Bronchiolitis

Bronchiolitis is inflammation of the bronchioles, the smallest air passages of the lungs. It usually occurs in children less than two years of age with the majority being aged between three and six months. It presents with coughing, wheezing and shortness of breath which can cause some children difficulty in feeding. This inflammation is usually caused by respiratory syncytial virus (70% of cases) and is much more common in the winter months.

Treatment is typically supportive with oxygen, monitoring, fluid and nutrition perhaps by gastric tube or intravenously. Nebulized hypertonic saline is also useful. There is insufficient evidence to support treatment with antibiotics, surfactant, chest physiotherapy or bronchodilatorsnebulized epinephrine. Bronchiolitis is common with up to one third of children being affected in their first year of life.

Signs and symptoms

In a typical case, an infant under two years of age develops cough, wheeze, and shortness of breath over one or two days. Crackles and/or wheeze are typical findings on listening to the chest with a stethoscope. The infant may be breathless for several days. After the acute illness, it is common for the airways to remain sensitive for several weeks, leading to recurrent cough and wheeze.