Bronchiolitis is a severe respiratory infection, commonly occurring throughout the year but increasing markedly during the transitional periods from winter to spring and autumn to winter, mainly in children under 2 years of age. The disease progresses quickly and is complicated, causing serious complications such as pneumonia, respiratory failure, and heart failure if not recognized, examined, and treated in time.
What is bronchiolitis in children?
Bronchiolitis in children is an inflammatory condition characterized by exudation and edema of the bronchiolar mucosa, leading to airway narrowing, respiratory infection, and obstruction of airflow.
Although bronchiolitis can occur at any age, it is most common in infants under 1 year old due to their immature immune systems and incomplete physical development.
The condition is also frequently seen in premature or low-birth-weight infants, children with weakened immunity or congenital diseases, and those regularly exposed to cigarette smoke, dust, mold, or crowded, poorly ventilated environments.
Causes of bronchiolitis in children
Experts report that 80–90% of bronchiolitis cases in children are caused by respiratory viruses, including: Respiratory syncytial virus (RSV) – accounting for 30–50% of cases, Rhinovirus, Influenza virus – about 25%, Adenovirus – about 10%, Parainfluenza virus, Enterovirus, Herpes simplex virus
In addition, certain bacteria such as streptococcus, pneumococcus, Mycoplasma pneumoniae, and Haemophilus influenzae (H. influenzae) can also cause bronchiolitis in children, though these are less common than viral causes.
Viruses and bacteria are transmitted through direct contact with nasal secretions or saliva containing pathogens. They spread and multiply rapidly, easily leading to outbreaks with a high risk of secondary infections.
Symptoms of bronchiolitis in children
Initial stage (early onset): symptoms resemble an upper respiratory tract infection, including:
- Runny nose, nasal congestion, sneezing
- Mild cough that gradually worsens, especially at night and in the morning
- Fatigue, irritability, refusal to breastfeed, loss of appetite
- Low-grade fever
Progressive stage (full development): symptoms become more severe, such as:
- Difficulty breathing, rapid breathing (respiratory rate > 60 breaths/min), wheezing, chest retractions, cyanosis
- Frequent coughing, severe coughing fits, chest tightness, worsening at night
- Nasal obstruction, nasal flaring
- High fever (>39°C), vomiting, fatigue, irritability, frequent crying
- Pale or bluish skin
Severe stage (warning signs): parents should take the child to a reputable medical facility immediately if any of the following appear:
- Rapid breathing, severe breathing difficulty, chest retractions
- Lethargy, drowsiness, or difficulty being awakened
- Cyanosis (bluish lips or skin), episodes of apnea
- High fever >39°C not responding to fever-reducing medication
- Signs of dehydration, poor feeding, or refusal to breastfeed
Is bronchiolitis in children contagious?
Bronchiolitis in children can be transmitted through two main routes of contact:
- Direct transmission: children may contract bronchiolitis from others through saliva droplets while talking, playing, kissing, or close contact with infected individuals.
- Indirect transmission: viruses can survive on objects for a certain period of time. If a child’s eyes, nose, or mouth come into contact with contaminated surfaces, the likelihood of infection is very high.
Diagnosis of bronchiolitis in children
Clinical examination and diagnosis The physician will evaluate the child’s current symptoms, determine whether the disease is in the initial, progressive, or severe stage, and listen to the lungs to detect abnormal respiratory sounds.
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Paraclinical diagnosis
- Pulse oximetry: to measure blood oxygen saturation.
- Chest X-ray: may show signs of emphysema with hyperlucent lungs; in more severe cases, patchy opacities may appear due to ventilation disorders, air trapping, or localized atelectasis.
- Complete blood count: white blood cells may be normal, decreased, or increased lymphocytes.
- Arterial blood gas analysis: findings may include SaO₂ < 92%, PaO₂ < 60 mmHg, and elevated PaCO₂.
- PCR technique or rapid test: viruses causing bronchiolitis can be isolated from nasopharyngeal or tracheal samples using nasal wash, suction, or swabs.
Safe and effective diagnosis and treatment of bronchiolitis in children at Hong Ngoc
Currently, there is no specific medication to cure bronchiolitis. Therefore, treatment principles focus on symptom management, fluid and electrolyte replacement, adequate nutrition, and ensuring sufficient oxygen for the child.
In cases of viral bronchiolitis:
- Antibiotics are not required.
- Keep the child warm and hydrated by giving warm fluids.
- Clean the nose with 0.9% saline solution (nasal drops).
- Reduce fever by warm compresses. Proper application can lower body temperature by about 1%. Administer paracetamol when the child’s temperature is ≥ 38.5°C, strictly following the doctor’s instructions.
- Use medications to thin and loosen mucus. Do not use fast-acting cough suppressants, as coughing helps clear mucus from the airways, supporting faster recovery.
- For infants or children unable to expel phlegm, parents should help with airway clearance methods such as chest physiotherapy, suctioning, or nebulization.
- Maintain a clean, warm, smoke-free environment.
In cases of bacterial bronchiolitis: Antibiotic treatment is required, with dosage and usage prescribed by a physician.
When a child shows early signs of bronchiolitis, parents should bring the child to a pediatric specialist for accurate diagnosis and timely treatment. This is essential to prevent serious complications such as pneumonia or respiratory failure.
Pediatrics Department – Hong Ngoc General Hospital is a trusted address for the diagnosis and treatment of bronchiolitis in children:
- One-on-one consultation with experienced specialists: each child is examined directly by a pediatrician with more than 20 years of experience. The cause of the illness can often be identified in just one visit, and doctors closely follow the child’s progress throughout treatment.
- WHO-standard treatment protocols: antibiotics are limited and prescribed only when there is bacterial co-infection or acute respiratory failure. This helps prevent antibiotic resistance and reduces the risk of recurrence. The treatment approach prioritizes combining medication with respiratory physiotherapy to shorten recovery time and improve outcomes.
Note: The information provided in this article by Hong Ngoc General Hospital is for reference only and does not replace professional medical diagnosis or treatment. For an accurate assessment, please visit a hospital where doctors can perform a direct examination and advise on the most appropriate treatment plan.
PEDIATRICS DEPARTMENT – HONG NGOC GENERAL HOSPITAL
Clinic and treatment locations:
- 55 Yen Ninh, Ba Dinh, Hanoi
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