An article entitled "Bronchiolitis" by Dr. Fadhel Sahib <br /><br />Introduction:<br />Bronchiolitis is a common lung infection in young individuals. The viral infection involves the lower respiratory tract and can present with signs of mild to moderate respiratory distress. The most common cause is the respiratory syncytial virus (RSV). Bronchiolitis is a mild, self-limited infection in the majority of children but may sometimes progress to respiratory failure in infants. Bronchiolitis is managed supportively with hydration and oxygen. No specific medications treat the infection.<br />What are the signs and symptoms of bronchiolitis?<br />Early signs and symptoms of bronchiolitis resemble those of the common cold, including:<br />A runny nose.<br />A slight fever (under 101 degrees Fahrenheit or 38 degrees Celsius).<br />A cough.<br />Fatigue.<br />Fussiness or irritability (infants).<br />What causes bronchiolitis?<br />A virus causes a bronchiolitis infection. Viruses that can lead to bronchiolitis include:<br />Respiratory syncytial virus (RSV).<br />Influenza (flu) virus.<br />Adenovirus.<br />Parainfluenza.<br />Metapneumovirus.<br />SARS-Cov-2 (the virus that causes COVID)<br />Diagnosis<br />Tests and X-rays are not usually needed to diagnose bronchiolitis. But the child's provider may recommend tests if the child is at risk of severe bronchiolitis, if symptoms are getting worse or if the provider thinks there may be another problem. <br />Tests may include:<br />1. Chest X-ray. A chest X-ray can show if there are signs of pneumonia.<br />2. Viral testing. A sample of mucus from your child's nose can be used to test for the virus causing bronchiolitis. <br />3. Blood tests. Occasionally, blood tests might be used to check your child's white blood cell count. A blood test can show if the level of oxygen in your child's bloodstream is low.<br />Differential Diagnosis<br />a. Asthma<br />b. Bacterial pneumonia<br />c. Gastroesophageal reflux disease (GERD)<br />d. Vascular ring<br />e. Croup<br />f. Foreign body aspiration<br />g. Pertussis<br />Complications<br />a. Nosocomial infection in infants who are admitted<br />b. Barotrauma is ventilation is required<br />c. Arrhythmias induced by beta-agonists<br />d. Nutritional deficiencies if there is persistent vomiting<br />Management and Treatment<br />Treatment for bronchiolitis focuses on symptom relief, including:<br />Antipyretic (fever reducer) medications.<br />Antiviral medications (like oseltamivir for the flu).<br />Bronchiolitis doesn’t always need treatment . Antibiotics won’t help because they’re ineffective at treating viral infections.<br /><br />the child may need to stay in the hospital if they have trouble breathing. the child may need oxygen therapy or intravenous (IV) fluids in the hospital.<br /><br />At-home bronchiolitis treatment<br />In addition to monitoring the child’s breathing during their illness, you can help the child feel better at home by:<br />a. Encouraging the child to get plenty of rest.<br />b. Feeding the child multiple small meals throughout the day if they don’t have an appetite for a full meal during regular meal times.<br />c. Giving the child plenty of fluids to prevent dehydration. Breast milk or formula is appropriate for children younger than 1 year. Infants can drink electrolyte beverages like Pedialyte®.<br />d. Setting up a humidifier near the child. Moist, wet air helps loosen mucus.<br />e. Using saline nose drops and a nasal suction to relieve a stuffy nose.<br />f. Giving the child a fever reducer like acetaminophen (Tylenol®) as directed by their healthcare provider. Giving aspirin to children can increase their risk of developing Reye’s syndrome.<br />Prognosis<br />Bronchiolitis is a self-limited infectious process. It is commonly managed with supportive care, hydration, fever control, and oxygenation. When the disorder is recognized and treated, the prognosis is excellent. The majority of children recover without any adverse effects. Past studies suggest that infants with severe bronchiolitis will develop wheezing in the future, but this has not been borne out by longitudinal studies.<br />Prevention<br />Can bronchiolitis be prevented?<br />It’s difficult to prevent bronchiolitis since the viruses that cause it are common. lower child’s risk of developing bronchiolitis by:<br />• Avoiding others who are sick.<br />• Practicing good handwashing.<br />• Washing and sanitizing frequently touched surfaces or objects like toys.<br />• Not sharing cups, forks or spoons.<br /><br />References :<br /> Polack FP, Stein RT, Custovic A. The Syndrome We Agreed to Call Bronchiolitis. J Infect Dis. 2019 Jun 19;220(2):184-186.<br /> Jo YM, Kim J, Chang J. Vaccine containing G protein fragment and recombinant baculovirus expressing M2 protein induces protective immunity to respiratory syncytial virus. Clin Exp Vaccine Res. 2019 Jan;8(1):43-53.<br /> Oz-Alcalay L, Ashkenazi S, Glatman-Freedman A, Weisman-Demri S, Lowenthal A, Livni G. Hospitalization for Respiratory Syncytial Virus Bronchiolitis in the Palivizumab Prophylaxis Era: Need for Reconsideration of Preventive Timing and Eligibility. Isr Med Assoc J. 2019 Feb;21(2):110-115.<br /> https://www.ncbi.nlm.nih.gov/books/NBK441959/<br /> https://www.nhs.uk/conditions/bronchiolitis/<br /> https://my.clevelandclinic.org/health/diseases/8272-bronchiolitis<br /> https://www.mayoclinic.org/diseases-conditions/bronchiolitis/diagnosis-treatment/drc-20351571