Back التهاب القصيبات Arabic Bronquiolitis AST Бронхиолит Bulgarian Bronquiolitis Catalan Akute Bronchiolitis German Bronquiolitis Spanish Bronkiolitis Basque التهاب نایژک Persian Bronchiolite French Bronquiolite Galician

Bronchiolitis

Not to be confused with bronchitis, Obliterative bronchiolitis, or bronchiolitis obliterans organizing pneumonia.

Bronchiolitis
An X-ray of a child with RSV showing the typical bilateral perihilar fullness of bronchiolitis.
SpecialtyEmergency medicine, pediatrics
SymptomsFever, cough, runny nose, wheezing, breathing problems[1]
ComplicationsShortness of breath, dehydration[1]
Usual onsetLess than 2 years old[2]
CausesViral disease (respiratory syncytial virus, human rhinovirus)[2]
Diagnostic methodBased on symptoms[1]
Differential diagnosisAsthma, pneumonia, heart failure, allergic reaction, cystic fibrosis[1]
TreatmentSymptomatic treatment (oxygen, support with feeding, intravenous fluids)[3]
Frequency~20% (children less than 2)[2][1]
Deaths1% (among those hospitalized)[4]

Bronchiolitis is inflammation of the small airways in the lungs. Acute bronchiolitis is due to a viral infection usually affecting children younger than two years of age.[5] Symptoms may include fever, cough, runny nose, wheezing, and breathing problems.[1] More severe cases may be associated with nasal flaring, grunting, or the skin between the ribs pulling in with breathing.[1] If the child has not been able to feed properly, signs of dehydration may be present.[1]

Chronic bronchiolitis is the general term used for small airways disease in adults, notably in chronic obstructive pulmonary disease.[5][6]

Acute bronchiolitis is usually the result of infection by respiratory syncytial virus (72% of cases) or human rhinovirus (26% of cases).[2] Diagnosis is generally based on symptoms.[1] Tests such as a chest X-ray or viral testing are not routinely needed.[2]

There is no specific treatment.[3][7] Symptomatic treatment at home is generally sufficient.[1] Occasionally, hospital admission for oxygen, support with feeding, or intravenous fluids is required.[1] Tentative evidence supports nebulized hypertonic saline.[8][needs update] Evidence for antibiotics, antivirals, bronchodilators, or nebulized epinephrine is either unclear or not supportive.[9]

About 10% to 30% of children under the age of two years are affected by bronchiolitis at some point in time.[1][2] It commonly occurs in the winter in the Northern Hemisphere.[1] It is the leading cause of hospitalizations in those less than one year of age in the United States.[10][7] The risk of death among those who are admitted to hospital is about 1%.[4] Outbreaks of the condition were first described in the 1940s.[11]

  1. ^ a b c d e f g h i j k l m Friedman JN, Rieder MJ, Walton JM (November 2014). "Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age". Paediatrics & Child Health. 19 (9): 485–498. doi:10.1093/pch/19.9.485. PMC 4235450. PMID 25414585.
  2. ^ a b c d e f Schroeder AR, Mansbach JM (June 2014). "Recent evidence on the management of bronchiolitis". Current Opinion in Pediatrics. 26 (3): 328–333. doi:10.1097/MOP.0000000000000090. PMC 4552182. PMID 24739493.
  3. ^ a b Hancock DG, Charles-Britton B, Dixon DL, Forsyth KD (September 2017). "The heterogeneity of viral bronchiolitis: A lack of universal consensus definitions". Pediatric Pulmonology. 52 (9): 1234–1240. doi:10.1002/ppul.23750. PMID 28672069. S2CID 3454691.
  4. ^ a b Ali A, Plint AC, Klassen TP (2012). "Bronchiolitis". In Kendig EL, Wilmott RW, Boat TF, Bush A, Chernick V (eds.). Kendig and Chernick's Disorders of the Respiratory Tract in Children. Elsevier Health Sciences. p. 450. ISBN 978-1437719840.
  5. ^ a b Ryu JH, Azadeh N, Samhouri B, Yi E (2020). "Recent advances in the understanding of bronchiolitis in adults". F1000Research. 9: 568. doi:10.12688/f1000research.21778.1. PMC 7281671. PMID 32551095.
  6. ^ Kumar V, Abbas AK, Aster JC (2018). Robbins basic pathology (Tenth ed.). Philadelphia, Pennsylvania: Elsevier. p. 502. ISBN 9780323353175.
  7. ^ a b Kirolos A, Manti S, Blacow R, Tse G, Wilson T, Lister M, et al. (October 2020). "A Systematic Review of Clinical Practice Guidelines for the Diagnosis and Management of Bronchiolitis". The Journal of Infectious Diseases. 222 (Suppl 7): S672–S679. doi:10.1093/infdis/jiz240. hdl:20.500.11820/7d4708e3-7cdc-49f7-a9b3-a29040f4ff4e. PMID 31541233.
  8. ^ Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP (December 2017). "Nebulised hypertonic saline solution for acute bronchiolitis in infants". The Cochrane Database of Systematic Reviews. 2017 (12): CD006458. doi:10.1002/14651858.CD006458.pub4. PMC 6485976. PMID 29265171.
  9. ^ Brooks CG, Harrison WN, Ralston SL (June 2016). "Association Between Hypertonic Saline and Hospital Length of Stay in Acute Viral Bronchiolitis: A Reanalysis of 2 Meta-analyses". JAMA Pediatrics. 170 (6): 577–584. doi:10.1001/jamapediatrics.2016.0079. PMID 27088767.
  10. ^ Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, et al. (November 2014). "Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis". Pediatrics. 134 (5): e1474–e1502. doi:10.1542/peds.2014-2742. PMID 25349312.
  11. ^ Graham BS, Anderson LJ (2013). Challenges and Opportunities for Respiratory Syncytial Virus Vaccines. Current Topics in Microbiology and Immunology. Vol. 372. Springer Science & Business Media. pp. 391–404. doi:10.1007/978-3-642-38919-1_20. ISBN 9783642389191. PMC 7121045. PMID 24362701.

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