Table of ContentsView AllTable of ContentsCauses and SymptomsAt-Risk GroupsTreatmentComplicationsWhen to Call the Healthcare Provider
Table of ContentsView All
View All
Table of Contents
Causes and Symptoms
At-Risk Groups
Treatment
Complications
When to Call the Healthcare Provider
Bronchiolitisandbronchitisare both infections that affect the lungs and can have overlapping symptoms such as a cough, wheezing, and low-grade fever. However, there are some very important differences in symptoms, causes, treatment, and ultimately, how they may affect future lung function.
Bronchiolitis is an inflammation of the small airways (bronchioles) and most often affects infants less than 2 years of age. Bronchitis causes inflammation of thebronchi(and bronchioles to a degree) and can affect people of any age.
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Symptoms common to both bronchiolitis and bronchitis include:
Bronchiolitis
The symptoms ofbronchiolitiscan differ from bronchitis both in how the infection affects the respiratory system and based on the age groups in which the infections are found.
Since bronchiolitis often occurs in young children who can’t express how they are feeling, objective signs that parents can visualize are often key in diagnosis.
Symptoms specific to bronchiolitis include:
A hallmark of bronchiolitis that is not seen with bronchitis is the minute-to-minute variation in symptoms. One moment a child may be sleeping comfortably, the next they may be agitated and appear quite ill, and then they may appear comfortable again after coughing and clearing mucus from their airways.
How Long Do Bronchiolitis Symptoms Last?Altogether, symptoms last around two weeks, although coughing and wheezing sometimes last longer.
How Long Do Bronchiolitis Symptoms Last?
Altogether, symptoms last around two weeks, although coughing and wheezing sometimes last longer.
Other symptoms may include:
An elevatedrespiratory rateis an important sign and has been coined the neglected vital sign. Respiratory rates run higher in children than adults, with normal respiratory rates in children being:
Bronchiolitis vs. Bronchitis: How to Differentiate and Treat Symptoms
Bronchitis
It’s important to briefly make a distinction between acute bronchitis and chronic bronchitis:
Symptoms of acute bronchitis that are less likely to be seen with bronchiolitis include:
Most cases of bronchitis are due to a viral infection, with the most common being:
Bacteria are the cause of only 1% to 10% of cases. Less commonly, atypical bacteria such as mycoplasma, chlamydia, andBordatella pertussis(the cause of whooping cough) are involved. Non-infectious bronchitis may also occur due to exposure to irritants such as smoke or dust.
BronchiolitisChildren, usually less than 2 years oldSymptoms can vary from minute to minuteDifficulty breathing may appear as chest retractions, nasal flaring, grunting, use of accessory musclesDecreased nursing/eating, decreased playfulnessBronchitisAny age (uncommon less than age 2)Symptoms either gradually improve or worsenA person may state they feel short of breathFatigue
BronchiolitisChildren, usually less than 2 years oldSymptoms can vary from minute to minuteDifficulty breathing may appear as chest retractions, nasal flaring, grunting, use of accessory musclesDecreased nursing/eating, decreased playfulness
Children, usually less than 2 years old
Symptoms can vary from minute to minute
Difficulty breathing may appear as chest retractions, nasal flaring, grunting, use of accessory muscles
Decreased nursing/eating, decreased playfulness
BronchitisAny age (uncommon less than age 2)Symptoms either gradually improve or worsenA person may state they feel short of breathFatigue
Any age (uncommon less than age 2)
Symptoms either gradually improve or worsen
A person may state they feel short of breath
Fatigue
Some people are more likely to develop bronchiolitis or bronchitis than others. In general, young children, especially those less than 2 years of age, are more likely to develop bronchiolitis, whereas bronchitis may occur in any age group (although it is uncommon before the age of 2).
Risk Factors for Bronchiolitis
A number of circumstances and conditions increase the chance that a child will develop bronchiolitis, and for those who develop the disease, separate factors increase the risk that it will be serious.
The risk of developing the disease primarily relates to the chance of being exposed to the causative viruses, whereas the chance that a child will become seriously ill is linked more with underlying medical conditions.
Risk factors for developing bronchiolitis include:
Factors that increase the chance that bronchiolitis will be serious include:
Risk Factors for Bronchitis
Like bronchiolitis, there are factors that increase the chance a person will develop the condition, as well as factors that may make developing the disease more serious.
Risk factors for developing bronchitis include:
Among those who develop bronchitis, some people are more likely to become seriously ill—for example, developing secondary complications such aspneumonia. This includes:
Causes and Risk Factors of Bronchitis
There are no formal treatments available for either uncomplicated bronchiolitis or bronchitis (except in uncommon cases when bronchitis is bacterial). The infection generally needs to “run its course.”
