Zapalenie oskrzelików
Etiologia i przyczyny
Zapalenie oskrzelików to ostra infekcja dolnych dróg oddechowych, głównie u niemowląt i małych dzieci, charakteryzująca się zapaleniem, obrzękiem i nadprodukcją śluzu w oskrzelikach, co prowadzi do zwężenia ich światła i utrudnienia przepływu powietrza. Etiologia jest przeważnie wirusowa, z wirusem syncytialnym układu oddechowego (RSV) odpowiadającym za 44-75% przypadków. Inne wirusy to rhinowirus (14-19%), metapneumowirus ludzki, wirus paragrypy (10-30%), adenowirus (5-10%), wirus grypy (10-20%), koronawirusy (w tym SARS-CoV-2) oraz bocawirus ludzki. Bakteryjne zapalenie oskrzelików, najczęściej wywołane przez Mycoplasma pneumoniae, jest rzadkie. Koinfekcje występują w 13-30% przypadków i mogą pogarszać przebieg choroby. Okres wylęgania wynosi 2-5 dni, a wydalanie wirusa trwa 6-21 dni. Transmisja odbywa się drogą kropelkową, bezpośrednim kontaktem z wydzieliną oraz przez skażone powierzchnie.
- Etiologia Zapalenia Oskrzelików
- Wirusowa etiologia zapalenia oskrzelików
- Bakteryjna etiologia zapalenia oskrzelików
- Koinfekcje w zapaleniu oskrzelików
- Mechanizm patogenetyczny zapalenia oskrzelików
- Transmisja patogenów wywołujących zapalenie oskrzelików
- Czynniki ryzyka zapalenia oskrzelików
- Odległe następstwa zapalenia oskrzelików
- Profilaktyka zapalenia oskrzelików
Etiologia Zapalenia Oskrzelików
Zapalenie oskrzelików (bronchiolitis) to ostre zakażenie dolnych dróg oddechowych, które występuje przede wszystkim u niemowląt i małych dzieci. Choroba powoduje stan zapalny, obrzęk i produkcję śluzu w najmniejszych drogach oddechowych płuc zwanych oskrzelikami. Te zmiany patologiczne prowadzą do zwężenia światła dróg oddechowych i utrudnienia przepływu powietrza, co objawia się trudnościami w oddychaniu.12
Wirusowa etiologia zapalenia oskrzelików
Zapalenie oskrzelików jest niemal zawsze wywoływane przez czynniki wirusowe. Wirus infekuje początkowo górne drogi oddechowe (nos, gardło, krtań), a następnie przenosi się do dolnych dróg oddechowych, gdzie powoduje stan zapalny małych oskrzeli (oskrzelików), prowadząc do ich obrzęku i nagromadzenia wydzieliny.12
Główne wirusy powodujące zapalenie oskrzelików
Wirusem najczęściej wywołującym zapalenie oskrzelików jest wirus syncytialny układu oddechowego (RSV), który jest odpowiedzialny za około 44-75% wszystkich przypadków.12 RSV jest powszechnym patogenem – niemal wszystkie dzieci mają kontakt z tym wirusem przed ukończeniem 2. roku życia.1 Pierwsza infekcja RSV jest zazwyczaj najcięższa, szczególnie jeśli występuje w okresie niemowlęcym.1
Oprócz RSV, zapalenie oskrzelików mogą wywoływać także inne wirusy, w tym:123
- Rhinowirus (wirus przeziębienia) – około 14-19% przypadków
- Metapneumowirus ludzki (hMPV) – odkryty w 2001 roku, coraz częściej identyfikowany jako czynnik etiologiczny
- Wirus paragrypy – odpowiedzialny za około 10-30% wszystkich przypadków zapalenia oskrzelików
- Adenowirus – stanowi około 5-10% przypadków
- Wirus grypy (influenza) – około 10-20% przypadków
- Koronawirus (w tym SARS-CoV-2, wywołujący COVID-19)
- Bocawirus ludzki (HBoV) – odkryty w 2005 roku, związany z infekcjami dolnych dróg oddechowych
Bakteryjna etiologia zapalenia oskrzelików
W rzadkich przypadkach zapalenie oskrzelików może być spowodowane przez bakterie. Najczęściej związane jest to z infekcją Mycoplasma pneumoniae, atypową bakterią wywołującą zakażenia układu oddechowego.12 Bakteryjne zapalenie oskrzelików stanowi jednak niewielki odsetek wszystkich przypadków tej choroby i jest znacznie rzadsze niż etiologia wirusowa.
