection.

Medications called bronchodilators, which open the airways do not seem to help bronchiolitis, and are therefore generally not given. In severe cases, the doctor may try a nebulizer albuterol treatment to see if it helps. During this treatment, a machine that creates a fine mist of medicine that the child breathes into the lungs.

Oral corticosteroid medicines and bruises on his chest to loosen mucus, a treatment called chest physiotherapy, have not been shown to be effective for bronchiolitis and are not recommended.

The in-Hospital care

A small number of children who may need a stay in the hospital. Your child may receive oxygen through a face mask to get enough oxygen in the blood. Your child may also receive fluids through a vein to prevent dehydration. In severe cases, a tube can be guided into the trachea to help breathing.

Lifestyle and home remedies

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

  • Humidify the air. If the air in your child's room is dry, a cool-mist humidifier or vaporizer can moisten the air. This can help loosen the mucus and reduce the cough. Be sure to keep the humidifier clean so that the bacteria and fungi do not grow in the machine.
  • Give your child fluids to stay hydrated. Children should have the formula, or breast milk exclusively. Your child's health care provider, you can add oral rehydration therapy. Older children can drink all you want, such as water, juice, or milk, while they're drinking. Your child can drink more slowly than usual due to the inflammation and the mucus in the nose. Offer small amounts of fluid frequently.
  • Try saline nose drops to relieve congestion. You can buy these drops over the counter. Are effective, safe and non-irritating to the nose, even for children. Put several drops into the opening in the side of the nose, called the nose, and then suction bulb nostril right away. Be careful not to press the bulb too far into the nose. Repeat the same steps for the other nostril.
  • Consider the possibility of pain relievers that you can buy without a prescription. For the treatment of fever or pain, ask your child's health care provider about giving your son babies, or children of over-the-counter fever and pain medicines such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). Those who are safer than aspirin. Aspirin is not recommended in children because of the risk of Reye's syndrome, a rare but potentially life-threatening. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin, because they have a greater risk of Reye's syndrome.
  • Avoid second-hand smoke. The smoke can worsen the symptoms of respiratory infections. If a family member smokes, ask them to smoke outside of the house and out of the car.

Do not use any other over-the-counter medications, with the exception of antipyretics and analgesics, and to treat coughs and colds in children under 6 years of age. Also, consider the possibility of avoiding the use of these medicines to children under 12 years of age. The risks to the children outweigh the benefits.

Preparing for your appointment

It is likely to start by seeing your child's primary care provider or pediatrician. Here's some information to help you prepare for the appointment.

What you can do

Before your appointment, make a list of:

  • Any of the symptoms of his son, including those that do not appear to be associated with a cold or the flu, and when they started.
  • Key personal information,such as if your child was born prematurely or has a heart or lung problem or a weakened immune system.
  • Questions to ask your provider.

Questions to ask your provider may include:

  • What is likely causing my child's symptoms? There are other possible causes?
  • Does my child need any tests?
  • How long do the symptoms last?
  • Can my child spread of this infection to other people?
  • What treatment do you recommend it?
  • What are other options for the treatment you are recommending?
  • Does my child need medication? If so, is there a generic option for the medication that you are recommending?
  • What can I do to make my child feel better?
  • Are there brochures or other printed material I can have? What websites do you suggest?

Feel free to ask questions during your appointment.

What to expect from your doctor

Your pediatrician may ask questions such as:

  • When he made his first child begins to have symptoms?
  • Does your child have symptoms all the time, or come and go?
  • How severe are the symptoms of your child?
  • What, in any case, it seems that the symptoms of your child better?
  • What, in any case, it seems that your child's symptoms worse?

The preparation for the questions they will help you make the most of your time with your child's health care provider.

Symptoms and treatment of Bronchiolitis