If the infection is due to influenza A and diagnosed shortly after the onset of symptoms, some healthcare providers may recommendTamiflu (oseltamivir). That said, measures can be taken to manage the symptoms and in some cases may reduce the chance that the infection will become more serious.
Both bronchiolitis and bronchitis last, on average, around two weeks. However, a cough or wheezing may persist for some people, even beyond three weeks.
Some treatments that may be recommended for bronchitis are not recommended for bronchiolitis—for example, bronchodilators—so we will discuss these separately.
For a fever or appearance of discomfort, Tylenol (acetaminophen) may be used for most children.Aspirin should not be used in childrendue to the risk ofReye’s syndrome.
Saline nose drops (and a suction bulb if necessary) may help relieve some congestion.
Roughly 3% of children who develop bronchiolitis end up being hospitalized, and bronchiolitis remains the most common reason for hospital admission in the first 12 months of life.
Inpatient treatment may include:
Nebulized hypertonic saline may help with airway swelling in infants.
According to clinical practice guidelines, medications such asalbuterol(and similar medications),epinephrine, and corticosteroids should not be used. Antibiotics are recommended only if there is clear evidence of a secondary bacterial infection present. When very severe, mechanical ventilation may be needed.
As far as the prevention of RSV, there are options:
Pregnant people can receive an RSV vaccine between weeks 32 and 36 of pregnancy if this falls between September and January. This would protect the infant during their first RSV season.
All other infants under 8 months old who are born shortly before or during RSV season should be immunized with an antibody called Beyfortus (nirsevimab). Some children up to 19 months old who are at risk for severe RSV disease may also receive the antibody to protect them during their second RSV season. Beyfortus is given as a single shot.
Beyfortus cannot cure ortreat a child diagnosed with RSV. If your child is at very high risk for RSV infection, your pediatrician may discuss these options with you.
For fever or discomfort, Tylenol (acetaminophen) is usually recommended. Resting, including taking a nap during the day if needed, can’t be understated. If you have a difficult time giving yourself permission to rest, imagine your body needing the energy to fight off the virus and heal your airways.
Should You Take Cough Medicine?Some people find cough medications or an expectorant helpful, but a 2021 study confirmed earlier findings and found that a spoonful of honey was actually more helpful than common cold and cough medications.Honey is not recommended for children less than 1 year old.
Should You Take Cough Medicine?
Some people find cough medications or an expectorant helpful, but a 2021 study confirmed earlier findings and found that a spoonful of honey was actually more helpful than common cold and cough medications.Honey is not recommended for children less than 1 year old.
Other treatments will depend on how symptoms progress. For example, if a secondary bacterial infection should develop, antibiotics may be necessary. Some people develop reactive airway disease with bronchitis, and treatments such as analbuterol inhalerto open the airways or corticosteroids to reduce inflammation may be needed.
How Bronchitis Is Treated
Both bronchiolitis and bronchitis may lead to complications, though the particular complications and when they might occur vary between the conditions.
With bronchiolitis, low oxygen levels (hypoxia) requiring oxygen supplementation may occur and require hospitalization. Dehydration may also occur and can be treated with IV fluids.
With severe disease, respiratory failure may sometimes occur, requiring mechanical ventilation and sedation. Bacterial co-infections, such asear infections(otitis media) andurinary tract infections, have also been seen.
A number of studies have evaluated the possible association of bronchiolitis early in life with wheezing and childhood asthma later on, with mixed results. When asthma is seen later in childhood, it’s also not known whether having bronchiolitis may damage the lungs in a way that would predispose to asthma, or if instead a child’s particular immune response or lung function might predispose them to develop both bronchiolitis and recurrent wheezing.
Wheezing Later in ChildhoodA 2021 review looking at 22 studies found that lower respiratory tract infections (such as bronchiolitis) in children less than 3 years of age were associated with an increased risk of the subsequent development of wheezing later in childhood. The risk was roughly three times higher than for those who did not have these infections.
Wheezing Later in Childhood
A 2021 review looking at 22 studies found that lower respiratory tract infections (such as bronchiolitis) in children less than 3 years of age were associated with an increased risk of the subsequent development of wheezing later in childhood. The risk was roughly three times higher than for those who did not have these infections.
Recurrent Respiratory Infections in Children
One of the most common complications of bronchitis is a secondary pneumonia which is most commonly bacterial.