Koinfekcje w zapaleniu oskrzelików
W około 13-30% przypadków zapalenia oskrzelików u niemowląt można stwierdzić jednoczesne zakażenie więcej niż jednym patogenem.12 Badania wskazują, że koinfekcje mogą prowadzić do cięższego przebiegu choroby, dłuższego utrzymywania się objawów i zwiększonego ryzyka niedotlenienia.1
Najczęstszymi kombinacjami koinfekcji są:1
- Zakażenie wirusowe z towarzyszącą infekcją Mycoplasma pneumoniae
- Jednoczesne zakażenie dwoma różnymi wirusami
Mechanizm patogenetyczny zapalenia oskrzelików
Patogeneza zapalenia oskrzelików obejmuje kilka etapów:12
- Wirus początkowo zakaża górne drogi oddechowe (nos, usta, gardło)
- Zakażenie rozprzestrzenia się w dół do tchawicy i oskrzeli, a następnie do oskrzelików
- Wirus powoduje stan zapalny i uszkodzenie komórek wyścielających drogi oddechowe
- Dochodzi do obrzęku śluzówki, zwiększonej produkcji śluzu i zwężenia światła oskrzelików
- Zmiany te blokują przepływ powietrza do i z płuc dziecka
Okres wylęgania wirusa wynosi zwykle 2-5 dni, a wydalanie wirusa w wydzielinie nosowej może trwać od 6 do 21 dni po wystąpieniu objawów.1
Transmisja patogenów wywołujących zapalenie oskrzelików
Wirusy powodujące zapalenie oskrzelików są wysoce zakaźne i łatwo się rozprzestrzeniają, szczególnie w sezonie jesienno-zimowym i wczesnowiosennym.12 Transmisja odbywa się poprzez:
- Bezpośredni kontakt z wydzieliną z nosa i gardła osoby zainfekowanej1
- Drogą kropelkową – podczas kaszlu, kichania lub mówienia1
- Kontakt pośredni – poprzez dotykanie przedmiotów (zabawki, klamki, naczynia) skażonych wirusem, a następnie przeniesienie go na błony śluzowe12
Czynniki ryzyka zapalenia oskrzelików
Określone czynniki mogą zwiększać ryzyko zachorowania na zapalenie oskrzelików lub rozwinięcia cięższej postaci choroby:123
Czynniki związane z dzieckiem
- Wiek – najbardziej narażone są niemowlęta poniżej 6 miesiąca życia, szczyt zachorowań przypada na 3-6 miesiąc życia12
- Wcześniactwo – dzieci urodzone przed 37. tygodniem ciąży12
- Wrodzone wady serca lub płuc12
- Obniżona odporność12
- Brak karmienia piersią – pokarm matki zawiera przeciwciała chroniące przed infekcjami12
Czynniki środowiskowe
- Narażenie na dym tytoniowy – zarówno bierne palenie, jak i ekspozycja na dym w okresie prenatalnym123
- Przebywanie w skupiskach ludzi – żłobki, przedszkola, zatłoczone warunki mieszkaniowe12
- Posiadanie starszego rodzeństwa uczęszczającego do szkoły/przedszkola1
- Sezonowość – częstsze występowanie w miesiącach jesienno-zimowych1
Odległe następstwa zapalenia oskrzelików
Zapalenie oskrzelików może być związane z długoterminowymi konsekwencjami zdrowotnymi, szczególnie w kontekście chorób układu oddechowego:12
Związek z astmą
Badania wskazują na potencjalny związek między przebytym zapaleniem oskrzelików a późniejszym rozwojem astmy. Szczególnie istotne są:123
- Ciężkie zakażenia RSV w okresie niemowlęcym są związane ze zwiększonym ryzykiem wystąpienia astmy w późniejszym wieku
- Infekcje rhinowirusem wydają się mieć silniejszy związek z późniejszym rozwojem astmy niż infekcje RSV
- Nie ustalono jednoznacznie, czy zapalenie oskrzelików jest przyczyną astmy, czy też oba stany mają wspólne podłoże genetyczne (np. skłonność do nadreaktywności dróg oddechowych)
Inne możliwe powikłania
