Bronchiolitis

General Illness Information

Common Name:

BRONCHIOLITIS

Medical Term: None Specified

Description: Bronchiolitis is a contagious viral infection of the airways of infants and young children that causes difficulty in bresthing especially breathing out.

Bronchiolitis mainly affects children under 18 months of age and most commonly in infants younger than 6 months.

Often occurs in epidemics

Causes:

Inflammation of the small airways called bronchioles; usually caused by a viral infection, most commonly respiratory syncytial virus (RSV) and para-influenza virus. Some young children develop this disorder after every cold. Bronchiolitis is contagious and often becomes epidemic.

Prevention:

Use a cool-mist humidifier in the child’s room. Use it every night during and after a respiratory infection for a child who is subject to bronchiolitis. Observe and avoid any activities that seem to trigger attacks in the child, such as active play in cool night air. Decrease the child’s exposure to groups of people, especially other children, to avoid colds.

Signs & Symptoms

Sudden breathing difficulty, usually preceded by fever and a mild common cold and cough, and characterized by the following:

  • Wheezing.
  • Rapid, shallow breathing (60 to 80 times a minute).
  • Retractions (seesaw movements) of the chest and abdomen, and nasal flaring.
  • Fever (occasionally).
  • Blue discoloration of skin or nails (severe cases).
  • Risk Factors
  • Lowered resistance, especially respiratory infection.
  • Family history of allergies.
  • Day care environment.
  • Contact with an infected person.

Diagnosis & Treatment

General Measures:

  • Keep the humidity in the child’s room as high as possible, preferably with an ultrasonic cool-mist humidifier. Clean humidifier daily. If you don’t have a humidifier, run cold or hot water in the shower with windows and doors closed to produce a high-humidity room. Hold the child in this room for 20 minutes several times a day, especially at bedtime. If the child awakens at night with wheezing or shortness of breath, repeat the process.
  • Breathing cool outside air may help.
  • Hospitalization for intensive care and oxygen (severe cases). An oxygen tent or a facemask usually gives oxygen. A ventilator may be necessary to assist breathing. An ultrasonic nebulizer may be used to open up the airways and to loosen the secretions.

Medications:

  • Antibiotics to fight secondary bacterial infection.
  • Anti-viral medications, such as ribavirin, may help in severe cases.
  • Bronchodilators (drugs that widen the airways in the lungs) may be helpful.

Activity:

Have the child rest until symptoms have subsided for 48 hours. Then normal activities may be resumed gradually.

Diet:

Offer the child clear fluids frequently.

Possible Complications:

Rarely, permanent lung damage leading to chronic bronchitis, collapse of a small portion of the lung, bronchiectasis, repeated pneumonia, and rarely, obstructive pulmonary disease (COPD).

Prognosis

Usually curable in 7 days with treatment. However, infants who have 2 or more episodes of bronchilitis before age 2 are more likely to develop asthma.

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