Bronchiolitis is an infection of the lower respiratory tract that usually affects infants. There is swelling in the smaller airways or bronchioles of the lung, which causes obstruction of air in the smaller airways.
The most common cause of bronchiolitis is a virus, most frequently the respiratory syncytial virus (RSV). However, many other viruses have been involved, including:
Some bacteria can also cause bronchiolitis. These include:
Initially, the virus causes an infection in the upper respiratory tract, and then spreads downward into the lower tract. The virus causes inflammation and even death of the cells inside the respiratory tract. This leads to obstruction of airflow in and out of the child's lungs.
The following are the most common symptoms of bronchiolitis. However, each child may experience symptoms differently. Symptoms may include:
The symptoms of bronchiolitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
Bronchiolitis is usually diagnosed solely on the history and physical examination of the child. Many tests may be ordered to rule out other diseases, such as pneumonia or asthma. In addition, the following tests may be ordered to help confirm the diagnosis:
Specific treatment for bronchiolitis will be determined by your child's physician based on:
Most cases are mild and can be treated at home. Because there is no cure for the disease, the goal of treatment is supportive of the symptoms. Antibiotics are ineffective in the treatment of bronchiolitis. Some infants, if they are having severe breathing problems, may be treated in the hospital. While in the hospital, treatment may include:
If your child's physician feels your child is stable enough to be treated at home, the following treatment may be recommended:
Note: It is also important for parents to elevate the child's head while sleeping.
An injection may be given to help decrease the chances of getting respiratory syncytial virus (RSV), which is the most common cause of bronchiolitis in children under 5 years of age. The medication is called either Palivizumab (Synagis), or respiratory syncytial immune globulin (RSV-IGIV). Specific recommendations regarding who should receive this vaccine are made by the American Academy of Pediatrics (AAP), and can be discussed with your child's physician. These vaccines are recommended only for high-risk infants, including premature infants (age at birth less than 35 weeks) and infants with chronic lung disease.