What is Bronchiolitis?

Bronchiolitis is an infection of the small breathing tubes (bronchioles) of the lungs. The bronchioles become swollen and narrowed. This causes coughing and wheezing, and may lead to difficulty breathing. Bronchiolitis is often confused with bronchitis, which is an infection of the larger, more central airways. Bronchiolitis is most common in infants but can also be seen in toddlers (generally under 2 years of age). Bronchiolitis is caused by a virus. Respiratory syncytial virus (RSV) is a common cause of bronchiolitis during the winter months, however several other respiratory viruses can cause bronchiolitis as well. These viruses are spread by contact with an infected person’s mucus or saliva. This can occur when others cough or sneeze at close proximity, or by hand- to-nose or hand-to-eye contact. Viruses often spread through families, daycare centers and hospitals. Limiting contact with other individuals and good handwashing can help prevent infection. Even so, by 2 years of age over 90% of children have been exposed to the viruses that cause bronchiolitis, including RSV.

Signs and Symptoms

Most adults and many children who are infected with RSV or other respiratory viruses get a cold. Younger children have smaller airways and are therefore more likely to develop bronchiolitis. The illness begins with cold symptoms such as a runny nose, cough, and fever. Within the first few days the cough becomes worse. There may be wheezing (a high-pitched whistling sound noted when breathing out), rapid breathing, or other signs of difficulty breathing. These signs may include retractions (tugging in between the ribs), a grunting noise when breathing out, flaring (widening) of the nostrils, or poor color of the lips and fingertips (very pale or blue). Babies will often drink less than normal. Most children begin to improve within 5-7 days of becoming ill but continue to cough for 2 weeks or more.

Treatment

Medications are usually not helpful in treating bronchiolitis. In some cases, inhaled medications may be tried with moderately ill children. Antibiotics are not effective since bronchiolitis is caused by a virus. Home therapy to ease the symptoms may provide some relief. This includes using saline nose drops for congestion, clearing mucus from the nose with a suction bulb, running a cool mist vaporizer/humidifier in the child’s room, taking the child into a steamy bathroom/shower, keeping the child in an upright position as much as possible, and encouraging fluids. Tylenol (acetaminophen) or ibuprofen may be given for fever or discomfort. Cough and cold medications should not be used. They are not helpful and have many side effects in young children.

When to Contact Us

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