DEFINITION
Bronchiolitis is a disease that often occurs in the airways
due to infection of the bronchioles (tiny airways which is branching from the
main airway). Bronchioles become inflamed, making it swell and fill with mucus,
causing breathing problems.
Bronchiolitis is most common in infants and young children
because of the small size of the airway so it can be easily clogged than in
older children or adults. Bronchiolitis usually occurs in infants aged 2 months
of the first, with a peak around the age of 3-6 months.
CAUSE
The most frequent cause of bronchiolitis is RSV (respiratory
syncytial virus). Other viruses that can cause bronchiolitis is parainfluenza,
influenza, adenovirus and metapneumovirus. In rare cases, bronchiolitis may be
caused by rhinoviruses, enteroviruses, measles virus, and mycoplasma bacteria.
The infection causes inflammation of the airways and make
the airway narrows, thereby inhibiting the flow of air into and out of the
lungs.
Bronchiolitis is an infectious disease. A person can be
infected with a virus such as the flu, which can be through sputter in the air
when the patient coughs, sneezes, or talks. A person can also be infected with
bronchiolitis through objects that are used in conjunction with the patient,
for example by touching a towel or toys that are contaminated and then touching
the eyes, nose, or mouth.
Although in adults RSV causes only mild symptoms, but in
infants can cause severe disease.
Bronchiolitis is usually more common in:
·
boys
·
children who were not breastfed
·
children living in congested environments
·
are in an environment that many smokers
·
aged less than 6 months
·
born prematurely (before 37 weeks gestation)
SYMPTOMS
Bronchiolitis begins with flu-like symptoms, ie runny nose,
sneezing, low fever, and slight cough. After a few days, the child becomes
difficulty in breathing, breathing becomes more rapid and cough worse. Usually
there is a wheezing sound when exhaling child. In most infants, the symptoms
experienced mild. Although there are respiratory problems, infants still
conscious and able to eat well.
In the more severe bronchiolitis, babies experiencing severe
shortness of breath and struggled to breathe. Babies born prematurely or
infants younger than 2 months of sometimes experience temporary stop breathing.
In the case of very severe and unusual, around the mouth can turn blue from
lack of oxygen. The child becomes fussy and agitated, and can become dehydrated
from vomiting and difficulty to drink. Usually there is a fever, but not
always. Some children may also experience ear infections.
DIAGNOSIS
Diagnosis is based on symptoms and physical examination.
Sometimes required examination of chest X-rays and blood gas analysis. Mucus
from the nasal swab can be examined to identify the virus cause.
TREATMENT
Most children recover at home within 3-5 days. Cough and
wheezing may continue until 2-4 weeks. If the child is getting crowded, the
skin becomes bluish, tired and dehydrated, the child should be immediately
hospitalized. With good care, the possibility of serious complications is
lower.
Most children can be treated at home with supportive care.
Make sure the child gets enough fluids. Breathe moist air to thin the thick
mucus. To that can be used humidifier or steam. Nasal mucus can be absorbed by
a special suction device to relieve nasal obstruction. Children need lots of
rest. Avoid children from cigarette smoke. Beware if the child is becoming
increasingly congested.
Some children need to be hospitalized to cope with the
conditions. At the hospital, the child will get oxygen to maintain adequate
oxygen levels in the blood and perhaps intravenous fluids to prevent
dehydration. In severe cases, infants sometimes become tired and experiencing
breathing stopped, for it was a hose can be inserted into the main airway
(trachea) and connected to a ventilator to help children in breathing.
For a very small baby and suffered severe pain, sometimes
can be given anti-viral medication to reduce the severity of the disease, but
to be effective must be given early in the disease. Because the cause is
usually a virus, then the drugs are not effective antibiotics to be used,
unless the child was also exposed to a bacterial infection.
PREVENTION
Some actions can be done to prevent bronchiolitis:
·
Do not carry a baby less than 3 months old to a
public place, especially if many children
·
Wash your hands frequently, especially before
touching the baby while being exposed to the flu. Use a face mask properly.
·
If the child affected by bronchiolitis, keep the
child to remain at home until healed to prevent transmission to others.
·
Influenza vaccine is recommended for everyone
older than 6 months. Although the vaccine does not prevent the most common
cause of bronchiolitis (respiratory syncytial virus), but the flu vaccine can help
prevent serious influenza.
·
Keep bathroom and kitchen surfaces clean,
especially if there are family members who have the flu.
·
Tissue simply disposable. Dispose of tissue that
have been used correctly, then wash your hands.
·
Use your own drinking cups. Do not use cups with
others.
·
Prepare a cleaning fluid (hand sanitizer) while
traveling out of the house.
·
Feeding the baby, so the baby gets immunity from
the mother.
REFERENCE
- K, Anand D., M, John T. bronchiolitis. Merck Manual Home
Health Handbook. 2009.
- D, Yamini. Bronchiolitis. Kidshealth. 2010.
- K, Neil K. bronchiolitis. Medline Plus. 2011.
- Mayo Clinic. Bronchiolitis. 2013.
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