Bronchiolitis

Topic Overview

What is bronchiolitis?

Bronchiolitis is an infection of the bronchioles , the small air passages in the lungs. It is common in children and is the leading cause of serious lower respiratory illness in infants.

What causes bronchiolitis?

Bronchiolitis is usually caused by a virus, especially respiratory syncytial virus (RSV), and frequently occurs in the late fall to early spring.

What are the symptoms?

Symptoms of bronchiolitis include runny nose, cough, and fever. After a few days, your child may experience shortness of breath and/or breathing that is rapid and labored with wheezing.

A severe infection in infants may cause a noticeably increased breathing rate. Seek immediate medical attention if your infant develops difficulty breathing.

If your child has heart disease or was born prematurely, call your doctor at the first sign of bronchiolitis.

Symptoms of bronchiolitis may last 3 to 4 days. Most children recover within a week.

How is bronchiolitis diagnosed?

A health professional may diagnose bronchiolitis based on a medical history, your child's symptoms, and a physical exam. Testing is usually not needed if your health professional suspects the bronchiolitis is caused by RSV.

How is it treated?

Home treatment to manage the symptoms of bronchiolitis is usually all that is necessary. Have your child drink plenty of liquids to avoid dehydration. If your child has a fever, acetaminophen (such as Tylenol) may help. Do not give aspirin to anyone younger than 20 because of the risk of Reye's syndrome, a serious illness.

Call a doctor if:

• Your child is vomiting and can't keep liquids down.
• Your child is breathing rapidly.
• You can see your child's skin pull in between the ribs (retractions) when breathing. This is a sign that your child is having difficulty breathing.

In severe cases, your doctor may suggest hospitalization and supplemental oxygen.

How can I prevent bronchiolitis?

It is common for children to develop respiratory problems (such as bronchiolitis caused by a viral infection) because they are often exposed to people who have infections to which they have not built up immunity. Bronchiolitis is spread just like a cold. To prevent bronchiolitis:

• Avoid contact with other children who have bronchiolitis or upper respiratory infections. If there is an ill child in the home, separate him or her from other children, if possible. Put the child in a room alone to sleep. If your child has bronchiolitis, keep him or her home from school or day care until he or she gets better.
• Wash your hands regularly to prevent spreading the disease. Hand-washing eliminates the germs on your hands and the spread of germs to your child when you touch your child or touch an object he or she might touch.
• Do not smoke or use other tobacco products around your child. Secondhand smoke irritates the mucous membranes in your child's nose, sinuses, and lungs and increases his or her risk for respiratory infections.

If your child is at risk of developing RSV, talk to your health professional about whether your child should receive injections of palivizumab (Synagis). This medication helps prevent bronchiolitis and other complications of RSV. It is injected once a month during RSV season—late fall to early spring.

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Author:	Debby Golonka, MPH	Last Updated August 9, 2006
Medical Review:	Michael J. Sexton, MD - Pediatrics
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