Do rzadszych, ale potencjalnie poważnych powikłań zapalenia oskrzelików należą:123
- Zapalenie płuc – jako bezpośrednie powikłanie ostrego zapalenia oskrzelików
- Niewydolność oddechowa – w ciężkich przypadkach
- Opóźnienia rozwojowe – w przypadku ciężkich infekcji wymagających hospitalizacji
- Psychologiczne następstwa – lęk lub strach przed niewydolnością oddechową u dzieci, które przeszły ciężkie zapalenie oskrzelików
Profilaktyka zapalenia oskrzelików
Choć całkowite zapobieganie zapaleniu oskrzelików jest trudne ze względu na powszechność wirusów je wywołujących, istnieją metody mogące zmniejszyć ryzyko zachorowania lub złagodzić jego przebieg:12
Środki ogólne
- Karmienie piersią – dostarcza przeciwciała chroniące przed infekcjami12
- Unikanie narażenia na dym tytoniowy12
- Częste mycie rąk i przestrzeganie zasad higieny, szczególnie w sezonie infekcyjnym
- Ograniczenie kontaktu z osobami chorymi na infekcje dróg oddechowych
Immunoprofilaktyka
Dla dzieci z grupy wysokiego ryzyka ciężkiego przebiegu infekcji RSV dostępne są preparaty immunoprofilaktyczne:123
- Paliwizumab (Synagis) – przeciwciało monoklonalne przeciwko wirusowi RSV, podawane comiesięcznie w sezonie zakażeń RSV dzieciom z grupy wysokiego ryzyka (wcześniaki, dzieci z wrodzonymi wadami serca lub płuc)
- Nirsewimab (Beyfortus) – przeciwciało o przedłużonym działaniu, które może być podawane niemowlętom w celu ochrony przed ciężkim przebiegiem zapalenia oskrzelików
- Szczepionki przeciwko RSV (w fazie badań) – w tym szczepionki dla kobiet w ciąży (np. RSVpreF), które mają na celu przekazanie przeciwciał dziecku
Zapalenie oskrzelików, choć zazwyczaj jest chorobą samoograniczającą się, stanowi poważne obciążenie dla zdrowia publicznego jako najczęstsza przyczyna hospitalizacji niemowląt poniżej pierwszego roku życia.12 Zrozumienie jego etiologii ma kluczowe znaczenie dla skutecznej diagnostyki, leczenia i opracowania strategii profilaktycznych.
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Materiały źródłowe
- #1 Bronchiolitis – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565
Bronchiolitis is a common lung infection in young children and infants. It causes swelling and irritation and a buildup of mucus in the small airways of the lung. These small airways are called bronchioles. Bronchiolitis is almost always caused by a virus. […] Bronchiolitis happens when a virus infects the bronchioles, which are the smallest airways in the lungs. The infection makes the bronchioles swollen and irritated. Mucus collects in these airways, which makes it difficult for air to flow freely in and out of the lungs. […] Bronchiolitis is usually caused by the respiratory syncytial virus (RSV). RSV is a common virus that infects just about every child by 2 years of age. Outbreaks of RSV infection often happen during the colder months of the year in some locations or the rainy season in others. A person can get it more than once. Bronchiolitis also can be caused by other viruses, including those that cause the flu or the common cold. […] The viruses that cause bronchiolitis are easily spread. You can get them through droplets in the air when someone who is sick coughs, sneezes or talks. You also can get them by touching shared items such as dishes, doorknobs, towels or toys and then touching your eyes, nose or mouth.