Potentially worrisome symptoms are listed below and frequently present in younger people who go on to developpneumonia. In people over the age of 75, however, symptoms of pneumonia may be more subtle, and it’s important to contact your healthcare provider with any concerns or if symptoms persist.
Both bronchiolitis and bronchitis most often resolve on their own, but it’s important to be aware of symptoms that could suggest complications and when to call your healthcare provider.
Signs of concern with bronchiolitis may include:
Signs to call your healthcare provider with bronchitis include:
A Word From Verywell
Both bronchitis and bronchiolitis are lower respiratory infections that usually run their course without problems. That said, it’s important to be aware of potential complications as well as when you should call your healthcare provider.
Since bronchiolitis often occurs in young infants, it can be very frightening for parents. Make sure to call your healthcare provider with any concerns, even if you suspect everything is OK. And trust your gut. Your instinct as a parent is often the best “diagnostic test” available.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Bronchiolitis.Florin TA, Plint AC, Zorc JJ.Viral bronchiolitis.Lancet.2017;389(10065):211-224. doi:10.1016/S0140-6736(16)30951-5Fleming S, Thompson M, Stevens R, et al.Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies.Lancet. 2011;377(9770):1011-8. doi:10.1016/S0140-6736(10)62226-XSilver AH, Nazif JM.Bronchiolitis.Pediatr Rev. 2019;40(11):568-576. doi:10.1542/pir.2018-0260MedlinePlus.Acute bronchitis.Kinkade S, Long NA.Acute bronchitis.Am Fam Physician. 2016;94(7):560-565.Ralston SL, Lieberthal AS, Meissner HC.Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.Pediatrics. 2014;134(5). doi:10.1542/peds.2014-2742Centers for Disease Control and Prevention.RSV in Infants and Young Children.Centers for Disease Control and Prevention.US Centers for Disease Control and Prevention, Acip evidence to recommendations for the use of the modern RSV vaccine (Mresvia) in all adults aged ≥75 and in adults aged 60–74 at increased risk of severe RSV disease. Advisory Committee on Immunization Practices (ACIP).Abuelgasim H, Albury C, Lee J.Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis.BMJ Evid Based Med.2021;26(2):57-64. doi:10.1136/bmjebm-2020-111336Kenmoe S, Bowo-Ngandji A, Kengne-Nde C, et al.Association between early viral LRTI and subsequent wheezing development, a meta-analysis and sensitivity analyses for studies comparable for confounding factors.PLoS One.2021;16(4):e0249831. doi:10.1371/journal.pone.0249831Additional ReadingPetrarca L, Jacinto T, Nenna R.The treatment of acute bronchiolitis: past, present and future.Breathe (Sheff).2017;13(1):e24-e26. doi:10.1183/20734735.000717Tormanen S, Lauhkonen E, Riikonen R, et al.Risk factors for asthma after infant bronchiolitis.Allergy. 2018;73(4):916-922. doi:10.1111/all.13347
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Bronchiolitis.Florin TA, Plint AC, Zorc JJ.Viral bronchiolitis.Lancet.2017;389(10065):211-224. doi:10.1016/S0140-6736(16)30951-5Fleming S, Thompson M, Stevens R, et al.Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies.Lancet. 2011;377(9770):1011-8. doi:10.1016/S0140-6736(10)62226-XSilver AH, Nazif JM.Bronchiolitis.Pediatr Rev. 2019;40(11):568-576. doi:10.1542/pir.2018-0260MedlinePlus.Acute bronchitis.Kinkade S, Long NA.Acute bronchitis.Am Fam Physician. 2016;94(7):560-565.Ralston SL, Lieberthal AS, Meissner HC.Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.Pediatrics. 2014;134(5). doi:10.1542/peds.2014-2742Centers for Disease Control and Prevention.RSV in Infants and Young Children.Centers for Disease Control and Prevention.US Centers for Disease Control and Prevention, Acip evidence to recommendations for the use of the modern RSV vaccine (Mresvia) in all adults aged ≥75 and in adults aged 60–74 at increased risk of severe RSV disease. Advisory Committee on Immunization Practices (ACIP).Abuelgasim H, Albury C, Lee J.Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis.BMJ Evid Based Med.2021;26(2):57-64. doi:10.1136/bmjebm-2020-111336Kenmoe S, Bowo-Ngandji A, Kengne-Nde C, et al.Association between early viral LRTI and subsequent wheezing development, a meta-analysis and sensitivity analyses for studies comparable for confounding factors.PLoS One.2021;16(4):e0249831. doi:10.1371/journal.pone.0249831Additional ReadingPetrarca L, Jacinto T, Nenna R.The treatment of acute bronchiolitis: past, present and future.Breathe (Sheff).2017;13(1):e24-e26. doi:10.1183/20734735.000717Tormanen S, Lauhkonen E, Riikonen R, et al.Risk factors for asthma after infant bronchiolitis.Allergy. 2018;73(4):916-922. doi:10.1111/all.13347
