BRONCHIOLITIS (common lower respiratory illness of young children)

Small children are very prone to viral infections involving the respiratory tract; most of them are Viral URI (upper respiratory tract infections). These URI usually have running nose along with fever and cough.

Whereas in Bronchiolitis, cough and fast breathing is major concern.Timely visit to child specialist/ Pediatrician is best for early detection and prevention of serious illness.

Bronchiolitis_anatomy_PI

Bronchiolitis: most common lower respiratory (airway) illness in Infants

Cause: viral illness (RSV virus most common, parainfluenza virus, influenza virus, adenovirus).

Symptoms usually get worse during the first three days and then gradually improve. During this time, your child may experience:

  • Cough and fast breathing (with audible wheezing or whistling sound sometimes).
  • ¬†Fever.
  • Noisy breathing
  • Irritability
  • Poor¬† feeding

Total duration of illness is around 1 week (with waxing and waning course).

Following are the danger signs

  • increased difficulty breathing or wheezing as they breathe
  • poor feeding
  • no wet nappy for 12 hours or more
  • a rapid breathing rate of > 50 breaths per minute in 2months to 12 months child
  • being very tired or lethargic

Bronchiolitits

Diagnosis: Clinical diagnosis, no investigations needed if diagnosis is clear from history and physical examinations done by a child specialist / Pediatrician.

Treatment:

Supportive:

  • Keep your child upright (symptoms worsen on lying down)
  • Drink plenty of fluids
  • steam inhalation or saline nebulization
  • Smoke free environment
  • paracetamol drops for fever
  • Saline nasal drops

Specific:

  • Nebulization with Adrenaline
  • Trial with salbutamol can be given, if response there then continue or else give adrenaline nebulization only.

Following drugs have no role in treatment of this disease:

  • Antibiotics
  • Steroids
  • Antiviral drugs like rabavirin etc

As this infection is viral illness, so it cannot be prevented but keeping good personal hygiene will decrease the chances of catching this illness in children.

Stay healthy

Regards

Dr Rahul

 

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