- #1 Bronchiolitis in Children | Phoenix Children’s Hospitalhttps://phoenixchildrens.org/specialties-conditions/bronchiolitis-children
Bronchiolitis is an infection of the lungs. Its when your child has swelling in the smaller airways (bronchioles) of the lung. This swelling blocks air in the smaller airways. Bronchiolitis is different than bronchitis. Bronchitis is an infection of the larger airways. […] The most common cause of bronchiolitis is a virus. At first, the virus causes an infection in the upper respiratory tract. This includes the nose, mouth, and throat. It then spreads down into the windpipe (trachea) and lungs (lower respiratory tract). The virus causes inflammation and even death of the cells inside the respiratory tract. This blocks airflow in and out of the childs lungs. […] Bronchiolitis is most often caused by the respiratory syncytial virus. But these other viruses can also cause it: Rhinovirus, Parainfluenza virus, Adenovirus, Influenza, Human metapneumovirus. […] In rare cases, bronchiolitis may be caused by bacteria.
- #1 Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou | BMC Infectious Diseases | Full Texthttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05772-x
Causative pathogen was detected in 83.2% (842 of 1012). The majority of these (614 [72.9%] of 842) were single virus infection. The most common pathogens detected were respiratory syncytial virus (RSV) (44.4%), MP (15.6%), and human rhinovirus (HRV) (14.4%). […] The most common pathogen detected in children with bronchiolitis is RSV, followed by MP and HRV. Coinfection leads to a longer period of illness, increased severity of the symptoms and increased risk of hypoxemia. […] The most common pathogens detected were RSV (44.4%), MP (15.6%), HRV (14.4%), HBoV (9.8%), and PIV (8.0%). Coinfection was identified in 137 (13.5%) of the patients. […] The current study indicated that a single viral infection (72.9%) was most common type of infection in children under 2years of age with bronchiolitis.
- #1 Bronchiolitishttps://www.nhs.uk/conditions/bronchiolitis/
Bronchiolitis is caused by a viral infection, usually respiratory syncytial virus (RSV). […] RSV is very common and spreads easily in coughs and sneezes. Almost all children get it at least once before they’re 2 years old. […] It’s not usually serious, but some babies and children have a higher risk of getting bronchiolitis, particularly: babies under 6 months old, babies and children who were born prematurely, babies and children with a weakened immune system, or long-term lung or heart conditions.
- #1 Patient education: Bronchiolitis and RSV in infants and children (Beyond the Basics) – UpToDatehttps://www.uptodate.com/contents/bronchiolitis-and-rsv-in-infants-and-children-beyond-the-basics/print
Bronchiolitis is caused by viruses that trigger inflammation of the small airways (bronchioles). […] Bronchiolitis is caused by viruses. […] Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis. However, many other viruses that cause colds in older children and adults can cause bronchiolitis in infants. Examples include rhinovirus (the common cold virus), influenza (the „flu”), and COVID-19. Some children can be infected with more than one virus at the same time. […] RSV infection can happen at any age. For children, the risk of having severe symptoms is greatest the first time the child is infected with the virus, particularly if they are infected during infancy.
- #1 Bronchiolitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK441959/
Bronchiolitis is a common lung infection in young individuals. The most common cause is the respiratory syncytial virus (RSV). […] The most common virus associated with bronchiolitis is the respiratory syncytial virus. However, over the years, many other viruses have been found to cause the same infection, and they include the following: Human rhinovirus, Coronavirus, Human metapneumovirus, Adenovirus, Parainfluenza virus, Human bocavirus. […] RSV accounts for the majority of cases, although in about 30% of infants, there may be 2 viruses present at the same time.
- #1 Bronchiolitis: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/961963-overview
Most cases of bronchiolitis result from a viral pathogen, such as RSV, rhinovirus, human metapneumovirus (hMPV), parainfluenza virus, adenovirus, coronavirus, influenza virus or human bocavirus. […] RSV is the most commonly isolated agent in 75% of children younger than 2 years who are hospitalized for bronchiolitis. […] Viral shedding in nasal secretions continues for 6-21 days after symptoms develop. The incubation period is 2-5 days. […] Rhinoviruses, the cause of the common cold, may cause bronchiolitis or lower respiratory tract infection and are frequently detected in dual infections. […] Parainfluenza virus causes 10-30% of all bronchiolitis cases. […] Adenovirus accounts for 5-10% of bronchiolitis cases while influenza virus accounts for 10-20%. […] The paramyxovirus hMPV, first identified in the Netherlands in 2001, has been increasingly implicated as an etiologic agent in bronchiolitis. […] Human bocavirus (HBoV), discovered in 2005, is known to cause both upper and lower respiratory tract infections and type 1 has been implicated in both bronchiolitis and pertussis-like syndromes.
