Bronchiolitis

Beatriz Morillo
MD, Sevilla, Spain
First Created: 02/05/2001  Last Updated: 02/05/2001

Patient Education

What is bronchiolitis?

Bronchiolitis is a viral infection of the lung that leads to difficulty in breathing, wheezing, and symptoms similar to asthma. It is usually seen in children between 4 months to 2 years of age.

What is the cause of bronchiolitis?

Viral infections such as a respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza virus, influenza virus, or adenovirus among others can cause inflammation (swelling) of the small airways of the lung (bronchioles) leading to narrowing of the air passage. This causes wheezing and rapid respiration with difficulty in breathing. It is seen in infants predominantly as their bronchioles are small in size and if there is even a little swelling, the air passage through the lungs becomes difficult. As the child grows older, the bronchioles become bigger and inflammation does not cause severe problems.

What happens if a child has bronchiolitis?

A child with bronchiolitis will have a low-grade fever, wheezing, and rapid breathing that may worsen for 2-3 days and then gradually improve. In most of the cases, the child can be looked after at home ensuring comfort measures and good hydration while the infection self resolves; however, if the child’s breathing is not good, or if there are difficulties to feed the child, he/she will need hospital admission for supportive therapy. Even the children who require admission, the vast majority of the cases will recover and won´t suffer from major problems. Occasionally the wheeze may last more than 7 days and the cough more than 14 days.

What is the treatment for bronchiolitis?

Unfortunately, there is no effective treatment for bronchiolitis. As mentioned above, if the symptoms are severe, the child may need hospitalization for oxygen supplementation and nasogastric feed or intravenous fluids.

At home:
Ensure that your child gets adequate fluids, as loss of water through respiration is more. If the child is breastfed, don't stop it, as breast milk during at least the first 6 months of life decreases the incidence of respiratory infections.

If the nose is blocked, saline drops can be put in each nostril to remove the dry or sticky mucus. Nasal aspirations should not be used, as they can be very distressing for the child. Try repositioning the child, seated or head slightly elevated, as this may help him/her breathing.

Smoke is related to increased severity and hospital admission in children with bronchiolitis. Avoid exposing the child to smoke and kindly consider smoking cessation.

As these viruses spread using the secretions of the child, ensure all the family members wash their hands with water and soap after contact with the child or his/her objects.

Danger Signs - Red Flags

What are the danger signs one should look for?

Your child should be immediately brought to the hospital if:

  • Breathing is difficult, with more than 60 breaths/minute

  • Child is lethargic

  • Child is having apnoeas (stopping breathing for seconds) or is getting blue (cyanosis)

  • Child refuses to feed or is not having any wet nappy in the last 12 hours.


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2. Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and Management of Bronchiolitis. PEDIATRICS. 2006 Oct 1;118(4):1774–93.
3. Bronchiolitis in children: diagnosis and management | Guidance and guidelines | NICE [Internet]. [cited 2016 Feb 5]. Available from: https://www.nice.org.uk/guidance/ng9
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8. Ingelfinger JR, Meissner HC. Viral Bronchiolitis in Children. N Engl J Med. 2016 Jan 7;374(1):62–72.
9. Bronchiolitis: Practice Essentials, Background, Pathophysiology. 2015 Oct 30 [cited 2016 Jan 18]; Available from: http://emedicine.medscape.com/article/961963-overview


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