Bronchiolitis (patient information): Difference between revisions
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==Overview== | ==Overview== | ||
[[Bronchiolitis]] is swelling and mucus buildup in the smallest air passages in the [[lungs]] ([[bronchioles]]), usually due to a viral infection. | [[Bronchiolitis]] is swelling and mucus buildup in the smallest air passages in the [[lungs]] ([[bronchioles]]), usually due to a [[viral infection]]. | ||
==What are the symptoms of Bronchiolitis?== | ==What are the symptoms of Bronchiolitis?== | ||
Some children have infections with few or minor symptoms. | Some children have [[infections]] with few or minor symptoms. | ||
Bronchiolitis begins as a mild [[upper respiratory infection]]. Over a period of 2 - 3 days, it can develop into increasing respiratory distress with wheezing and a "tight" wheezy [[cough]]. | [[Bronchiolitis]] begins as a mild [[upper respiratory infection]]. Over a period of 2 - 3 days, it can develop into increasing [[respiratory distress]] with [[wheezing]] and a "tight" wheezy [[cough]]. | ||
The infant's breathing rate may increase ([[tachypnea]]), and the infant may become irritable or anxious-looking. If the disease is severe enough, the infant may turn bluish ([[cyanosis|cyanotic]]), which is an emergency. | The infant's [[breathing rate]] may increase ([[tachypnea]]), and the infant may become [[irritable]] or anxious-looking. If the [[disease]] is severe enough, the infant may turn bluish ([[cyanosis|cyanotic]]), which is an emergency. | ||
As the effort of breathing increases, parents may see the child's nostrils flaring with each breath and the muscles between the ribs retracting (intercostal retractions) as the child tries to breathe in air. This can be exhausting for the child, and very young infants may become so tired that they have difficulty maintaining breathing. | As the effort of breathing increases, parents may see the child's nostrils flaring with each breath and the muscles between the ribs retracting ([[Intercostal muscles|intercostal retractions]]) as the child tries to breathe in air. This can be exhausting for the child, and very young infants may become so tired that they have difficulty maintaining breathing. | ||
Symptoms include: | Symptoms include: | ||
*Bluish skin due to lack of [[oxygen]] ([[cyanosis]]) | *Bluish skin due to lack of [[oxygen]] ([[cyanosis]]) | ||
*Cough, [[wheezing]], [[shortness of breath]], or [[difficulty breathing]] | *[[Cough]], [[wheezing]], [[shortness of breath]], or [[difficulty breathing]] | ||
*[[Fever]] | *[[Fever]] | ||
*Intercostal retractions | *[[Intercostal muscles|Intercostal retractions]] | ||
*[[Nasal flaring]] in infants | *[[Nasal flaring]] in [[infants]] | ||
*Rapid breathing (tachypnea) | *Rapid breathing ([[tachypnea]]) | ||
==What causes Bronchiolitis?== | ==What causes Bronchiolitis?== | ||
Bronchiolitis usually affects children under the age of 2, with a peak age of 3 - 6 months. It is a common, and sometimes severe illness. [[Respiratory syncytial virus]] ([[RSV]]) is the most common cause. Other viruses that can cause bronchiolitis include: | [[Bronchiolitis]] usually affects children under the age of 2, with a peak age of 3 - 6 months. It is a common, and sometimes severe illness. [[Respiratory syncytial virus]] ([[RSV]]) is the most common cause. Other [[viruses]] that can cause [[bronchiolitis]] include: | ||
* [[Adenovirus]] | * [[Adenovirus]] | ||
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* [[Parainfluenza]] | * [[Parainfluenza]] | ||
The virus is transmitted from person to person by direct contact with nasal fluids, or by airborne droplets. Although RSV generally causes only mild symptoms in an adult, it can cause severe illness in an infant. | The [[virus]] is transmitted from person to person by direct contact with nasal fluids, or by airborne droplets. Although [[RSV]] generally causes only mild symptoms in an adult, it can cause severe illness in an infant. | ||
Bronchiolitis is seasonal and appears more often in the fall and winter months. It is a very common reason for infants to be hospitalized during winter and early spring. It is estimated that by their first year, more than half of all infants have been exposed to RSV. | [[Bronchiolitis]] is seasonal and appears more often in the fall and winter months. It is a very common reason for infants to be hospitalized during winter and early spring. It is estimated that by their first year, more than half of all infants have been exposed to [[RSV]]. | ||
Risk factors include: | Risk factors include: | ||
* Exposure to cigarette smoke | * Exposure to [[cigarette smoke]] | ||
* Age younger than 6 months old | * Age younger than 6 months old | ||
* Living in crowded conditions | * Living in crowded conditions | ||
* Lack of breast-feeding | * Lack of [[breast-feeding]] | ||
* Prematurity (being born before 37 weeks gestation) | * [[Prematurity]] (being born before 37 weeks [[gestation]]) | ||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
Call your health care provider immediately, or go to the emergency room if the child with bronchiolitis: | Call your health care provider immediately, or go to the emergency room if the child with [[bronchiolitis]]: | ||
