Acute Bronchitis in Children

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What is bronchitis?

Bronchitis is an inflammation of the large breathing tubes (airways) that are called bronchi, which causes increased production of mucus and other changes. Although there are several different types of bronchitis, the two most common are acute and chronic (primarily affects adults).

What is acute bronchitis?

Acute bronchitis is the inflammation of mucous membranes of the bronchial tubes.

What causes acute bronchitis?

Acute bronchitis is usually caused by infectious agents such as bacteria or viruses. It may also be caused by physical or chemical agents--dusts, allergens, strong fumes, and those from chemical cleaning compounds, or tobacco smoke. Acute asthmatic bronchitis may happen as the result of an asthma attack, or it may be the cause of an asthma attack.

In children, the most common cause of bronchitis is a virus, although it can be caused by bacteria. Acute bronchitis is usually a mild condition.

Acute bronchitis may follow the common cold or other viral infections in the upper respiratory tract. It may also occur in children with chronic sinusitis, allergies, or those with enlarged tonsils and adenoids. Pneumonia is a complication that can follow bronchitis.

What are the symptoms of acute bronchitis?

The following are the most common symptoms for acute bronchitis. However, each child may experience symptoms differently. Symptoms may include:

• Runny nose, usually before a cough starts

• Malaise (an overall body discomfort or not feeling well)

• Chills

• Slight fever

• Back and muscle pain

• Wheezing

• Sore throat

In the earlier stages of the condition, children may experience a dry, non-productive cough which progresses later to an abundant mucus-filled cough. Younger children may have some vomiting or gagging with the cough. The symptoms of bronchitis usually last seven to 14 days, but may also persist for three to four weeks.

The symptoms of acute bronchitis may resemble other conditions or medical problems. Consult your child's doctor for a diagnosis.

How is acute bronchitis diagnosed?

Bronchitis is usually diagnosed solely on the history and physical examination of the child. Many tests may be ordered to rule out other diseases, such as pneumonia or asthma. In addition, the following tests may be ordered to help confirm diagnosis:

• Chest X-rays--a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

• Arterial blood gas--to analyze the amount of carbon dioxide and oxygen in the blood.

• Pulse oximetry--an oximeter is a small machine that measures the amount of oxygen in the blood. To obtain this measurement, a small sensor (like a Band-Aid) is taped onto a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless and the red light does not get hot.

• Sputum and nasal discharge cultures--test used to find and identify the microorganism causing an infection.

• Lung (pulmonary function) tests--diagnostic tests that help to measure the lungs' ability to exchange oxygen and carbon dioxide appropriately. The tests are usually performed with special machines that a person must breathe into.

Treatment for acute bronchitis

Specific treatment for acute bronchitis will be determined by your child's doctor based on:

• Your child's age, overall health, and medical history

• Extent of the condition

• Your child's tolerance for specific medications, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

In many cases, antibiotic treatment is not necessary to treat acute bronchitis, since most of the infections are caused by viruses. Even children who have been coughing for longer that eight to 10 days usually do not need antibiotics. Treatment should include good hand hygiene and avoidance of secondhand tobacco smoke. Most of the treatment is supportive of the symptoms your child may have, and may include:

• Analgesics, such as acetaminophen (for fever and discomfort)

• Cough medicine

• Increased fluid intake

• Cool mist humidifier in the room may be helpful

Antihistamines should be avoided, in most cases, because they dry up the secretions and can make the cough worse.

Always consult your child's doctor for advice before giving OTC cold medication to children younger than 6 years of age. The American Academy of Pediatrics does not recommend giving OTC cough and cold medications to children under two years of age, because these medicines may cause harmful side-effects that can be life-threatening.