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Bronchiolitis

Posted on: 02/17/2010

BRONCHIOLITIS
Nicole Mackey, PNP

 
    Bronchiolitis is a common illness of the respiratory tract caused by a viral infection that affects the tiny airways (bronchioles) that lead to the lungs.  These airways can swell and fill with mucus, causing cold-like symptoms in infants and children younger than two years of age. In most cases, they tolerate these symptoms just fine and only home care is needed.
   More than half of the cases of bronchiolitis are caused by respiratory synctical virus (RSV).  The most common time to see this virus is between November and March.  Premature infants and/or infants with underlying medical conditions are more likely to have a harder time with bronchiolitis. Infants that attend daycare are at a greater risk to get the virus due to close proximity of other children.
   Almost all children will get a RSV infection by the time they are three years old.  The majority of them develop a runny nose, cough and fever.  Only a small number go on to develop bronchiolitis.
 
Signs and symptoms of bronchiolitis
Increased respiratory rate without a fever (breathing fast)
Retractions (drawing in of the neck and chest)
Nasal flaring
Wheezing (high pitched musical sound when breathing out)
Inability to take bottle due to increased work at breathing
 
If your infant or young child exhibits the above symptoms, please call the office for an appointment.
 
    There are no medications or antibiotics that treat bronchiolitis.  Supportive treatment, including infant Tylenol, vaporizer and raising the head of the bed will help with symptoms.  If, on exam, your child is wheezing, we may try a nebulizer treatment with a bronchodialator to see if that opens up his/her small airways. If it does help, we may have you do them at home for a few days. If it does not help, but infant is comfortable and not in distress, we will send you home with a plan for supportive treatment and when to follow up.  If your infant has increased work at breathing, to the point where they cannot suck, feed and breathe, they may need to go to the hospital for fluids or supplemental oxygen.  Again, since this is a virus, no antibiotics will help. 
    There are steps that you can take to prevent RSV and other viruses.  These include: good handwashing by all, keeping baby away from sick contacts and crowded places, no exposure to tobacco smoke, and being immunized against influenza beginning at six months of age. 
    The cough and cold symptoms related to bronchiolitis typically last 10-14 days with a peak in symptoms around day three. Wheezing and cough can last anywhere from 3-6 weeks. If child begins to have difficulty breathing or is having recurrent fevers, he/she should be seen in the office.