* Becomes lethargic | * Becomes [[lethargic]] | ||
* Develops a bluish color in the skin, nails, or lips | * Develops a [[Cyanosis|bluish]] color in the [[skin]], [[Nail beds|nails]], or [[lips]] | ||
* Develops rapid, shallow breathing | * Develops rapid, shallow breathing | ||
* Has a cold that suddenly worsens | * Has a cold that suddenly worsens | ||
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==Diagnosis== | ==Diagnosis== | ||
Signs include: | Signs include: | ||
* Decreased blood oxygen | * Decreased [[Blood oxygen level|blood oxygen]] | ||
* Wheezing and crackling sounds heard through stethoscope exam of chest | * [[Wheezing]] and [[Crackles|crackling sounds]] heard through [[stethoscope]] exam of chest | ||
Tests include: | Tests include: | ||
* Blood gases | * [[Arterial blood gas|Blood gases]] | ||
* Chest x-ray | * [[Chest X-ray|Chest x-ray]] | ||
* Nasal fluid cultures (to determine which virus is present) | * Nasal fluid cultures (to determine which [[virus]] is present) | ||
==Treatment options== | ==Treatment options== | ||
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* Chest clapping | * Chest clapping | ||
* Drinking enough fluids. Breast milk or formula are okay for children younger than 12 months. Offer warm lemonade or apple juice if your child is over 4 months. | * Drinking enough fluids. [[Breast milk]] or [[formula]] are okay for children younger than 12 months. Offer warm lemonade or apple juice if your child is over 4 months. | ||
* Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a humidifier to moisten the air your child is breathing. Follow the directions that come with the humidifier. | * Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a [[Humidifier Lung|humidifier]] to moisten the air your child is breathing. Follow the directions that come with the [[Humidifier Lung|humidifier]]. | ||
* Getting plenty of rest | * Getting plenty of rest | ||
* Do not let anyone smoke in the house, car, or anywhere near your child. | * Do not let anyone [[smoke]] in the house, car, or anywhere near your child. | ||
Antibiotics are not effective against viral infections. Most medications have little effect on bronchiolitis. Children in the hospital may need oxygen therapy and fluids given through a vein (IV) to stay hydrated. | [[Antibiotics]] are not effective against [[viral]] [[infections]]. Most [[medications]] have little effect on [[bronchiolitis]]. Children in the hospital may need oxygen therapy and fluids given through a vein (IV) to stay hydrated. | ||
In extremely ill children, antiviral medications (such as [[ribavirin]]) are used in rare cases. | In extremely ill children, antiviral medications (such as [[ribavirin]]) are used in rare cases. | ||
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* Airway disease, including [[asthma]], later in life | * Airway disease, including [[asthma]], later in life | ||
* [[Respiratory failure]] | * [[Respiratory failure]] | ||
* Additional infection, such as [[pneumonia]] | * Additional [[infection]], such as [[pneumonia]] | ||
==Prevention== | ==Prevention== | ||
Most cases of bronchiolitis are not easily preventable because the viruses that cause the disorder are common in the environment. Careful attention to hand washing, especially around infants, can help prevent the spread of respiratory viruses. | Most cases of [[bronchiolitis]] are not easily preventable because the [[viruses]] that cause the disorder are common in the environment. Careful attention to hand washing, especially around infants, can help prevent the spread of respiratory [[viruses]]. | ||
Family members with an upper respiratory infection should be especially careful around infants. Wash your hands often, especially before handling the child. | Family members with an [[upper respiratory infection]] should be especially careful around infants. Wash your hands often, especially before handling the child. | ||
At this date, there is no RSV vaccine available. However, there is an effective product, called [[palivizumab]] (Synagis), for infants who are at high risk of developing severe disease from RSV. Ask your child's doctor whether this medication is right for your child. | At this date, there is no [[RSV]] vaccine available. However, there is an effective product, called [[palivizumab]] (Synagis), for infants who are at high risk of developing severe disease from RSV. Ask your child's doctor whether this medication is right for your child. | ||
==Sources== | ==Sources== | ||
http://www.nlm.nih.gov/medlineplus/ency/article/000975.htm | http://www.nlm.nih.gov/medlineplus/ency/article/000975.htm | ||
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[[Category:Patient information]] | [[Category:Patient information]] | ||
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[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Emergency medicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
Latest revision as of 20:43, 29 July 2020
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Bronchiolitis |
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Bronchiolitis On the Web |
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For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles), usually due to a viral infection.
