Bronchiolitis
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Within your lungs, the main airways (bronchi) branch off into smaller and smaller passageways, the smallest of which are called bronchioles. At the end of the bronchioles are tiny air sacs (alveoli).
Bronchiolitis is a common lung infection in young children and infants. It causes inflammation and congestion in the small airways (bronchioles) of the lung. Bronchiolitis is almost always caused by a virus. Typically, the peak time for bronchiolitis is during the winter months.
Bronchiolitis starts out with symptoms similar to those of a common cold but then progresses to coughing, wheezing and sometimes difficulty breathing. Symptoms of bronchiolitis can last for several days to weeks, even a month.
Most children get better with care at home. A very small percentage of children require hospitalization.
For the first few days, the signs and symptoms of bronchiolitis are similar to those of a cold:
After this, there may be a week or more of difficulty breathing or a whistling noise when the child breathes out (wheezing).
Many infants will also have an ear infection (otitis media).
If it’s difficult to get your child to eat or drink and his or her breathing becomes more rapid or labored, call your child’s doctor. This is especially important if your child is younger than 12 weeks old or has other risk factors for bronchiolitis — including premature birth or a heart or lung condition.
The following signs and symptoms are reasons to seek prompt medical attention:
Bronchiolitis occurs when a virus infects the bronchioles, which are the smallest airways in your lungs. The infection makes the bronchioles swell and become inflamed. Mucus collects in these airways, which makes it difficult for air to flow freely in and out of the lungs.
Most cases of bronchiolitis are caused by the respiratory syncytial virus (RSV). RSV is a common virus that infects just about every child by the age of 2. Outbreaks of the RSV infection occur every winter. Bronchiolitis can also be caused by other viruses, including those that cause the flu or the common cold. Infants can be reinfected with RSV because at least two strains exist.
The viruses that cause bronchiolitis are easily spread. You can contract them through droplets in the air when someone who is sick coughs, sneezes or talks. You can also get them by touching shared objects — such as utensils, towels or toys — and then touching your eyes, nose or mouth.
Infants younger than 3 months of age are at greatest risk of getting bronchiolitis because their lungs and immune systems aren’t yet fully developed.
Other factors that are associated with an increased risk of bronchiolitis in infants, or more severe illness due to bronchiolitis, include:
Complications of severe bronchiolitis may include:
If these occur, your child may need hospitalization. Severe respiratory failure may require that a tube be inserted into the trachea to help the child’s breathing until the infection has run its course.
If your baby was born prematurely, has a heart or lung condition, or has a compromised immune system, watch closely for beginning signs of bronchiolitis. The infection can quickly become severe. In such cases, your child will usually need hospitalization.
Because the viruses that cause bronchiolitis spread from person to person, one of the best ways to prevent it is to wash your hands frequently — especially before touching your baby when you have a cold or other respiratory illness. Wearing a face mask at this time is appropriate.
If your child has bronchiolitis, keep him or her at home until the illness is past to avoid spreading it to others.
Other commonsense ways to help curb infection include:
There are no vaccines for the most common causes of bronchiolitis (RSV and rhinovirus). However, an annual flu shot is recommended for everyone older than 6 months.
Infants at high risk of the RSV infection, such as those born very prematurely or with a heart-lung condition or a depressed immune system, may be given the medication palivizumab (Synagis) to decrease the likelihood of RSV infections.
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Bronchiolitis
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