Bronchiolitis: Symptoms, Diagnosis, and Treatment

What is Bronchiolitis Disease?

Bronchiolitis is a contagious viral infection predominantly affecting children under 2. It targets the bronchiolar airways, the small pathways in the lungs, causing them to narrow and making breathing difficult. This condition, often caused by various bronchiolitis viruses, is seasonal, occurring mostly in the winter and early spring.

What is the Difference Between Bronchiolitis and Bronchitis? 

While both bronchiolitis and bronchitis affect the respiratory system, they differ significantly in their specific targets, typical patient demographics, and causes. The differences are highlighted below:

What are the Signs and Symptoms of Bronchiolitis?

Early signs and symptoms of the bronchiolitis virus can be similar to those of the common cold, such as:

• Runny nose
• A slight fever (below 101 degrees Fahrenheit or 38 degrees Celsius)
• Cough
• Fatigue
• Fussiness or irritability in infants

As bronchiolitis progresses and affects the child's airways, it may lead to breathing-related symptoms like:

• Rapid or shallow breathing
• Wheezing
• Grunting noises during breathing
• Nostril flaring

In cases of severe bronchiolitis, it's crucial to seek immediate medical attention if the child experiences:

• Difficulty sucking or swallowing (inability to feed).
• Nostril flaring during breathing.
• Chest retractions (skin pulling tightly against the rib cage, making the chest appear to pull inward).
• The bluish, grey, or pale skin tone on the lips, fingers, or toes (cyanosis).
• Dry mouth, lack of urination, or crying without producing tears (signs of dehydration).

What Causes Bronchiolitis?

Bronchiolitis is an infection primarily caused by viruses, with several culprits that can lead to its development. These viruses include:

Respiratory Syncytial Virus (RSV)

RSV is a common respiratory virus that can affect people of all ages. In infants and young children, it is a leading cause of bronchiolitis.

Influenza (Flu) virus

The influenza virus, known for causing seasonal flu, is another potential trigger for bronchiolitis. Awareness of the symptoms and seeking prompt medical attention is essential, especially during flu season.

Adenovirus

Adenoviruses are a diverse group of viruses that can cause respiratory illnesses, including bronchiolitis. Understanding these viruses is crucial for effective prevention and management.

Parainfluenza

Parainfluenza viruses contribute to various respiratory infections and are recognized as one of the factors leading to bronchiolitis in some instances.

Metapneumovirus

Metapneumovirus is associated with respiratory tract infections and can be a significant player in the development of bronchiolitis, particularly in young children.

SARS-CoV-2 (COVID-19 Virus)

The infamous virus responsible for the COVID-19 pandemic, SARS-CoV-2, can also manifest as bronchiolitis. It is crucial to stay informed about the evolving understanding of the virus's impact on respiratory health.

What are the Risk Factors for Bronchiolitis? 

The key risk factors for bronchiolitis are:

• Premature birth: Infants born prematurely, especially those born more than ten weeks early, have a higher risk due to less developed lungs and immune systems.
• Congenital heart or lung disease: Babies with heart or lung conditions present at birth are at increased risk.
• Weakened immune system: Infants with compromised immune systems are more susceptible, whether due to a medical condition or medical treatment.
• Exposure to smoke: Exposure to tobacco smoke or other environmental pollutants can increase the risk of bronchiolitis.
• Lack of breastfeeding: Breastfeeding provides vital antibodies that strengthen a baby's immune system. Infants who aren't breastfed may have a higher risk.
• Living conditions: Overcrowded living conditions can facilitate the spread of viruses that cause bronchiolitis.

How is Bronchiolitis Diagnosed? 

A healthcare provider typically diagnoses bronchiolitis based on the observed symptoms and by listening to the child's lungs using a stethoscope.

Diagnostic tests and X-rays are generally not necessary for diagnosing bronchiolitis. However, if the child is at risk of severe bronchiolitis if symptoms worsen or there is suspicion of another issue, the healthcare provider may recommend specific tests.

These tests may comprise:

• Chest X-ray: This imaging test can reveal signs of pneumonia.
• Viral testing: A swab, gently inserted into the child's nose, can be used to collect a mucus sample for testing to identify the virus causing bronchiolitis.
• Blood tests: Blood tests may be conducted to assess the child's white blood cell count. An elevated white blood cell count indicates the body's response to an infection. Additionally, blood tests can determine if the oxygen level in the child's bloodstream is low.

The healthcare provider may also assess the child for signs of dehydration, mainly if the child has been reluctant to eat or drink or has experienced vomiting. Indications of dehydration include dry mouth and skin, excessive fatigue, and reduced or absent urine output.

How is Bronchiolitis Treated? 

Treatment for bronchiolitis primarily focuses on alleviating symptoms. Special attention is given to managing allergic bronchiolitis, which may require additional interventions. The treatment includes:

• Fever-reducing medications (antipyretics).
• Antiviral drugs, such as oseltamivir, if the flu causes bronchiolitis.

Not all cases of bronchiolitis require treatment, so it's advisable to consult with the child's bronchiolitis treatment doctor if symptoms arise. Antibiotics are not effective against viral infections and are therefore not recommended.

Hospitalisation may be necessary if the child experiences difficulty breathing. Bronchiolitis treatment hospitals often provide oxygen therapy or intravenous (IV).

For at-home bronchiolitis care, consider the following:

• Ensure the child gets ample rest.
• Offer multiple small meals throughout the day if a full meal is unappealing during regular meal times.
• Provide plenty of fluids to prevent dehydration. Breast milk or formula is suitable for children under one year, while infants can consume electrolyte beverages like Pedialyte®.
• Use a humidifier in the child's vicinity to create moist air, which can help loosen mucus.

What are the Complications of Bronchiolitis? 

Complications arising from severe bronchiolitis can include:

• Insufficient oxygen levels in the body.
• Instances of breathing pauses are particularly prevalent in infants born prematurely and those under two months old.
• Challenges in adequately consuming liquids lead to dehydration due to excessive fluid loss.
• The inability to attain the required level of oxygen is known as respiratory failure.

In the event of any mentioned complication, hospitalisation may be necessary. Severe respiratory failure might require the insertion of a tube into the windpipe to assist with breathing until the infection improves.

Conclusion

Addressing bronchiolitis effectively involves thoroughly understanding its symptoms, an accurate diagnosis, and appropriate treatment. Our commitment at Max Healthcare centres on delivering exemplary care and personalised treatment strategies for young patients affected by bronchiolitis. Focusing on patient-centred care, we integrate advanced medical knowledge, cutting-edge treatment methods, and a holistic approach to ensure the best possible outcomes for children with this respiratory condition. Our dedicated healthcare professionals are devoted to providing compassionate care, ensuring that each patient receives a tailored treatment plan suited to their unique needs.