Bronchiolitis: Causes, Symptoms And Treatment
Bronchiolitis affects up to 20% of children under 2 years of age. It is much more likely to appear symptomatically in immunocompromised infants.
Acute bronchiolitis is a very common disease in children. Its approximate annual incidence worldwide is 10%; that is, one in 10 children under the age of 2 suffers from it each year. In addition, it is the most common cause of hospitalization for respiratory infections in this age group (1 to 5%).
There is no consensus on the definition of bronchiolitis, but it is usually associated with episodes of respiratory distress with wheezing preceded by a clinical picture of a catarrhal nature. If you want to know all about this disease, we encourage you to keep reading.
Causes of bronchiolitis
As the United States National Library of Medicine reports, bronchiolitis is a common lung infection in young children. From a clinical point of view, it is characterized by the accumulation of mucus in the smallest airways of the lungs (bronchioles). It is usually due to a viral invasion.
According to the journal Pediatría Integral, bronchiolitis occurs during epidemics in winter and early spring. The most affected population group are young children aged 3 to 6 months. Here are some of the most common causative agents.
1. Respiratory syncytial virus (RSV)
A negative single-stranded RNA virus of the paramyxovirus family ( Paramyxoviridae ) is responsible for 56% of patients with bronchiolitis requiring hospitalization. It is ubiquitous in most countries around the world and it is estimated that almost all children in the world have already suffered from the disease by the age of 4.
2. Rhinovirus
It is a genus of virus from the Picornaviridae family . They are the most common infectious agents in humans (causing colds) and there are more than 110 serological types capable of causing symptoms in our species. Although less common than with RSVs, rhinoviruses can also cause bronchiolitis in infants.
3. Parainfluenza virus type 3
The MSDmanuals portal shows us that parainfluenza viruses are classified into 4 types. Type 3 is the one that causes the most cases of bronchiolitis. But variants 1 and 2 can also generate it exceptionally. Infections caused by parainfluenza are indistinguishable from those caused by RSV, but they are generally less serious.
Risk factors
Bronchiolitis can affect anyone, but it is much more common in breastfed and immunocompromised children. As noted by the KidsHealth portal, some of the most common risk factors are as follows:
- Being a baby or toddler: their noses and airways are much more fragile than those of adults. Their bronchial tree is shorter and smaller in diameter so, faced with inflammation, the risk of obstruction is much higher.
- Belong to the group of infants who have experienced premature births.
- In children who have a weakened immune system or concomitant pulmonary and cardiovascular disease.
- Exposure to tobacco smoke, repeated stay in environments with high density of children, and exposure to certain toxic chemicals.
In general, being a young child is the most important risk factor. As we said, about 70% of infants come into contact with respiratory syncytial virus during the first year of life. However, this does not mean that they will suffer from bronchiolitis: only 22% actually develop symptoms.
Symptoms of bronchiolitis
The United States National Library of Medicine shows us some of the most common symptoms of bronchiolitis in infants. However, not all children develop them. Among them we can find the following:
- Difficulty breathing, including wheezing and shortness of breath.
- Cough, fatigue and fever. These clinical signs are some of the precedents for bronchiolitis, which is typical of catarrhal infection.
- The muscles around the ribs sag when the child tries to inhale. The baby’s nostrils become inflamed as he breathes with the intention of taking in more air with each inhalation cycle.
- Tachypnea; that is, rapid breathing.
Usually, bronchiolitis manifests itself 24 to 48 hours after the previous clinical signs. The average duration of symptoms is thus 12 days. However, up to 18% of affected infants carry the clinical picture for 21 days, exceptionally reaching one month (9%).
Possible complications
As noted by previously cited sources, loss of breathing capacity in a newborn baby can be fatal. If your child has had symptoms of bronchiolitis and one day you notice their skin with a bluish tone (cyanosis), it is essential that you go to an emergency medical center. Cyanosis indicates very severe shortness of breath.
Pauses in breathing, dehydration, and low levels of oxygen in the blood are also clinical signs that indicate considerable severity of bronchiolitis. These signs only appear (in the vast majority of cases) in premature babies or in those with previous illness.
What treatment options are there?
According to the specialist portal Neumoped, there is no drug that facilitates healing from bronchiolitis. Since this is a viral disease, you can only hope that the infant’s immune system will be able to fight viruses on its own. However, most cases are mild and do not require medical intervention.
It should be noted that, on these occasions, deciding on the consumption of antibiotics is absolutely useless. This could only worsen the clinical picture by encouraging the bacterial strains that live inside the infant to become stronger in the long term. In any case, in children admitted to hospital, the approach changes radically.
Hospital treatment
When an infant is admitted with bronchiolitis, the biggest worry is that they will regain a normal breathing rate. For this, oxygen (30-40%) is applied in a nasal cannula or a face mask in order to maintain an oxygen saturation above 90%. Endotracheal intubation is necessary in the most severe cases.
On the other hand, we also want the patient to regain a natural water balance. For this, oral serum intakes are administered and, in the most compromised cases, intravenously (IV).
Recommendations at home
The vast majority of cases are in fact treated at home with patience and dedication. Although it is not possible to help the child to fight the disease, its symptoms can be alleviated by a series of very simple actions. Among them are the following:
- Keep the infant hydrated : Make sure the infant is getting an adequate amount of fluid to avoid dehydration due to illness.
- Perform frequent nasal washes : There are over-the-counter fluids at the drugstore that help decongest the upper respiratory tract in infants and adults. This will make it easier for the patient to breathe.
- Keep the child upright, even when he falls asleep : this will promote good air circulation, much better than if he was lying down.
- Use a humidifier : It is always a good idea to place a vaporizer in the sick baby’s room, especially at bedtime. This will soften the accumulated mucus and, as a result, the symptoms of cough and nasal congestion will be alleviated.
A common illness that usually resolves on its own
As we have said in the previous lines, bronchiolitis is an extremely common disease in infants and therefore there is no need to worry if a child has it. The vast majority of cases resolve on their own, so just being patient and following certain instructions at home will make the child more comfortable.
In any case, if you notice any of the clinical signs mentioned in the “possible complications” section, it is essential that you go to an emergency center quickly. If a child’s respiratory capacity is severely compromised, his or her life is in danger in the short term.
