Bronchiolitis in Children

Bronchiolitis is a lower respiratory tract infection in infants. It is caused by virus and results in inflammatory obstruction of the small airways of the lower respiratory tract. Bronchiolitis develops in children younger than 2 years old. The peak incidence is approximately 6 months of age. A virus, usually respiratory syncytial virus invades the bronchioles causing obstruction from mucus, cellular debris, and edema. Other viruses that   may cause bronchiolitis in infants include para influenza type 3 virus, mycoplasma and adeno virus. 

Respiratory syncytial virus (RSV) is transmitted through droplets that contain viral particles when coughing, sneezing or breathing. Adults infected with RSV can easily transmit the virus to the child. If an RSV infected person uses hands to touch a child's eye, nose, or mouth the virus spreads and infect the child. A child with bronchiolitis should be kept away from other infants and individuals susceptible to severe respiratory infection until the wheezing and fever subsides.  Infants with mothers who smoke cigarettes are at risk for contracting bronchiolitis. The symptoms include upper respiratory tract infections, runny nose (rhinorrhea), sneezing, wheezy cough and difficulty breathing.

The fever develops and gradually respiratory distress is evidenced by rapid breathing (usually 60-80breaths/min), wheezing (a whistling sound heard when the children breaths out) and cough. The rate of breathing makes it difficult to feed the children. The child seems restless and irritable because of less air. In more severe cases rapid breathing, wheezing, crackles, chest retractions and cyanosis are seen. Usually the mild cases resolve in 1-3 days while severe the course lengthens.

Virus may be detected in nasopharyngeal secretion. Treatment is based on the level of severity. In case of uncomplicated cases treatment is symptomatic. Treatment includes the use of fluids, antipyretic and humidified air or oxygen. A bronchodilator may be administered to relieve wheezing, this might be continued if a response is obtained. Antibiotics are not helpful unless there is a secondary bacterial infection. Corticosteriods are harmful for infants thus, is not indicated.