Definition Bronchiolitis is an inflammation in the bronchioles, or small airways in the lungs. It is characterised by wheezing. It usually affects children under 2 years of age.
What is going on in the body? Bronchiolitis is a common condition in which an infection, such as a cold or flu, causes the bronchioles, or small airways in the lungs, to swell. Along with the swelling, there is an increased amount of mucous produced. This is a common illness in children under the age of 2, although it may sometimes affect older people. Bronchiolitis can be more serious in infants and young children, because their airways are much narrower than in adults or older children.
What are the signs and symptoms of the disease? Signs and symptoms of bronchiolitis include:
After a few days, the symptoms may also include the following:
breathing faster than usual
wheezing, a high-pitched sound that occurs when a person breathes out through swollen airways
cyanosis, or bluish skin, caused by not getting enough oxygen into the bloodstream. This can happen when a child has a lot of trouble breathing
What are the causes and risks of the disease? The most common cause of bronchiolitis is a virus called respiratory syncytial virus, or RSV. Other viruses and certain types of bacterial infections can also cause bronchiolitis. Bronchiolitis can occur in a child when someone who has a cold or the flu spreads this virus to the child. Most cases of bronchiolitis occur in the winter and early spring. Most children with bronchiolitis have mild symptoms. However, about 5% of children with this illness have to be hospitalised. Whether this is necessary depends on:
how young the child is
how much trouble the child has breathing
whether the child is getting enough oxygen
whether the child is able to eat well enough during the illness
The majority of children with bronchiolitis do very well. They usually get over their symptoms in about 7 to 10 days.
What can be done to prevent the disease? It can be difficult to prevent bronchiolitis. It may help to keep a young child away from others who have a cold or flu. If someone in the household is coughing or sneezing, they should wash their hands frequently. Also, any person who handles children should wash their hands often.
Persons should cough, sneeze, or blow their noses into tissues and throw the tissues in the garbage. They should not cough or sneeze near others.
How is the disease diagnosed? A doctor usually takes a history of how symptoms started and then does a physical examination. Usually, the illness starts with 1 to 2 days of nasal congestion. Then breathing gradually becomes more difficult. The child may start to breathe more rapidly and may exhale more forcefully. The doctor will listen for wheezing and look for trouble breathing or rapid breathing. X-rays of the chest may be taken as well.
What are the long-term effects of the disease? Some children who have had an episode of bronchiolitis may be prone to further episodes of wheezing. This is especially true for children who needed to be hospitalised for a bout with bronchiolitis. These children may also develop allergy symptoms.
What are the risks to others? Viral and bacterial infections are contagious.
What are the treatments for the disease? Treatment for bronchiolitis consists of providing warm, moist air. Parents should check with the doctor about using a vaporiser or humidifier to moisten the air. A humidifier is a machine that moistens the air with a cool mist. A vaporiser is a machine that turns water into steam to moisten the air.
Young infants who have cyanosis, or bluish lips and nail beds, may need to be hospitalised. Infants who have had repeated attacks of bronchiolitis, or those who are breathing very rapidly and shallowly, may need to be hospitalised as well.
The medications used will depend on the cause and severity of the bronchiolitis.
Sometimes breathing treatments with a nebuliser are needed. Breathing treatments involve a machine that sprays out a light mist of medication through a mask. Children who are having an extremely hard time breathing may need a ventilator, or artificial breathing machine.
What are the side effects of the treatments? Side effects vary, depending on the treatment used.
Medications, such as antibiotics, can cause stomach upset and allergic reactions.
Vaporisers can cause burns.
A child may become jittery or have a rapid heart beat from the medications used with breathing treatments.
There may be more significant side effects if a child needs to be put on a ventilator.
What happens after treatment for the disease? After a child recovers from bronchiolitis, no further treatment is usually needed. However, this depends on how much trouble the child had breathing and what kind of treatment was given.
How is the disease monitored? A doctor may have a child return for several visits to make sure that the symptoms are improving. If a child needs to stay in the hospital, he or she will often have the level of oxygen in the blood checked frequently. Most children with bronchiolitis recover without much intervention.
Author: Eileen McLaughlin, RN, BSN Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