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Bronchiolitis.Florin TA, Plint AC, Zorc JJ.Viral bronchiolitis.Lancet.2017;389(10065):211-224. doi:10.1016/S0140-6736(16)30951-5Fleming S, Thompson M, Stevens R, et al.Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies.Lancet. 2011;377(9770):1011-8. doi:10.1016/S0140-6736(10)62226-XSilver AH, Nazif JM.Bronchiolitis.Pediatr Rev. 2019;40(11):568-576. doi:10.1542/pir.2018-0260MedlinePlus.Acute bronchitis.Kinkade S, Long NA.Acute bronchitis.Am Fam Physician. 2016;94(7):560-565.Ralston SL, Lieberthal AS, Meissner HC.Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.Pediatrics. 2014;134(5). doi:10.1542/peds.2014-2742Centers for Disease Control and Prevention.RSV in Infants and Young Children.Centers for Disease Control and Prevention.US Centers for Disease Control and Prevention, Acip evidence to recommendations for the use of the modern RSV vaccine (Mresvia) in all adults aged ≥75 and in adults aged 60–74 at increased risk of severe RSV disease. Advisory Committee on Immunization Practices (ACIP).Abuelgasim H, Albury C, Lee J.Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis.BMJ Evid Based Med.2021;26(2):57-64. doi:10.1136/bmjebm-2020-111336Kenmoe S, Bowo-Ngandji A, Kengne-Nde C, et al.Association between early viral LRTI and subsequent wheezing development, a meta-analysis and sensitivity analyses for studies comparable for confounding factors.PLoS One.2021;16(4):e0249831. doi:10.1371/journal.pone.0249831
Cleveland Clinic.Bronchiolitis.
Florin TA, Plint AC, Zorc JJ.Viral bronchiolitis.Lancet.2017;389(10065):211-224. doi:10.1016/S0140-6736(16)30951-5
Fleming S, Thompson M, Stevens R, et al.Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies.Lancet. 2011;377(9770):1011-8. doi:10.1016/S0140-6736(10)62226-X
Silver AH, Nazif JM.Bronchiolitis.Pediatr Rev. 2019;40(11):568-576. doi:10.1542/pir.2018-0260
MedlinePlus.Acute bronchitis.
Kinkade S, Long NA.Acute bronchitis.Am Fam Physician. 2016;94(7):560-565.
Ralston SL, Lieberthal AS, Meissner HC.Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.Pediatrics. 2014;134(5). doi:10.1542/peds.2014-2742
Centers for Disease Control and Prevention.RSV in Infants and Young Children.
Centers for Disease Control and Prevention.US Centers for Disease Control and Prevention, Acip evidence to recommendations for the use of the modern RSV vaccine (Mresvia) in all adults aged ≥75 and in adults aged 60–74 at increased risk of severe RSV disease. Advisory Committee on Immunization Practices (ACIP).
Abuelgasim H, Albury C, Lee J.Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis.BMJ Evid Based Med.2021;26(2):57-64. doi:10.1136/bmjebm-2020-111336
Kenmoe S, Bowo-Ngandji A, Kengne-Nde C, et al.Association between early viral LRTI and subsequent wheezing development, a meta-analysis and sensitivity analyses for studies comparable for confounding factors.PLoS One.2021;16(4):e0249831. doi:10.1371/journal.pone.0249831
Petrarca L, Jacinto T, Nenna R.The treatment of acute bronchiolitis: past, present and future.Breathe (Sheff).2017;13(1):e24-e26. doi:10.1183/20734735.000717Tormanen S, Lauhkonen E, Riikonen R, et al.Risk factors for asthma after infant bronchiolitis.Allergy. 2018;73(4):916-922. doi:10.1111/all.13347
Petrarca L, Jacinto T, Nenna R.The treatment of acute bronchiolitis: past, present and future.Breathe (Sheff).2017;13(1):e24-e26. doi:10.1183/20734735.000717
Tormanen S, Lauhkonen E, Riikonen R, et al.Risk factors for asthma after infant bronchiolitis.Allergy. 2018;73(4):916-922. doi:10.1111/all.13347
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