Bronchiolitis is a viral infection of the small airways of the lungs known as bronchioles. While there are several types of viruses which can cause Bronchiolitis, the most common is respiratory syncytial virus (RSV). This virus attacks the small airways in the lungs, causing swelling of the membranes lining the airway and increased mucous production. This leads to narrowing of the airways with difficulty breathing, rapid breathing, cough, and often wheezing. Wheezing (high pitched whistling sound) can also be due to the infection causing the muscle surrounding the bronchioles to be "twitchy". The muscle can contract, squeezing the airway, and causing it to narrow.
Symptoms of Bronchiolitis vary in both children and adults. Rarely do adults suffer more the a "cold" with a runny nose and cough. In children under 1 to 2 years of age, symptoms can range from mild runny nose and cough to severe pneumonia. Hopefully your child will have only a mild case. Most children can be cared for at home quite safely. The child with mild disease is alert and playful. When quiet, his rate of breathing is between 40 to 50 breaths/minute and he has only slight inward movement of the skin between his ribs when he breathes in. Should your child develop any of the following signs please notify me or one of my associates:
Rate of breathing of 60 breaths per minute when quiet
Very noticeable inward movement of the skin between the ribs with each breath
Severe wheezing
Persistent vomiting
Difficulty breathing
Treatment of bronchiolitis varies depending on the severity of the bronchiolitis and the responsiveness to medicines for wheezing (if it is present). THE COUGH ASSOCIATED WITH BRONCHIOLITIS MAY LAST FOR UP TO SIX WEEKS. This is due to the increased mucous production in the airways. Making certain your child takes adequate liquids and "tincture of time" may be the wisest approach for a child with mild disease.
If your child has wheezing and responds to a trial of albuterol (Ventolin/Proventil) or Xopenex in the office, he or she will benefit from a group of medicines known as "bronchodilators". These medicines relax the muscle wall surrounding each bronchiole. If wheezing was primarily from narrowing of the bronchiole due to muscle "twitchiness", the bronchodilators you give at home will help these muscles to relax. This will decrease the wheezing and cough due to airway tightness.
Common types of beta-agonists are: adrenalin and albuterol (Ventolin/Proventil) and Xopenex. These medicines can cause children to be more active than usual and to have more difficulty getting to sleep at night. These medicines are usually prescribed for a one week period and given 3 to 4 times daily.