Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prevention
Also Known As
Laura Porter / Verywell
Bronchiolitis Symptoms
After acute symptoms pass, coughing and wheezing can persist for several weeks. Most cases of bronchiolitis are self-limiting and do not cause long-term harm or injury.
In rare instances, bronchiolitis can lead to severedehydration(due to poor feeding), respiratory distress (the inability to catch one’s breath), orrespiratory failure(the inability to keep up with the body’s oxygen demands).
When to Call 911
Call 911 or go to your nearest emergency room if your child develops signs of severe bronchiolitis, including:
Pediatric bronchiolitis is rarely fatal. Even if a child with the condition needs to be hospitalized, the chance they won’t survive is less than a 1%; only five of every 100,000 children who develop bronchiolitis die as a result.
When to Worry About Your Child’s Wheezing
The condition starts with an acute infection of the epithelial cells that line the smaller airways of the lungs.
Verywell / Gary Ferster
In adults and older children, these common viruses will generally only affect theupper respiratory tractbecause the immune system is able to limit their spread. But because infants and younger children don’t yet have a strong or robust immune response, viruses like these can more readily infiltrate the lower respiratory tract.
When this occurs, the infection will trigger an inflammatory response that causes the bronchioles to constrict (narrow). The inflammation, in turn, causes goblet cells in the airways torelease excess mucus, causing obstruction and characteristic wheezing.
Risk Factors
There are a number of risk factors that can predispose a child to bronchiolitis:
The Dangers of RSV in Preemies
Bronchiolitis is typically diagnosed with a clinical exam.This would include a physical examination along with a review of the child’s symptoms and medical history.
The physical exam would involve listening for breathing sounds with a stethoscope to detect crackles and high-pitched purring or whistling sounds characteristic of lower respiratory infections. Rapid breathing and nasal flaring are other tell-tale signs.
Rapid tests are available to detect specific viruses. But, as the results have little impact on how the infection is managed, they usually aren’t performed unless the symptoms are severe or recurrent.
Chest X-rays may be ordered but also have their limitations. While they can help identify early respiratory failure in children with severe illness, their usefulness in mild to moderate cases is less certain.
It is not uncommon for children with bronchiolitis to develop a secondary bacterial infection. Because cases of UTI can be treated, aurinalysismay be ordered to check for this.
Otitis media can often be diagnosed with a visual examination of the ear.
Why Rapid Flu Tests Can Be Falsely Negative
Differential Diagnoses
The treatment of bronchiolitis is mainly supportive. Unless a secondary bacterial infection is identified, antibiotics are not prescribed as they only treat bacteria, not viruses.
Antiviral drugsare not used to treat viral respiratory infection except in the cases of influenza and children hospitalized with RSV.
The antiviral drugTamiflu (oseltamivir)may reduce the severity of flu in infants and toddlers if taken within 48 hours of the first symptoms. With that said, acute symptoms of bronchiolitis tend to develop within three to five days of exposure, meaning that the drug may be better able to prevent bronchiolitis than treat it once it occurs.
Mild to moderate bronchiolitis tends to resolve fully within two to three weeks without treatment. Most guidelines recommend bed rest with sufficient fluids and nutrition. It’s also important to keep a child with bronchiolitis away from smoke.
If your child has a fever, ask your pediatrician if you can useChildren’s Tylenol (acetaminophen)or Children’s Motrin (ibuprofen), both of which are available as syrups.
Do not give a child aspirin, as it brings a risk ofReye’s syndrome, a rare but potentially life-threatening condition.
Some parents like using steam inhalation or cool mist humidifiers to relieve respiratory symptoms, although there is little evidence to support their use.
How Recurrent Respiratory Infections Are Treated in Children
Hospitalization
As many as 3% of infants in the United States require hospitalization as a result of bronchiolitis. Severe cases often demand more aggressive interventions to avoid or treat respiratory failure, including:
As with mild to moderate cases, inhaled bronchodilators or steroids do little to relieve symptoms or aid in recovery.
Why Albuterol Is No Longer Used for Bronchiolitis
There is no vaccine currently available to prevent cold viruses or parainfluenza viruses.
