Bronchiolitis is an acute infectious disease of the lower respiratory tract in which pathological changes affect small bronchioles.
Inflammation of the bronchioles is caused by a viral infection.In 80% of cases, these are RS viruses (respiratory epithelial virus), and in the remaining cases, rhinoviruses,influenzaand paralyzed influenza viruses,adenovirusesand metapneumoviruses.
Infection occurs through droplets, i.e. through the transmission of microorganisms when sneezing orcoughing. The source of infection is primarily older siblings attending kindergarten or school, less often adults, including parents and guardians. Inflammation of the bronchioles develops about 5 days after exposure to the virus.
Most children have a mild courseand do not require hospitalization. Only 1-2% of children require a hospital stay, and a small percentage of them developrespiratory failure.
Risk factors for more severe bronchiolitis includeprematurity, chronic respiratory diseases, heart defects, neurological diseases, immune disorders, age less than 3 months, breastfeeding less than 2 months, nursery attendance, contact with preschool and school-age siblings, exposure to to tobacco smoke.
In this article, Niketrainers.com.co will tell you:
How common is bronchiolitis?
Most cases of bronchiolitis are diagnosed in the fall-winter period.The disease season begins in November or December, peaks in January or February, and ends in March, and sometimes April. Infection affects small children up to the age of 2. Boys get sick a little more often than girls.
How is bronchiolitis manifested?
Usually, at the beginning of the disease, mild signs of upper respiratory tract infection, such as runny nose, dry coughing accompanied by a mild fever,appear. After 2-3 days, the cough increases and becomes wet, which is directly related to the appearance of a thick, difficult to expectorate. Most often the symptoms are accompanied byshortnessof breath . You may hearwheezing. The baby has rapid breathing, moves its nostrils, grunts, gets tired while eating, stops feeding. After undressing, the work of additional respiratory muscles is visible – the intercostal space, the zygomatic fossa under the chin, and the supra- and subclavian fossa are drawn in.
During auscultation, the doctor finds the features of airway narrowing in the form of generalized, bilateral wheezing (resulting mainly from excess secretion).
What to do in case of symptoms of bronchiolitis?
A child in good general condition, despite a runny nose and elevated temperature, who eats and drinks eagerly, can be treated at home. Gently clean the nose (with a blower or other suitable device) of any residual secretions. Sea water can also be used directly in the nasal passages. Antipyretics should be given in the event of fever. It is also necessary to ensure optimal environmental conditions, the air in the child’s room should be relatively cool (approx. 18-20 ° C) and humidified.
Urgent medical consultation and assessment of indications for hospitalization require the occurrence of increased dyspnoea, respiratory effort,apnea,cyanosisor feeding problems.
How does a doctor make a diagnosis of bronchiolitis?
Usually, a medical history and symptoms found in a physical examination are sufficient to diagnose and evaluate the indications for hospitalization. During the visit, vital parameters such as the number of breaths, heart rate and oxygen saturation in the blood are measured.
In some cases, achest X-rayis performed , mainly to differentiate frompneumonia,and blood is drawn for examination.
It is also possible to perform a quick test for the presence of RSV infection after collecting secretions from the back of the throat (or the nasal cavities). This test is performed mainly for epidemiological purposes, as its positive result in a child with bronchiolitis diagnosed on the basis of clinical symptoms does not change the procedure.
What are the treatments for bronchiolitis?
There is no causal treatment – antiviral. Symptomatic treatment is applied, and in the case of saturation drops, oxygen therapy with an oxygen mask or mustache.
In some cases, bronchodilators are used, but indications for such treatment depend on the individual case. Anti-inflammatory drugs such as inhaled or systemic corticosteroids are not recommended. Antibiotic therapy is used in infants with bacterial complications such as otitis media.
Is it possible to cure bronchiolitis completely?
One in about 1,000 children with bronchiolitis is admitted to intensive care due to respiratory failure. Severe bronchiolitis is the greatest risk in babies born prematurely or with other diseases or abnormalities.
It should be emphasized, however, that most infants become mildly infected and recover within approximately 2 to 3 weeks. It should be remembered about the possibility of the development of further infections caused by the RS virus. It is related to the lack of permanent immune memory after infection. Most often they are milder than the first infection.
What should I do after treatment for bronchiolitis is completed?
The RS virus damages the respiratory epithelium. After having bronchiolitis up to around 13 months of age, there is an increased risk of recurrent bronchial obstruction. Therefore, in the event of subsequent illness, always inform the doctor that the child has had bronchiolitis.
What to do to avoid getting bronchiolitis?
Breastfeeding is a natural method of preventing respiratory infections. A minimum period of 6 months of breastfeeding is recommended. In addition, infants and young children cannot be exposed to tobacco smoke, because the harmful substances contained in it reduce immunity.
Due to the way of infection, preventing the spread of infection includes thorough washing of the cancer, preferably disinfecting them with an alcohol-based preparation after contact with a sick person.
In the prevention of infection with RS virus, a monoclonal antibody directed against the virus is used. Indications for such treatment are individual and include mainly premature children or children with a defect in the circulatory system that causes haemodynamic disturbance
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