Infections

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Bronchiolitis

Bronchiolitis is an infection of the lower respiratory tract. Respiratory syncytial virus (RSV) is one of the most common causes of bronchiolitis but other viruses can cause it too. All children typically become infected with RSV within the first 2 years of life and about 20% of those will get bronchiolitis while the rest may simply have symptoms of the common cold.

The usual initial symptoms include common cold symptoms such as a runny nose and a low grade fever (100-102). Symptoms then progress in the next 1-2 days to include cough and changes in breathing such as wheezing, tugging in of the muscles above, in between and/or under the ribs as well as nasal flaring and breathing fast which can lead to feeding difficulties. The progression typically peaks on day 3-5 then improves. The cough and runny nose can last more than 2 weeks.

How can it be avoided?

As it is transmitted from person to person through sneezing, coughing or from direct contact of an object (cups, toys, ect.), viruses are very contagious especially in the first several days of symptoms. Washing hands frequently, covering coughs and avoidance of fingers or hands in the mouth, nose or eyes will help. Avoidance of tobacco exposure can also decrease the risk.

High risk infants (prematurity, chronic lung or congenital heart disease) may be eligible to obtain Synagis (palivizumab). It is an RSV antibody to help in decreasing the severity of RSV but will not treat a child already sick with RSV.

Can an episode of bronchiolitis become complicated?

Yes, at times hospitalization may be needed if your child is not able to maintain hydration or is having difficulty breathing. Bronchiolitis can also be associated with other bacterial infections.

If your child is less than 3 months of age and has a fever of 100.4 or more they will need to be seen immediately to evaluate for potential bacterial infections.

Will antibiotics help?

Since bronchiolitis is caused by a virus, antibiotics are not effective. Inappropriate use of antibiotics may lead to side effects and increased resistance by bacteria.

How do you treat bronchiolitis?

The best treatments for bronchiolitis are home remedies and simple measures for symptomatic relief. If your child is having symptoms but they are not causing discomfort, interruption of sleep or feedings, then no interventions are needed. Occasionally your doctor may try breathing treatments; these have only been shown to help with a minority of children with bronchiolitis.

15316 Huebner Rd, Ste 102; San Antonio, TX 78248 (210) 479-9292 www.throughtheyearspediatrics.com Infections

Please see our website for particular recommendations on ways to provide symptomatic relief sfor fever, runny nose or nasal congestion and cough.

When should I bring my child in to get seen?

 All infants less than 3 months of age with a cough should be seen in the office  All infants less than 3 months of age with fever of 100.4 or more should be evaluated immediately  If you child’s cough is worsening and is interfering with feeding and drinking, especially if your child is taking less than half of their normal fluid intake or is having less than one wet diaper or urine output every 6 hours.  If your child’s cough is causing vomiting  If your child is not improving after several days or develops a fever over 102.  If your child seems short of breath or having trouble breathing  For any other concern you may have.

15316 Huebner Rd, Ste 102; San Antonio, TX 78248 (210) 479-9292