To prevent the flu, the Centers for Disease Control and Prevention (CDC) recommends annual flu shots for anyone 6 months of age or older. For people between 2 and 49, anasal flu vaccineis also available.Flu vaccination for the entire household is of the utmost importance in families where there are infants, elderly adults, orothers at high risk of flu complications.
During cold or flu season, the risk of infection can be reduced with dedicated handwashing, the avoidance of mouth-to-face contact, and the isolation of anyone with a suspected or active infection.
If there is a local outbreak of RSV in daycare or preschool, it is important to pull your child out until health officials tell you that it is safe to return.
There are two ways to prevent RSV in infants. Pregnant people can receive an RSV vaccine between weeks 32 and 36 to protect their babies after birth. Or, infants may be immunized with a protective antibody before or during RSV season. The antibody is recommended for all infants under 8 months old if their mother didn’t receive the RSV vaccine, as well as infants up to 19 months old with certain high-risk factors.
There are three vaccine options to prevent severe RSV disease in adults, each given as a one-time shot. The vaccine is recommended for adults aged 60-74 who have risk factors such as chronic heart or lung disease, or for all adults over age 75. One of the vaccines, Abrsyvo, is also approved for adults ages 18-59 who are at increased risk of lower respiratory tract disease.
12 Vaccines Recommended for All Young Children
A Word From Verywell
Bronchiolitis is babies and toddlers can be very distressing to them and their parents. Even though the condition is relatively common and usually resolves on its own, it is important to see your child’s pediatrician to confirm the diagnosis. In some cases, wheezing may be a sign of a more serious condition, such as pneumonia.
12 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.Barker AF, Bergeron A, Rom WN, Hertz MI.Obliterative bronchiolitis.N Eng J Med.2014 May;370(19):1820-8. doi:10.1056/NEJMra1204664Justice NA, Le JK.Bronchiolitis. In: StatPearls.Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review.Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23Erickson EN, Bhakta RT, Mendez MD.Pediatric bronchiolitis. In: StatPearls.Farzana R, Hoque M, Kamal MS, Choudhury MM.Role of parental smoking in severe bronchiolitis: A hospital-based case-control study.Int J Pediatr. 2017;2017:9476367. doi:10.1155/2017/9476367Friedman JN, Rieder MJ, Walton JM; Canadian Paediatric Society, Acute Care Committee, Drug Therapy and Hazardous Substances Committee.Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age. Paediatr Child Health. 2014 Nov;19(9):485-98. doi: 10.1093/pch/19.9.485.Iqbal SM.Management of acute viral bronchiolitis in children: Evidence beyond guidelines.Sudan J Paediatr.2012;12(1):40-8.Umoren R, Odey F, Meremikwu MM.Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age.Cochrane Database Syst Rev. 2011(1):CD006435. doi:10.1002/14651858.CD006435.pub2Hasegawa K, Tsugawa Y, Brown DF, Mansbach JM, Camargo CA.Trends in bronchiolitis hospitalizations in the United States, 2000-2009.Pediatrics.2013;132(1):28-36. doi:10.1542/peds.2012-3877Centers for Disease Control and Prevention.Children & influenza (flu).Centers for Disease Control and Prevention.RSV in Infants and Young Children.Centers for Disease Control and Prevention.Vaccines for Adults Ages 60 and Over.
12 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.Barker AF, Bergeron A, Rom WN, Hertz MI.Obliterative bronchiolitis.N Eng J Med.2014 May;370(19):1820-8. doi:10.1056/NEJMra1204664Justice NA, Le JK.Bronchiolitis. In: StatPearls.Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review.Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23Erickson EN, Bhakta RT, Mendez MD.Pediatric bronchiolitis. In: StatPearls.Farzana R, Hoque M, Kamal MS, Choudhury MM.Role of parental smoking in severe bronchiolitis: A hospital-based case-control study.Int J Pediatr. 2017;2017:9476367. doi:10.1155/2017/9476367Friedman JN, Rieder MJ, Walton JM; Canadian Paediatric Society, Acute Care Committee, Drug Therapy and Hazardous Substances Committee.Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age. Paediatr Child Health. 2014 Nov;19(9):485-98. doi: 10.1093/pch/19.9.485.Iqbal SM.Management of acute viral bronchiolitis in children: Evidence beyond guidelines.Sudan J Paediatr.2012;12(1):40-8.Umoren R, Odey F, Meremikwu MM.Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age.Cochrane Database Syst Rev. 2011(1):CD006435. doi:10.1002/14651858.CD006435.pub2Hasegawa K, Tsugawa Y, Brown DF, Mansbach JM, Camargo CA.Trends in bronchiolitis hospitalizations in the United States, 2000-2009.Pediatrics.2013;132(1):28-36. doi:10.1542/peds.2012-3877Centers for Disease Control and Prevention.Children & influenza (flu).Centers for Disease Control and Prevention.RSV in Infants and Young Children.Centers for Disease Control and Prevention.Vaccines for Adults Ages 60 and Over.
