Bronchiolitis
Disease Details
Family Health Simplified
- Description
- Bronchiolitis is a common lung infection in infants and young children, characterized by inflammation and congestion in the small airways (bronchioles) of the lung.
- Type
- Bronchiolitis is an infectious disease that primarily affects the small airways (bronchioles) in the lungs, typically caused by viruses such as the respiratory syncytial virus (RSV). It does not have a genetic transmission, as it is not an inherited condition but rather an acute viral infection.
- Signs And Symptoms
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Bronchiolitis typically presents in children under two years old and is characterized by a constellation of respiratory symptoms that consists of fever, rhinorrhea, cough, wheeze, tachypnea and increased work of breathing such as nasal flaring or grunting that develops over one to three days. Crackles or wheeze are typical findings on listening to the chest with a stethoscope. The child may also experience apnea, or brief pauses in breathing. After the acute illness, it is common for the airways to remain sensitive for several weeks, leading to recurrent cough and wheeze.Some signs of severe disease include:
increased work of breathing (such as use of accessory muscles of respiration, rib & sternal retraction, tracheal tug)
severe chest wall recession (Hoover's sign)
presence of nasal flaring and/or grunting
increased respiratory rate above normal
hypoxia (low oxygen levels)
cyanosis (bluish skin)
lethargy and decreased activity
poor feeding (less than half of usual fluid intake in preceding 24 hours)
history of stopping breathing - Prognosis
- Bronchiolitis, commonly caused by respiratory syncytial virus (RSV), often affects infants and young children. The prognosis is generally good, with most children recovering fully within 1-2 weeks. Severe cases can lead to hospitalizations, especially in infants under 6 months or those with underlying health conditions. Long-term complications are rare, but some children may develop recurrent wheezing or asthma.
- Onset
- Bronchiolitis typically has an onset characterized by symptoms that appear gradually, often starting with upper respiratory tract infection signs such as a runny nose, cough, and mild fever. These symptoms can progress over a few days to include wheezing, difficulty breathing, and increased respiratory rate.
- Prevalence
- Bronchiolitis is a common respiratory infection affecting the small airways in the lungs, predominantly seen in infants and young children. It is most frequently caused by the Respiratory Syncytial Virus (RSV). The prevalence of bronchiolitis varies by season and geography but generally peaks during the colder months. It is particularly prevalent in infants under 2 years of age, with the highest incidence occurring between 2 and 6 months old. Annually, bronchiolitis leads to significant numbers of hospitalizations in this age group.
- Epidemiology
- Bronchiolitis typically affects infants and children younger than two years, principally during the autumn and winter. It is the leading cause of hospital admission for respiratory disease among infants in the United States and accounts for one out of every 13 primary care visits. Bronchiolitis accounts for 3% of emergency department visits for children under 2 years old. Bronchiolitis is the most frequent lower respiratory tract infection and hospitalization in infants worldwide.
- Intractability
- Bronchiolitis is generally not considered intractable. It is a common, often self-limiting respiratory infection that primarily affects infants and young children. Most cases can be managed with supportive care, and symptoms typically resolve within a few weeks. However, severe cases may require hospitalization, especially in individuals with underlying health conditions.
- Disease Severity
- Bronchiolitis is a respiratory infection that primarily affects infants and young children, usually caused by viruses such as the respiratory syncytial virus (RSV). The severity can vary. Most cases are mild and can be managed at home with supportive care, including hydration and monitoring. Severe cases may require hospitalization for oxygen therapy, fluids, and more intensive respiratory support. The severity can be influenced by the child's age, underlying health conditions, and the specific virus involved.
- Healthcare Professionals
- Disease Ontology ID - DOID:2942
- Pathophysiology
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Bronchiolitis is an inflammatory respiratory condition affecting the bronchioles, primarily seen in infants and young children. The pathophysiology involves:
1. **Viral Infection**: Usually caused by respiratory syncytial virus (RSV), but also other viruses like adenovirus, influenza, and parainfluenza.
