Acute Bronchiolitis: Causes, Signs and How to Treat

Written by Medicover Team and Medically Reviewed by Dr Bhima Shankar , Pulmonologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Acute bronchiolitis is a viral infection that leads to the inflammation and congestion of the bronchioles. It is most commonly caused by the Respiratory Syncytial Virus (RSV), though other viruses such as adenovirus, influenza, and parainfluenza can also be responsible. The condition is highly prevalent among infants, especially those under two years of age.

How Many Types of Acute Bronchiolitis?

Acute bronchiolitis can be categorized based on the severity and underlying causative agent:

Mild Bronchiolitis: Characterized by mild symptoms such as nasal congestion, mild cough, and low-grade fever. Infants with mild bronchiolitis generally do not require hospitalization.
Moderate Bronchiolitis: Symptoms may include wheezing, persistent cough, and difficulty breathing. Hospitalization may be necessary for monitoring and supportive care.
Severe Bronchiolitis: This type involves severe respiratory distress, cyanosis (bluish skin due to lack of oxygen), and potentially life-threatening complications. Immediate medical intervention and hospitalization are required.

What Are the Causes of Acute Bronchiolitis?

Understanding the causes of acute bronchiolitis is essential for prevention and management. The predominant cause is viral infections, with RSV being the most common culprit. Other contributing factors include:

Premature birth: Infants born prematurely have underdeveloped lungs, making them more susceptible.
Environmental factors: Exposure to tobacco smoke, pollution, and crowded living conditions increases the risk.
Weakened immune system: Infants with compromised immune systems are more prone to infections.

What Are the Symptoms of Acute Bronchiolitis?

Recognizing the symptoms of acute bronchiolitis in infants is pivotal for timely intervention. The initial symptoms often resemble those of a common cold, but they can quickly escalate. Key symptoms include:

Nasal congestion and runny nose: The earliest signs of infection.
Cough: Initially mild but can become persistent and severe.
Wheezing: High-pitched whistling sounds during breathing, indicative of narrowed airways.
Rapid or labored breathing: Infants may exhibit fast breathing or struggle to breathe.
Fever: Mild to moderate fever is common.
Poor feeding: Infants may have difficulty feeding due to respiratory distress.
Irritability: General fussiness and discomfort due to difficulty breathing.

When to See a Pulmonologist?

Acute bronchiolitis can escalate quickly, especially in infants and young children. Persistent breathing difficulties, poor feeding, or worsening symptoms may signal complications requiring prompt medical evaluation with pulmonologist or hospital admission.

You should see a doctor if you have:

Rapid or labored breathing lasting more than a day or two, especially in infants under 12 months.
Poor feeding, reduced wet diapers, or signs of mild dehydration alongside respiratory symptoms.
Persistent wheezing or coughing that does not improve after several days of home care.

Get medical help immediately if:

The child's lips, fingertips, or skin appear bluish or grayish, indicating dangerously low oxygen levels.
Breathing becomes extremely fast, shallow, or the chest visibly sinks with each breath (retractions).
The child becomes unresponsive, limp, or cannot be roused from sleep normally.

These could be signs of a serious complication like respiratory failure, which needs urgent care.

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How Is the Diagnosis of Acute Bronchiolitis Confirmed?

Diagnosing acute bronchiolitis involves a combination of clinical examination and diagnostic tests. Physicians typically follow these steps:

Clinical Examination

A thorough physical examination is conducted to assess the infant's respiratory status. This includes listening to the lungs for wheezing or crackling sounds, checking for signs of respiratory distress, and evaluating overall health.

Diagnostic Tests

Pulse Oximetry: Measures the oxygen saturation in the blood to assess the severity of respiratory compromise.
Chest X-ray: Helps in ruling out other conditions such as pneumonia or foreign body aspiration.
Nasal Swab Test: Identifies the viral cause by detecting specific viral antigens.
Blood Tests: May be conducted to check for markers of infection or to rule out bacterial infections.

What is the Treatment for Acute Bronchiolitis?

The treatment of acute bronchiolitis is primarily supportive, focusing on relieving symptoms and ensuring adequate oxygenation. Specific treatments may include:

Supportive Care

Hydration: Ensuring the infant remains well-hydrated is crucial. Oral or intravenous fluids may be administered.
Oxygen Therapy: Provided to infants with low oxygen levels to maintain adequate oxygen saturation.
Nasal Suctioning: Helps in clearing nasal secretions to improve breathing.

Medications

Bronchodilators: Administered to relieve wheezing and improve airflow, though their efficacy in bronchiolitis is variable.
Antiviral Medications: In severe cases, antiviral drugs may be considered, particularly for high-risk infants.
Antibiotics: Only prescribed if a secondary bacterial infection is suspected.

Hospitalization

Infants with severe bronchiolitis or those at high risk may require hospitalization for closer monitoring and intensive care. Interventions may include:

Mechanical Ventilation: In cases of severe respiratory failure, mechanical ventilation support may be necessary.
Continuous Positive Airway Pressure (CPAP): Helps keep the airways open and supports breathing.

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Preventing Acute Bronchiolitis

Prevention strategies focus on minimizing exposure to infectious agents and maintaining overall infant health:

Hand Hygiene: Regular hand washing by caregivers to reduce the transmission of viruses.
Avoiding Crowded Places: Especially during peak respiratory virus seasons.
Breastfeeding: Provides essential antibodies that help protect against infections.
Immunoprophylaxis: High-risk infants may receive RSV immunoglobulin during peak seasons.