Bronchiolitis is the inflammation of the bronchioles. Bronchioles are the smallest air passages of the lung. This is the most common infection of the respiratory tract. The inflammation in the bronchioles causes mucus accumulation in the bronchioles thus making breathing difficult. Bronchiolitis usually occurs due to a viral infection.
Bronchiolitis is mainly seen in:
1) Those who live in crowded conditions.
2) Infants and children as they have small airways which get blocked easily due to inflammation.
3) Most commonly seen in the first 2 years of life. Peak age of occurrence is 3 to 6 months.
4) Also seen in children who have not been breastfed.
5) Those children who have been exposed to cigarette smoke.
6) Premature babies (those born before 37 weeks of gestation).
Bronchiolitis also shows a seasonal variation which appears more commonly in the fall and during winter months. This is also the reason for infants being hospitalized during these months.
Respiratory syncytial virus is the most common cause of bronchiolitis. It can also be caused by influenza, parainfluenza or adenovirus.
The respiratory syncytial virus shows mild symptoms in adults although it may cause serious illness in an infant.
The symptoms of bronchiolitis usually begin as a mild infection of the respiratory tract. The condition can gradually develop into a respiratory distress one over a period of 2-3 days. The infant may show signs of irritability with increase in the respiratory rate (tachypnea) which may or may not worsen with time.The initial signs may mimic those of a common cold such as mild fever and cough or a running nose.
In more severe conditions the following symptoms are seen:
1) Irritability, difficulty in sleeping, signs of fatigue seen.
2) Rapid breathing.
3) Rapid heartbeat.
4) Flaring nostrils.
5) Drawing in of the neck and the chest while breathing (retraction).
6) May show the signs of dehydration.
7) In some very serious conditions there may be temporary stoppage of breathing (apnea) due to which the child may appear blue (cyanotic).This is a medical emergency.
Bronchiolitis is a contagious infection.This infection is mostly airborne. It spreads through sneeze, or when the infected individual coughs or laughs.
-One should wash their hands frequently.
-Cigarette smoking should be avoided.
-The infant should be kept away from any other infected individual.
-Chest X-rays should be taken and studied.
-Blood gases examination.
-Nasal fluid culture.
On examination through a stethoscope, a typical wheezing and crackling sounds are heard.
No treatment is generally required in mild cases. The condition may subside on its own. No vaccine has been developed for the treatment of bronchiolitis yet. Medications lessen the severity of the condition. Medication are generally given to open the blocked airway.
Antibodies to the respiratory syncytial virus may be injected monthly or during the peak seasons. This treatment is generally recommended for infants who have a higher risk of getting bronchiolitis. Premature babies and those infants who have a chronic lung disease are said to be at a higher risk of getting bronchiolitis.
In severe cases hospitalization may be needed.
The incubation period (the period between the infection and the appearance of symptoms) varies from several days to a week. In most cases the infection lasts usually for 12 days. In severe cases the infection may last for weeks.
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