2. **Inflammation**: The viral infection triggers an immune response, leading to inflammation and swelling of the bronchiolar walls.
3. **Mucus Production**: Increased production of mucus further narrows the airways.
4. **Airflow Obstruction**: The combination of swelling, mucus, and cellular debris obstructs the small airways, leading to difficulties in breathing and impaired gas exchange.
5. **Bronchoconstriction**: In some cases, there is also smooth muscle constriction, which exacerbates the airflow limitation.
This condition typically results in symptoms like wheezing, coughing, and difficulty breathing, and is more severe in younger children due to their narrower airways. - Carrier Status
- Bronchiolitis is not a condition with a carrier status as it is an acute viral infection, most commonly caused by the Respiratory Syncytial Virus (RSV). There is no "carrier" state for this illness like there is for some genetic diseases. Instead, individuals can be infected with the virus and present symptoms or be asymptomatic while still being able to transmit the virus to others.
- Mechanism
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Bronchiolitis is primarily a respiratory condition characterized by inflammation and congestion in the bronchioles, the small airways of the lung.
**Mechanism:**
1. **Infection:** Bronchiolitis is most commonly caused by viral infections, particularly the Respiratory Syncytial Virus (RSV), but other viruses such as rhinovirus, influenza, and parainfluenza can also be responsible.
2. **Inflammation:** The virus infects the epithelial cells lining the bronchioles, causing inflammation and cell death.
3. **Mucus Production:** The infected cells release chemokines and cytokines, leading to increased mucus production and the recruitment of immune cells to the site of infection.
4. **Airway Obstruction:** These immune responses cause swelling and mucus accumulation, which obstructs the small airways, leading to difficulty in breathing and decreased oxygen exchange.
**Molecular Mechanisms:**
1. **Viral Entry:** RSV attaches to the host cell via the interaction of its glycoproteins (G and F proteins) with cellular receptors like CX3CR1 and nucleolin.
2. **Innate Immune Response:** Infected cells recognize the viral presence using pattern recognition receptors (PRRs) like Toll-like receptors (TLRs) and RIG-I-like receptors (RLRs). This triggers the production of type I and type III interferons (IFNs), initiating antiviral responses.
3. **Cytokine Production:** The infected cells release pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α, and chemokines like CCL2 and CXCL10, recruiting neutrophils, macrophages, and other immune cells to the infection site.
4. **Epithelial Cell Damage:** The immune response, while targeting the virus, also leads to collateral damage of the epithelial cells, contributing to airway edema and mucus hypersecretion.
5. **Adaptive Immune Response:** Dendritic cells and other antigen-presenting cells process and present viral antigens to T cells, leading to a more targeted immune response involving CD8+ cytotoxic T cells and CD4+ helper T cells.
Bronchiolitis results from a combination of direct viral damage and a robust immune response, which together cause the hallmark symptoms of airway obstruction and respiratory distress. - Treatment
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Bronchiolitis is a common respiratory infection, usually caused by respiratory syncytial virus (RSV), that primarily affects infants and young children.
**Treatment for Bronchiolitis:**
1. **Supportive Care:** The mainstay of treatment is supportive care, which includes:
- Ensuring adequate hydration, either orally or intravenously if necessary.
- Maintaining oxygenation, potentially requiring supplemental oxygen if the child is hypoxic.
2. **Symptom Management:**
- Nasal suctioning to clear mucus and alleviate breathing difficulties.
- Antipyretics like acetaminophen or ibuprofen to manage fever and discomfort.
3. **Monitoring:** Close monitoring of respiratory status and oxygen levels.
4. **Hospitalization:** In severe cases, hospitalization may be required for advanced respiratory support, such as high-flow nasal cannula or mechanical ventilation.
**Note:** The use of bronchodilators, steroids, or antibiotics is generally not recommended unless there are specific indications. Always consult a healthcare provider for personalized medical advice. - Compassionate Use Treatment
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Compassionate use treatment for bronchiolitis generally refers to providing treatments that are not yet approved or widely available but may be considered in severe cases where conventional treatments have failed. This requires special authorization.
Off-label treatments for bronchiolitis might include the use of medications like nebulized hypertonic saline or certain antivirals, though their efficacy can be variable and they are not standard care.
Experimental treatments may involve participation in clinical trials investigating new therapies, such as novel antivirals, monoclonal antibodies, or other anti-inflammatory agents. To pursue these options, consultation with a medical specialist and consideration of current clinical research protocols are typically necessary. - Lifestyle Recommendations
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For bronchiolitis, here are some lifestyle recommendations:
1. **Fluid Intake**: Ensure the patient stays well-hydrated to help thin mucus and keep the body functioning properly.
2. **Rest**: Plenty of rest is essential for recovery.
3. **Humidified Air**: Use a humidifier or take the patient into a steamed bathroom to help ease breathing.
4. **Avoid Irritants**: Keep the patient away from smoke, pollutants, and strong odors that can exacerbate symptoms.
5. **Hand Hygiene**: Practice good hand hygiene to prevent the spread of infection.
6. **Elevate Head**: When sleeping, keep the head elevated to help ease breathing.
7. **Small, Frequent Meals**: Offer smaller, more frequent meals if the patient is struggling to eat.
Always consult with a healthcare provider for personalized advice and treatment. - Medication
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Bronchiolitis is typically caused by a viral infection, most commonly respiratory syncytial virus (RSV). As it is a viral infection, antibiotics are not effective. Treatment primarily involves supportive care, which includes ensuring the patient stays hydrated and maintaining adequate oxygen levels.
Medications that might be used in certain cases include:
1. Antipyretics - such as acetaminophen or ibuprofen to reduce fever and discomfort.
2. Bronchodilators - while not commonly recommended, may be prescribed in specific cases if wheezing is significant.
3. Supplemental Oxygen - in cases where oxygen levels are low.
Always consult a healthcare provider for an appropriate treatment plan. - Repurposable Drugs
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For bronchiolitis, repurposable drugs have been explored to manage symptoms and address the inflammation associated with the disease, but there is no definitive list of such drugs specifically approved for bronchiolitis. Medications like corticosteroids, bronchodilators, and antiviral agents (such as ribavirin) have been studied and occasionally used off-label, although their efficacy can be variable and is often debated among clinicians.
Not applicable (nan). - Metabolites
- Bronchiolitis primarily affects infants and young children. The condition involves inflammation of the small airways, or bronchioles, typically caused by viral infections such as the respiratory syncytial virus (RSV). Metabolites involved in bronchiolitis can include those associated with inflammatory processes, like increased levels of cytokines and chemokines. Often, there's heightened production of mucus and changes in the metabolic processing of lipids and glucose within the affected tissues. The specific metabolic changes can vary depending on the severity and underlying cause of the bronchiolitis.
- Nutraceuticals
- There is currently no strong scientific evidence that supports the use of nutraceuticals specifically for treating bronchiolitis. Management typically focuses on supportive care, such as hydration, oxygen therapy, and sometimes bronchodilators. Always consult with a healthcare professional for the most appropriate treatment options.
- Peptides
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Bronchiolitis, primarily caused by respiratory syncytial virus (RSV), is a common lung infection in young children, affecting the bronchioles. Treatment often focuses on managing symptoms, as there are no specific antiviral drugs for RSV.
Peptide-based therapies have been explored for their potential to inhibit viral replication and reduce inflammation in bronchiolitis. These therapeutic peptides can target specific viral proteins or host cell receptors involved in the infection process.
Nanotechnology offers promising novel approaches for bronchiolitis treatment. Nanoparticles can be engineered to deliver drugs, including antiviral peptides, directly to the respiratory tract, enhancing efficacy and minimizing side effects. Moreover, nanocarriers can facilitate controlled and sustained release of therapeutic agents, improving treatment outcomes in bronchiolitis.
Research in both fields is ongoing, aiming to create more effective treatment strategies for this condition.