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Bronchiolitis

Bronchiolitis is a common condition that occurs as a result of a respiratory infection that affects infants and young children most often because their airways are smaller and can become blocked more easily than older children or adults.  Bronchioles are tiny airways that lead to the lungs. Bronchiolitis occurs when these airways become inflamed and fill with mucus, making it difficult to breathe.

Typically, the condition occurs during a child’s first 2 years. It is more common in boys than girls, children who have not been breastfed, children that live in crowded conditions, children that attend day care, and children that are exposed to cigarette smoke.

Though it is commonly a mild illness, bronchiolitis can lead to more serious infections that require hospitalization. Conditions that affect the risk of serious include prematurity, weakened immune system, and prior heart or lung disease.

In many cases, bronchiolitis is caused by a viral infection, most commonly respiratory syncytial virus (RSV), but can also develop with other viruses, such as influenza and adenovirus.

Initial signs and symptoms of bronchiolitis include stuffiness, runny nose and mild cough. These symptoms often last for one or two days, after which the cough worsens and the child begins wheezing (making high-pitched whistling noises when breathing out).

More severe respiratory problems may gradually develop including:

 

rapid, shallow breathing

rapid heartbeat

drawing in of the neck and chest with each breath (retractions)

flaring of the nostrils

irritability with difficulty sleeping and signs of fatigue

fever

poor appetite

vomiting after cough

apnea (period of brief lapse in breathing) in young infants, especially those born prematurely

 

In severe cases, symptoms may worsen quickly. The germs that cause bronchiolitis are contagious and can spread through tiny droplets of fluid from an infected person’s nose and mouth.

Bronchiolitis normally lasts about 7 days, but severe cases may last for several weeks. Most cases are mild and don’t require professional treatment. Antibiotics are not used to treat bronchiolitis because it is caused by a viral infection, though a child may be prescribed something to open his or her airways. Infants that are having difficulty breathing should be seen by a doctor. Those that are moderately to severely ill may need to be hospitalized so that they can be watched closely and receive fluids and oxygen.

Most children do not require more than rest and fluids to recover from bronchiolitis. This may be difficult because infants with bronchiolitis may not feel like drinking, so they should be offered fluids in smaller amounts and more frequently.

Call your child’s doctor if your child:

has rapid breathing accompanied by retractions and/or wheezing

may be dehydrated due to poor appetite or vomiting (signs of dehydration in infants include diapers that are drier than usual and fatigue)

has a high fever

has a cough that continues to worsen

 

Seek immediate medical attention if your child is having difficulty breathing, the cough, retractions, and wheezing worsen or if his or her lips or fingernails appear blue.