What is bronchiolitis?
Bronchiolitis, or acute bronchiolitis, is the inflammation of the bronchioles, which are the smallest airways lacking cartilage, which communicate with the alveoli, where thegas exchange of oxygen and carbon oxide takes place.
Bronchiolitisis one of the most common causes of hospitalizationsduring childhood, particularly in children under two years of age, especially during the winter months or, in tropical climates, during the rainy season.
To highlight: Preterm infants, infants with chronic conditions (e.g., cystic fibrosis), congenital heart disease, or chronic lung disease (bronchopulmonary dysplasia) are more likely to develop bronchiolitis.
What are the causes of bronchiolitis?
Bronchiolitis isusually caused by a virus (to a lesser extent, also by bacteria such asMycoplasma pneumoniae), lodged in the small pathways of children. Next, we will describe the most common ones.
1. Respiratory syncytial virus
It is the main agent responsible for 75% ofhospitalization cases for bronchiolitis in children under 24 months of age, and 20-40% of cases in total. Respiratory syncytial virus has two subtypes: A and B.
The former produces more severe symptoms, requiring Immediate Primary Caretag. The incubation period is 2 to 5 days, and children’s nasal secretions remain infectious 6 to 21 days after the onset of symptoms.
2. Influenza and parainfluenza
The influenza virus represents a small percentage in contrast to the previous one (only 10-20%). The parainfluenza virus causes 10 to 30% of cases , according to statistics published in the journal Pediatric Infectious Diseases . (1)
Note:Parainfluenza virus outbreaks begin in the first months of the year, and their time is usually sporadic. They are generally associated withSymptoms of Croup (inflammation of the larynx, trachea, and bronchi passageways).
3. Adenovirus and coronavirus
Adenovirus is the cause of 5 to 10% of casestag. While certain strains of coronavirus only cause 2%, according to a study of the viral etiologies of bronchiolitis, published in the journalPediatrics Infectious Diseases . (two)
What symptoms does bronchiolitis present?
Due to its symptoms, bronchiolitis can be confused with other pathologiesof the respiratory tract. If your baby or any other small member of the family has difficulties, you should take them to a health center. Next, we will mention the most important ones.
1. Cough, fever and nasal congestion
The severity of these symptoms varies among children. The course of these is also dynamic; for some, the disease does not progress and theyexperience only mild symptoms, while other children require hospitalization.
Important: The degree of severity will also depend on whether there are associated chronic conditions, such as cystic fibrosis. In a case like this, infection by viruses and/or bacteria are frequent.
2. Breathing difficulty
It represents the greatest risk in patients,since the diameter of their airways are smaller than those of an adult. Consequently, patients developCyanosis (blue discoloration of the skin) and hypoxia (decreased oxygen in the blood).
Note: Certain children may develop nasal flaring, which is a widening of the nostrils as a result of increased effort to breathe due to airway obstruction.
3. Fatigue and lack of appetite
The infection reduces the appetite of children , so the doctor must make sure to maintain adequate hydration, which, along with the symptoms of respiratory distress , could worsen the condition.
How is bronchiolitis cured?
In children who do not present other underlying pathologies, treatment is oriented towards support measures,such as proper hydration, oxygenation of the infant, and some drugs. Here are the most common treatments:
1. Drugs recommended by a specialist
According to the American Society of Pediatrics , treatment should not involve medications such as albuterol, norepinephrine, or or systemic corticosteroids for infants or children diagnosed with bronchiolitis. (3)
Important: Moreover, the use of antibiotics is recommended only in a case where there is a concomitant bacterial infection.
2. Oxygenation and hydration
Oxygen therapy (administration of oxygen to patients) is recommended to maintain blood saturation greater than 90% (if it drops, it represents a warning sign).
Note: Hydration is achieved through intravenous or nasogastric administration, only in those children who cannot be hydrated orally.
4. Saline Drops for Nasal Congestion
The saline or saline solution can be administered in the form of drops or through the nebulizationof these. The saline increases the mucociliary sweep, making it easier for the respiratory tract to eliminate and remove the viruses housed there, as well as allowing hydration.
5. Rest and fluid intake
In mild cases of bronchiolitis, primary care is based on rest and hydration. Therefore,the child should be prevented from exerting physical effort and allowed to rest enough, in addition to constantly monitoring their temperature and general condition. (4)
Key Conclusions
- Bronchiolitis is a particularly common infection in children, especially during the first 24 months of life.
- The infection produces inflammation of the bronchioles , caused by viruses such as respiratory syncytial virus, coronavirus, or bacteria such as mycoplasma pneumoniae.
- Symptoms include Shortness of breath (causing signs such as nasal flaring), cough, fever, runny nose, and fatigue.
- As a treatment, studies indicate that the use of saline solution and hydration are favorable for the recovery of patients.
- In a mild case, rest and hydration are key to ensuring a timely recovery.
University Professional in the area of Human Resources, Postgraduate in Occupational Health and Hygiene of the Work Environment, 14 years of experience in the area of health. Interested in topics of Psychology, Occupational Health, and General Medicine.