Health Library BronchiolitisFrom Healthwise

What is bronchiolitis?

Bronchiolitis is an infection of the bronchioles, the small air passages in the lungs. It is common in young children and is the leading cause of serious lower respiratory illness in infants.

What causes bronchiolitis?

Bronchiolitis is usually caused by a virus, especially respiratory syncytial virus (RSV), and frequently occurs in the late fall to early spring.

What are the symptoms?

Symptoms of bronchiolitis include runny nose, cough, and fever. After a few days, your child may experience shortness of breath and/or breathing that is rapid and labored with wheezing.

A severe infection in infants may cause a noticeably increased breathing rate. For information on what to do if your child has trouble breathing, see the topic Respiratory Problems, Age 11 and Younger.

If your child has heart disease or was born prematurely, call your doctor at the first sign of bronchiolitis.

Symptoms of bronchiolitis may last 3 to 4 days. Most children recover within a week.

How is bronchiolitis diagnosed?

A doctor may diagnose bronchiolitis based on a medical history, your child's symptoms, and a physical exam. Testing is usually not needed if your doctor suspects the bronchiolitis is caused by RSV.

How is it treated?

Home treatment to manage the symptoms of bronchiolitis is usually all that is needed. Have your child drink plenty of liquids to avoid dehydration. If your baby has a stuffy nose, it can be helpful to use a suction bulb to remove mucus. Acetaminophen (such as Tylenol) may help ease discomfort. But other over-the-counter cough and cold medicines are not recommended. Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome, a serious illness.

The doctor may suggest bronchodilator medicine if your child has shown the tendency to have allergic reactions ( atopy). In severe cases, your child may need to stay in the hospital or get extra oxygen.

How can I prevent bronchiolitis?

It is common for children to get respiratory problems (such as bronchiolitis caused by a viral infection) because they are often exposed to people who have infections to which they have not built up immunity. Bronchiolitis is spread just like a cold. To prevent bronchiolitis:

• Avoid contact with other children who have bronchiolitis or upper respiratory infections. If there is an ill child in the home, separate him or her from other children, if possible. Put the child in a room alone to sleep. If your child has bronchiolitis, keep him or her home from school or day care until he or she gets better.
• Wash your hands often to prevent spreading the disease. Hand-washing removes the germs on your hands and helps stop the spread of germs to your child when you touch your child or touch an object he or she might touch.
• Do not smoke or use other tobacco products around your child. Secondhand smoke irritates the mucous membranes in your child's nose, sinuses, and lungs and increases his or her risk for respiratory infections.

If your child was born early (prematurely), has heart or lung disease, or has other conditions that make it more likely to have problems from RSV, ask the doctor if palivizumab (Synagis) might help. This medicine helps prevent bronchiolitis and other problems from RSV in children most likely to have problems (susceptible). It is injected once a month during RSV season—late fall to early spring.

• Ear Infections
• Respiratory Problems, Age 11 and Younger
• Respiratory Syncytial Virus (RSV) Infection

Other Works Consulted

• Hayden FG and Ison MG (2006). Respiratory viral infections. In DC Dale, DD Federman, eds., ACP Medicine, section 7, chap. 25. New York: WebMD.
• Kerby GS, et al. (2007). Bronchiolitis section of Respiratory tract and mediastinum. In WW Hay Jr et al., eds., Current Pediatric Diagnosis and Treatment, 18th ed., pp. 506–507. New York: McGraw-Hill.
• Lozano JM (2007). Bronchiolitis, search date October 2006. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.
• Murray DL (2003). Infectious diseases. In CD Rudolph et al., eds., Rudolph's Pediatrics, 21st ed., pp. 1065–1068. New York: McGraw-Hill.
• Subcommittee on Diagnosis and Management of Bronchiolitis, American Academy of Pediatrics (2006). Diagnosis and management of bronchiolitis. Pediatrics, 118(4): 1774–1793.

Author:	Debby Golonka, MPH	Last Updated: July 11, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics Mark A. Rasmus, MD - Pulmonary, Critical Care and Sleep Medicine
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