- #1 Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou | BMC Infectious Diseases | Full Texthttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05772-x
In our study, MP was detected in 15.6% of our patients. […] One hundred and thirty seven (16.3%) of our patients had infection due to two pathogens. […] The impact of coinfection on the severity of bronchiolitis still remains questionable. […] Our findings in this study indicated that the duration of symptoms and duration of hospitalization in cases of single virus infection were significantly less than those observed in case of combined viral and MP infection. Thus, we believe that coinfection can aggravate the disease. […] RSV was identified as the most common pathogen causing bronchiolitis in infants and young children, followed by MP and HRV. Coinfection with multiple pathogens leads to persistence of the disease for a longer period and increased severity of the symptoms. In particular, coinfection increases the risk of hypoxemia.
- #1 Bronchiolitis in Children – Stanford Medicine Children’s Healthhttps://www.stanfordchildrens.org/en/topic/default?id=bronchiolitis-in-children-90-P02929
Bronchiolitis is an infection of the lungs. Its when your child has swelling in the smaller airways (bronchioles) of the lung. This swelling blocks air in the smaller airways. […] The most common cause of bronchiolitis is a virus. At first, the virus causes an infection in the upper respiratory tract. This includes the nose, mouth, and throat. It then spreads downward into the windpipe (trachea) and lungs (lower respiratory tract). The virus causes inflammation and even death of the cells inside the respiratory tract. This blocks airflow in and out of the childs lungs. […] Bronchiolitis is most often caused by the respiratory syncytial virus (RSV). But these other viruses can also cause it: Rhinovirus, Parainfluenza virus, Adenovirus, Influenza, Human metapneumovirus. […] In rare cases, bronchiolitis may be caused by bacteria.
- #1 Bronchiolitis: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000975.htm
Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles). It is usually due to a viral infection. […] Bronchiolitis usually affects children under the age of 2, with a peak age of 3 to 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. More than half of all infants are exposed to this virus by their first birthday. […] Other viruses that can cause bronchiolitis include: Adenovirus, Influenza, Parainfluenza. […] The virus is spread to infants by coming into direct contact with nose and throat fluids of someone who has the illness. […] Bronchiolitis occurs more often in the fall and winter than other times of the year. […] Risk factors of bronchiolitis include: Being around cigarette smoke, Being younger than 6 months old, Living in crowded conditions, Not being breastfed, Being born before 37 weeks of pregnancy.
- #1 Bronchiolitis Causes & Symptomshttps://my.clevelandclinic.org/health/diseases/8272-bronchiolitis
Bronchiolitis is a viral infection that targets the small airways of a childs lungs. […] A virus causes a bronchiolitis infection. Viruses that can lead to bronchiolitis include: Respiratory syncytial virus (RSV), Influenza (flu) virus, Adenovirus, Parainfluenza, Metapneumovirus, SARS-Cov-2 (the virus that causes COVID). […] Bronchiolitis most often affects children younger than 2 years old. […] Your child may be more at risk of developing severe bronchiolitis if they: Were born before 37 weeks of pregnancy, Have a congenital (present at birth) lung or heart condition, Have a compromised immune system, Live or play in group settings like daycare. […] Complications of bronchiolitis include: Pneumonia, Asthma, Respiratory failure. […] Some children develop asthma as they grow if they had bronchiolitis when they were infants. While less common, some children may develop pneumonia after bronchiolitis. […] Yes. Since there are many viruses that can cause bronchiolitis, your child can develop the infection more than once.