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.
Barker AF, Bergeron A, Rom WN, Hertz MI.Obliterative bronchiolitis.N Eng J Med.2014 May;370(19):1820-8. doi:10.1056/NEJMra1204664Justice NA, Le JK.Bronchiolitis. In: StatPearls.Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review.Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23Erickson EN, Bhakta RT, Mendez MD.Pediatric bronchiolitis. In: StatPearls.Farzana R, Hoque M, Kamal MS, Choudhury MM.Role of parental smoking in severe bronchiolitis: A hospital-based case-control study.Int J Pediatr. 2017;2017:9476367. doi:10.1155/2017/9476367Friedman JN, Rieder MJ, Walton JM; Canadian Paediatric Society, Acute Care Committee, Drug Therapy and Hazardous Substances Committee.Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age. Paediatr Child Health. 2014 Nov;19(9):485-98. doi: 10.1093/pch/19.9.485.Iqbal SM.Management of acute viral bronchiolitis in children: Evidence beyond guidelines.Sudan J Paediatr.2012;12(1):40-8.Umoren R, Odey F, Meremikwu MM.Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age.Cochrane Database Syst Rev. 2011(1):CD006435. doi:10.1002/14651858.CD006435.pub2Hasegawa K, Tsugawa Y, Brown DF, Mansbach JM, Camargo CA.Trends in bronchiolitis hospitalizations in the United States, 2000-2009.Pediatrics.2013;132(1):28-36. doi:10.1542/peds.2012-3877Centers for Disease Control and Prevention.Children & influenza (flu).Centers for Disease Control and Prevention.RSV in Infants and Young Children.Centers for Disease Control and Prevention.Vaccines for Adults Ages 60 and Over.
Barker AF, Bergeron A, Rom WN, Hertz MI.Obliterative bronchiolitis.N Eng J Med.2014 May;370(19):1820-8. doi:10.1056/NEJMra1204664
Justice NA, Le JK.Bronchiolitis. In: StatPearls.
Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review.Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23
Erickson EN, Bhakta RT, Mendez MD.Pediatric bronchiolitis. In: StatPearls.
Farzana R, Hoque M, Kamal MS, Choudhury MM.Role of parental smoking in severe bronchiolitis: A hospital-based case-control study.Int J Pediatr. 2017;2017:9476367. doi:10.1155/2017/9476367
Friedman JN, Rieder MJ, Walton JM; Canadian Paediatric Society, Acute Care Committee, Drug Therapy and Hazardous Substances Committee.Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age. Paediatr Child Health. 2014 Nov;19(9):485-98. doi: 10.1093/pch/19.9.485.
Iqbal SM.Management of acute viral bronchiolitis in children: Evidence beyond guidelines.Sudan J Paediatr.2012;12(1):40-8.
Umoren R, Odey F, Meremikwu MM.Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age.Cochrane Database Syst Rev. 2011(1):CD006435. doi:10.1002/14651858.CD006435.pub2
Hasegawa K, Tsugawa Y, Brown DF, Mansbach JM, Camargo CA.Trends in bronchiolitis hospitalizations in the United States, 2000-2009.Pediatrics.2013;132(1):28-36. doi:10.1542/peds.2012-3877
Centers for Disease Control and Prevention.Children & influenza (flu).
Centers for Disease Control and Prevention.RSV in Infants and Young Children.
Centers for Disease Control and Prevention.Vaccines for Adults Ages 60 and Over.
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