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Bronchiolitis

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GENERAL INFORMATION

DESCRIPTION
Bronchiolitis is inflammation of the bronchioles, the smallest branches of the respiratory tree. These carry air from the large bronchial tubes to microscopic air sacs in the lungs. The air sacs transfer oxygen to the bloodstream. Bronchiolitis can affect children of both sexes, usually under age 6.

Appropriate health care includes:

  • Self-care after diagnosis.
  • Physician’s monitoring of general condition and medications.
  • Hospitalization for intensive care and oxygen (severe cases).

SIGNS & SYMPTOMS

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

  • Wheezing.
  • Rapid, shallow breathing (60 to 80 times a minute).
  • Retractions (see-saw movements) of the chest and abdomen.
  • Fever.
  • Blue skin or nails (severe cases).

CAUSES

Viral or bacterial infection, or a combination of the two. Some young children develop this disorder after every cold. Bronchiolitis is contagious and often becomes epidemic.

RISK FACTORS

  • Illness that has lowered resistance, especially respiratory infection.
  • Family history of allergies.
  • Obesity in infancy.

PREVENTING COMPLICATIONS OR RECURRENCE

  • 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 the cool night air.
  • Decrease the child’s exposure to groups of people, especially other children, to avoid colds.

BASIC INFORMATION

MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory blood studies.
  • X-rays of the lungs.

POSSIBLE COMPLICATIONS

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

PROBABLE OUTCOME

Usually curable in 7 days with treatment. Some studies indicate that infants who have 2 or more episodes of bronchiolitis before age 2 are more likely to develop allergies and asthma.

TREATMENT

HOME CARE

Keep the humidity in the child’s room as high as possible, preferably with a cool-mist humidifier. 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.

MEDICATION

Your doctor may prescribe antibiotics to fight bacterial infections.

ACTIVITY

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

DIET & FLUIDS

Offer the child clear fluids frequently. Give water, tea, carbonated drinks, lemonade, weak bouillon, diluted fruit juice, or gelatin. Don’t offer milk; it may thicken mucus secretions.

OK TO GO TO SCHOOL?

When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.

CALL YOUR DOCTOR IF

  • Symptoms don’t improve in 4 hours, despite treatment.
  • Temperature (rectal) rises to 101F (38.3C) or higher.
  • Breathing becomes more difficult.
  • A cough begins that produces colored phlegm.
  • The skin, lips, or nails turn dark blue.
  • The child becomes lethargic.

From the Complete Guide to Pediatric Symptoms, Illness & Medications by H. Winter Griffith, M.D. © 1989 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange.

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