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Bronchiolitis

Pronounced: Bronk-ee-oh-LIE-tus

Definition

Bronchiolitis is a viral infection of the lungs most common in young children. It causes the small airways of the lungs (bronchioles) to swell. This makes breathing difficult.

Causes

Bronchiolitis is caused by one of several of viruses that spread from person to person, such as respiratory syncytial virus (RSV) and influenza.

Risk Factors

Bronchiolitis is most common in premature babies and children under 2 years old. It is also more common in the winter. Other things that may raise the risk are:

  • Child care attendance or older siblings that attend childcare or schools
  • Exposure to environmental pollution including secondhand smoke
  • Congenital abnormalities of the heart or lungs
  • Cardiopulmonary disease
  • Weak immune systems
  • Severe neuromuscular disease

Symptoms

The first symptoms will be the same as a common cold. This may include stuffy or runny nose, cough, and mild fever. After a few days, the cough will worsen and breathing will be faster.

Symptoms may be:

  • Rapid breathing
  • Wheezing or crackling noises when breathing out
  • Changes in breathing patterns, such as using the belly muscles to help move air, widening nostrils, or grunting while breathing
  • Periods of no breathing
  • A chest that sinks in between the ribs or under the ribcage with each breath
  • Poor feeding
  • Blue skin color around lips or fingertips
  • Fever

Diagnosis

You will be asked about your child's symptoms and health history. A physical exam will be done. The doctor will be able to diagnose bronchiolitis based on this information.

Treatment

Viral infections cannot be cured with medicine. The virus often goes away in 2 to 3 weeks.

The goal of treatment is supportive care while the child heals. This may include:

  • Acetaminophen to lower a fever
  • Suctioning any fluids blocking the airway
  • Oxygen therapy
  • Nutrition therapy with an IV or a feeding tube

Prevention

Babies who are at high risk for bronchiolitis by RSV may be given medicine to lessen the risk.

Viruses cannot always be prevented. They are common and spread easily. To lower the risk:

  • Avoid contact with people who are sick.
  • Practice good hand hygiene.
  • Avoid exposure to secondhand smoke.
  • Babies over 6 months old should get the influenza vaccine.
  • Breastfeed for the first 6 months of life when possible.
RESOURCES:

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

Kids Health—Nemours Foundation
http://kidshealth.org

CANADIAN RESOURCES:

Caring for Kids—The Canadian Paediatric Society
http://www.caringforkids.cps.ca

The Lung Association
http://www.lung.ca

REFERENCES:

Bronchiolitis. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Bronchiolitis.aspx. Updated September 24, 2019. Accessed January 8, 2020, 2015.

Bronchiolitis. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/bronchiolitis. Updated September 24, 2019. Accessed January 8, 2020.

Friedman JN, Rieder MJ, et al. Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age. Paediatr Child Health. 2014 Nov;19(9):485-498.

Treating bronchiolitis in infants. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/chest-lungs/pages/Treating-Bronchiolitis-in-Infants.aspx. Updated November 21, 2015. Accessed January 8, 2020.

6/8/2015 DynaMed Systematic Literature Surveillancehttps://www.dynamed.com/condition/bronchiolitis: National Institute for Health and Care Excellence. Bronchiolitis in children. Available at: http://www.nice.org.uk/guidance/NG9/informationforpublic. Accessed January 8, 2020.

Last reviewed September 2019 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 8/5/2020