Causative and risk factors
Bronchiolitis is usually a viral disease caused due to respiratory syncytial virus [RSV]. Influenza, parainfluenza, rhinovirus, adenovirus, coronavirus, metapneumovirus are the other viruses that cause this diseases. Premature, low birth weight babies and those with congenital heart disease are at higher risk of having bronchiolitis.
Clinical presentation
The child presents with cough, shortness of breath, nasal stuffiness, increased crying episodes, poor breast feeding, lethargy. Lowered respiratory rate, nasal flaring, apnoea, recession of chest wall, cyanosis. On physical examination wheezing and crackles may be found.
Investigations
Medical history of the complaints by the parents and Clinical examination by the peadatrician helps in diagnosis. A chest x – ray may give an idea of the disease. Routine blood test and specific Tests for indentifying specific virus by nasopharyngeal aspiration can be done.
Treatment
Most of the time the infection resolves within two to three weeks by itself. Bronchodilators, inhaled hypertonic saline, reduce the chances of complications and hasten recovery. Antibiotics prevent the bacterial infection accompanying the disease. Breast feeding in the first month of birth provides protection against infection.
Other modes of treatment like homoeopathy also help in relieving the symptoms.
Recent updates
Recent study shows association between delivery by caesarean section and incidence of bronchiolitis. Vaccines for infants who meet certain criteria are available such as palivizumab.