What are the symptoms of Bronchiolitis?
Some children have infections with few or minor symptoms.
Bronchiolitis begins as a mild upper respiratory infection. Over a period of 2 - 3 days, it can develop into increasing respiratory distress with wheezing and a "tight" wheezy cough.
The infant's breathing rate may increase (tachypnea), and the infant may become irritable or anxious-looking. If the disease is severe enough, the infant may turn bluish (cyanotic), which is an emergency.
As the effort of breathing increases, parents may see the child's nostrils flaring with each breath and the muscles between the ribs retracting (intercostal retractions) as the child tries to breathe in air. This can be exhausting for the child, and very young infants may become so tired that they have difficulty maintaining breathing.
Symptoms include:
- Bluish skin due to lack of oxygen (cyanosis)
- Cough, wheezing, shortness of breath, or difficulty breathing
- Fever
- Intercostal retractions
- Nasal flaring in infants
- Rapid breathing (tachypnea)
What causes Bronchiolitis?
Bronchiolitis usually affects children under the age of 2, with a peak age of 3 - 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. Other viruses that can cause bronchiolitis include:
The virus is transmitted from person to person by direct contact with nasal fluids, or by airborne droplets. Although RSV generally causes only mild symptoms in an adult, it can cause severe illness in an infant.
Bronchiolitis is seasonal and appears more often in the fall and winter months. It is a very common reason for infants to be hospitalized during winter and early spring. It is estimated that by their first year, more than half of all infants have been exposed to RSV.
Risk factors include:
- Exposure to cigarette smoke
- Age younger than 6 months old
- Living in crowded conditions
- Lack of breast-feeding
- Prematurity (being born before 37 weeks gestation)
When to seek urgent medical care?
Call your health care provider immediately, or go to the emergency room if the child with bronchiolitis:
- Becomes lethargic
- Develops a bluish color in the skin, nails, or lips
- Develops rapid, shallow breathing
- Has a cold that suddenly worsens
- Has difficulty breathing
- Flares nostrils or retracts chest muscles in an effort to breathe
Diagnosis
Signs include:
- Decreased blood oxygen
- Wheezing and crackling sounds heard through stethoscope exam of chest
Tests include:
- Blood gases
- Chest x-ray
- Nasal fluid cultures (to determine which virus is present)
Treatment options
Sometimes, no treatment is necessary.
Supportive therapy can include:
- Chest clapping
- Drinking enough fluids. Breast milk or formula are okay for children younger than 12 months. Offer warm lemonade or apple juice if your child is over 4 months.
- Breathing moist (wet) air helps loosen the sticky mucus that may be choking your child. You can use a humidifier to moisten the air your child is breathing. Follow the directions that come with the humidifier.
- Getting plenty of rest
- Do not let anyone smoke in the house, car, or anywhere near your child.
Antibiotics are not effective against viral infections. Most medications have little effect on bronchiolitis. Children in the hospital may need oxygen therapy and fluids given through a vein (IV) to stay hydrated.
In extremely ill children, antiviral medications (such as ribavirin) are used in rare cases.
Where to find medical care for Bronchiolitis?
Directions to Hospitals Treating Bronchiolitis
What to expect (Outlook/Prognosis)?
Usually, the symptoms get better within a week, and breathing difficulty usually improves by the third day. The mortality rate is less than 1%.
Possible complications
- Airway disease, including asthma, later in life
- Respiratory failure
- Additional infection, such as pneumonia
Prevention
Most cases of bronchiolitis are not easily preventable because the viruses that cause the disorder are common in the environment. Careful attention to hand washing, especially around infants, can help prevent the spread of respiratory viruses.
Family members with an upper respiratory infection should be especially careful around infants. Wash your hands often, especially before handling the child.
At this date, there is no RSV vaccine available. However, there is an effective product, called palivizumab (Synagis), for infants who are at high risk of developing severe disease from RSV. Ask your child's doctor whether this medication is right for your child.