- #1 Managing Long-Term Effects of Bronchiolitis: Expert Guidancehttps://www.kidsvillepeds.com/blog/1182881-what-is-bronchiolitis-disease/
Bronchiolitis disease targets the bronchioles, the smallest airways in the lungs, leading to inflammation and mucus buildup that can make breathing difficult for little ones. […] In most cases, bronchiolitis is a mild illness that can be managed at home with supportive care. […] However, there are situations where the condition may escalate, requiring more intensive medical intervention. […] Certain risk factors increase the likelihood of a child developing bronchiolitis. […] Exposure to cigarette smoke also significantly elevates the risk, as it can irritate the respiratory tract and weaken the immune response. […] Attending daycare or having siblings who attend school can expose young children to viruses more frequently, raising their risk of bronchiolitis. […] Breastfeeding has been shown to offer some protective benefits against bronchiolitis, as it provides antibodies that help bolster a child’s immune system.
- #1 Bronchiolitis – UF Healthhttps://ufhealth.org/conditions-and-treatments/bronchiolitis
Risk factors of bronchiolitis include: Being around cigarette smoke, Being younger than 6 months old, Living in crowded conditions, Not being breastfed, Being born before 37 weeks of pregnancy. […] Most cases of bronchiolitis cannot be prevented because the viruses that cause the infection are common in the environment.
- #1 Bronchiolitishttps://www2.hse.ie/conditions/bronchiolitis/
Bronchiolitis is a common chest infection in babies and young children. Its caused by a virus called respiratory syncytial virus (RSV). […] The virus that causes bronchiolitis can spread to other children. […] Breastfeeding your baby may prevent them from getting bronchiolitis. This is because babies get special proteins called antibodies from breastmilk. Antibodies can protect your child from infection. […] Children with existing health problems or who were born premature are at high risk of severe bronchiolitis. They might get monthly antibody injections. This will reduce the severity of an infection. […] There may be a link between bronchiolitis and respiratory conditions in later life. […] Research has found that some children who get repeated bouts of bronchiolitis might be more prone to getting asthma when they are older. But it is not clear whether it is bronchiolitis or other factors that have caused this.
- #1 Bronchiolitis | Better Health Channelhttps://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bronchiolitis
Bronchiolitis is a chest infection caused by a virus. It affects the small breathing tubes in the lungs. […] Bronchiolitis is a common viral chest infection in babies under 6 months of age. […] Smoking in the household increases the risk of babies getting bronchiolitis or any other respiratory illness. […] Bronchiolitis can be passed on to others. […] Bronchiolitis does not mean a child will develop asthma. […] Wheezing or bronchiolitis in babies does not mean that a baby will progress to more persistent symptoms and develop asthma in childhood.
- #1https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=ug1890spec
Bronchiolitis is an infection caused by a virus. […] The most common virus that causes bronchiolitis is RSV (respiratory syncytial virus). […] Bronchiolitis happens the same way in most children. […] There is no medicine for bronchiolitis. Antibiotics do not work because bronchiolitis is caused by a virus. […] Palivizumab (Synagis) is a medicine that can help prevent bronchiolitis and other problems in children with a high risk of getting very sick from RSV.
- #1 Bronchiolitis – symptoms, causes and treatment | healthdirecthttps://www.healthdirect.gov.au/bronchiolitis
Bronchiolitis is a common chest infection caused by a virus. […] Bronchiolitis is caused by an infection, usually with respiratory syncytial virus (RSV). […] Bronchiolitis can also be caused by other viruses. The viruses spread through small droplets when infected people cough, talk or sneeze. […] Respiratory syncytial virus (RSV) is usually responsible for bronchiolitis, although other viruses can also cause bronchiolitis. […] Bronchiolitis is the most common cause of hospital admission in infants younger than six months.
- #2 Bronchiolitis: Symptoms, causes, and treatmenthttps://www.medicalnewstoday.com/articles/326580
Bronchiolitis is a lung infection that mostly occurs in infants in the autumn and winter months, although adults may also develop it. […] The most common cause of bronchiolitis is a virus called respiratory syncytial virus (RSV). Infants who become infected with RSV can develop severe symptoms that require hospitalization. […] