American Medical Association Family Medical Guide - American Medical Association [197]
Bronchiolitis
Bronchiolitis is a potentially life-threatening viral infection of the lungs that causes the bronchioles to swell, blocking the exchange of oxygen and carbon dioxide in the alveoli (the tiny sacs in which gas exchange between the lungs and the blood occurs).
Symptoms
The symptoms of bronchiolitis include a runny nose, a slight fever, a cough, and shortness of breath. In severe cases, a child may experience rapid (more than 40 breaths per minute), labored breathing, and his or her skin may look blue, especially around the lips and at the fingertips. The child may need to sit up to breathe and may also wheeze. He or she may vomit and be unable to keep liquids down. If your child’s skin ever looks bluish, take him or her to the nearest hospital emergency department immediately.
Diagnosis
To diagnose bronchiolitis, the doctor will ask you about your child’s symptoms and examine him or her for signs of dehydration, such as a dry mouth, sunken eyes, and a sunken soft spot. He or she will use a stethoscope to listen to the child’s lungs for characteristic wheezing or bubbling noises that indicate the presence of mucus in the bronchioles.
Treatment
In mild cases of bronchiolitis, treatment may not be necessary. Your doctor probably will recommend giving your child plenty of liquids and using a cool-mist vaporizer in the child’s bedroom while he or she is sleeping to help relieve congestion. Give your child acetaminophen or ibuprofen (not aspirin) if he or she has a fever. In some cases, a doctor may prescribe liquid medication or nebulizer treatments with a bronchodilator drug to control the coughing and wheezing. A nebulizer is a device that mixes medication with water vapor to produce a mist that the person inhales. To help prevent the infection from spreading, wash your hands frequently, especially after caring for your child.
Recurring Colds or Coldlike Symptoms
It is normal for a child to have a number of coughs and colds, especially during the winter, and usually it is not a cause for concern. Children who are in day care with several children frequently get colds, as do children in their first few years of school, because they are exposed to many new viruses. Gradually, however, they acquire immunity to increasing numbers of cold viruses.
A child’s cold is often accompanied by a cough because, instead of blowing his or her nose, a child usually sniffs mucus down into the throat. The mucus irritates the throat, and the child coughs in an attempt to eliminate the mucus. Abdominal pain resulting from swallowing mucus is another common symptom in a child with a cold. In some cases, a child with a cold may complain of abdominal pain, which is actually muscle strain caused by coughing.
When to See a Doctor
Your child may not have a cold, even if he or she has cold symptoms. In some children, coldlike symptoms result from an allergic reaction (see page 912). If your child sneezes and has a runny nose and watery eyes during the warm months, he or she probably has an allergy to pollen. However, if the symptoms occur throughout the year, your child may be allergic to some other allergen, such as mold or dust mites. In some children, recurring coughs result from a serious underlying disorder. For example, a recurring cough that is accompanied by wheezing may be a symptom of asthma (see page 640), sinusitis (see page 651), or enlarged adenoids (see page