Bronchiolitis

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Bronchiolitis

Topic Overview

What is bronchiolitis?

Bronchiolitis is an infection of the bronchioles, the small air passages in the lungs. It is common in young 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 laboured with wheezing.

A severe infection in infants may cause a noticeably increased breathing rate. For information on what to do if your child has trouble breathing, see the topic Respiratory Problems, Age 11 and Younger.

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

Symptoms of bronchiolitis may last up to 5 days. Most children get better in 1 to 2 weeks.

How is bronchiolitis diagnosed?

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

How is it treated?

Home treatment to manage the symptoms of bronchiolitis is usually all that is needed. Have your child drink plenty of liquids to avoid dehydration. If your baby has a stuffy nose, use a suction bulb to remove mucus. Fever medicine (such as acetaminophen or ibuprofen) may help reduce fever discomfort. Do not give ASA to anyone younger than 20 because of the risk of Reye syndrome, a serious illness. Over-the-counter cough and cold medicines are not recommended.

The doctor may suggest bronchodilator medicine if your child has shown the tendency to have allergic reactions (atopy). In severe cases, your child may need to stay in the hospital or get extra oxygen.

How can I prevent bronchiolitis?

It is common for children to get 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 daycare until he or she gets better.
  • Wash your hands often to prevent spreading the disease. Handwashing removes the germs on your hands and helps stop 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. Second-hand 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 was born early (prematurely), has heart or lung disease, or has other conditions that make it more likely to have problems from RSV, ask the doctor if palivizumab (Synagis) might help. This medicine helps prevent bronchiolitis and other problems from RSV in children most likely to have problems (susceptible). It is injected once a month during RSV season—late fall to early spring.

Other Places To Get Help

Organizations

American Lung Association
1301 Pennsylvania Avenue NW
Suite 800
Washington, DC  20004
Phone: 1-800-LUNG-USA (1-800-586-4872)
1-800-548-8252 (to speak with a lung professional)
(212) 315-8700
Email: info@lungusa.org
Web Address: www.lungusa.org
 

The American Lung Association provides programs of education, community service, and advocacy. Some of the topics available include asthma, tobacco control, emphysema, infectious disease, asbestos, carbon monoxide, radon, and ozone.


Canadian Paediatric Society
2305 Saint Laurent Boulevard
Ottawa, ON  K1G 4J8
Phone: (613) 526-9397
Fax: (613) 526-3332
Email: info@cps.ca
Web Address: www.cps.ca
 

The Canadian Paediatric Society (CPS) promotes quality health care for Canadian children and establishes guidelines for paediatric care. The organization offers educational materials on a variety of topics, including information on immunizations, pregnancy, safety issues, and teen health.


Canadian Paediatric Society
2305 Saint Laurent Blvd.
Ottawa, Ontario K1G 4J8
Canada
Phone: Phone: 613-526-9397
Fax: Fax: 613-526-3322
Email: info@cps.ca
Web Address: www.caringforkids.cps.ca
 

Caring for Kids is produced by the Canadian Paediatric Society, a national association that advocates for the health needs of children and youth


KidsHealth for Parents, Children, and Teens
4600 Touchton Road East, Building 200
Suite 500
Jacksonville, FL  32246
Phone: (904) 232-4100
Fax: (904) 232-4125
Web Address: www.kidshealth.org
 

This Web site is sponsored by Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This Web site offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly e-mails about your area of interest.


References

Other Works Consulted

  • Gadomski AM, Bhasale AL (2006). Bronchodilators for bronchiolitis. Cochrane Database of Systematic Reviews (3).
  • Hall CB, McBride JT (2010). Bronchiolitis. In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed., vol. 1, pp. 885–889. Philadelphia: Churchill Livingstone Elsevier.
  • Hayden FG and Ison MG (2006). Respiratory viral infections. In DC Dale, DD Federman, eds., ACP Medicine, section 7, chap. 25. New York: WebMD.
  • Infectious Diseases and Immunizations Committee, Canadian Paediatric Society (2009). Prevention of respiratory syncytial virus infection. Paediatrics and Child Health, 14(8): 521–526.
  • Kerby GS, et al. (2009). Bronchiolitis section of Respiratory tract and mediastinum. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 19th ed., pp. 484–485. New York: McGraw-Hill.
  • Lozano JM (2007). Bronchiolitis, search date October 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
  • Seiden JA (2009). Bronchiolitis: An evidence-based approach to management. Clinical Pediatric Emergency Medicine, 10(2): 75–81.
  • Subcommittee on Diagnosis and Management of Bronchiolitis, American Academy of Pediatrics (2006). Diagnosis and management of bronchiolitis. Pediatrics, 118(4): 1774–1793.
  • Welliver RC (2009). Bronchiolitis and infectious asthma. In RD Feigin et al., eds., Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed., vol. 1, pp. 277–288. Philadelphia: Saunders Elsevier.
  • Zore JJ, Hall CB (2010). Bronchiolitis: Recent evidence on diagnosis and management. Pediatrics, 125(2): 342–349.

Credits

By Healthwise Staff
Primary Medical Reviewer John Pope, MD - Pediatrics
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
Last Revised September 3, 2010

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