Acute Bronchiolitis

OVERVIEW

Acute bronchiolitis refers to an infections/inflammatory condition that involves the bronchioles. This most often will occur in young children and infants.

Source
Source
WHAT CAUSES IT?

Respiratory syncytial virus (RSV) is most often the cause of this condition. Other causes of this condition can include:

WHY IS IT A PROBLEM?

This inflammation in the bronchioles can make breathing more difficult, and can lead to respiratory distress.

WHAT MAKES US SUSPECT IT?

Risk Factors:

Young age (<2 years of age)

Initial Presentation:

  • Upper respiratory tract symptoms (prodrome): rhinitis, fever, cough
  • Respiratory distress (later on): grunting, nasal flaring, intercostal retractions
  • Paroxysmal wheezing is common but may be absent in patients.   

History Of Present Illness:

  • Associated symptoms: apnea, poor feeding

Vital Signs:

  • Fever is possible
  • Oxygen desaturation can occur in more severe cases

Respiratory Exam (Physical Exam):

  • Signs of respiratory distress
  • Wheezing/crackles may be heard on auscultation
CLINICAL WORKUP

Polymerase Chain Reaction (PCR): nasopharyngeal secretions may be analyzed with PCR to detect specific pathogens.

AT WHAT POINT ARE WE COMFORTABLE MAKING THE DIAGNOSIS?

Patients (especially those <2 years of age) are given the diagnosis of bronchitis based upon the history and physical. Diagnostic testing is not really recommended for this diagnosis.

HOW DO WE TREAT IT?

Because there is no cure for bronchiolitis treatment is aimed at symptom control: antibiotics, cough medications, and decongestants are generally not recommended.

  • Fever: acetaminophen/ibuprofen can be used to control temperatures
  • Runny nose/congestion: saline nose spray and bulb suctioning (infants) can be used
  • Dehydration: oral intake of fluids is an important component of supportive care

 

Page Updated: 12.06.2016