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Pediatrics - Bronchiolitis
Bronchiolitis is a term used to describe a common viral illness in infants up to 2 years of age. The infectious agent is often identified as respiratory syncytial virus (RSV). This infection involves the bronchial airways in the lungs. Infants from 2 months to 2 years can be affected, but most cases occur
in the 2-6 month group. Winter and spring are the most common seasons in which bronchiolitis occurs. Common symptoms and signs include: rapid respiratory rate, wheezing, congestion, runny nose, and fever. Evaluation will include a physical examination to search for a possible bacterial infection which would require treatment with antibiotics. Nasopharyngeal viral cultures are frequently positive for the presence of respiratory syncytial virus (RSV). Depending upon the severity of the illness
and age of the infant, a chest x-ray and blood tests may be performed. Treatment usually involves general supportive care and fever control with acetaminophen. Plenty of fluids or juice will keep the child well hydrated and make the secretions easier to accommodate. Saline nose drops (available pre-mixed and in nonprescription) may be placed in each nostril, then suctioned clear with a soft bulb tipped syringe (available at the pharmacy). A cool mist vaporizer (in the bedroom) can also help keep the nasal passages clear. More pronounced wheezing could warrant the use of a prescription bronchodilator medication (e.g. Alupent, Proventil) administered in the emergency room, or routinely at home. Decongestants are usually not prescribed for infants under 15 months. Children who may require hospitalization for more serious infection may receive nebulized (aerosolized) treatments with (Riboviran) a newer antiviral medication. Bronchiolitis should run its course in about 4-5 days, but it can persist for over a week. Close pediatric follow-up is important in order to make certain there is no underlying bacterial illness that will require the addition of
antibiotic therapy. See your Pediatrician.
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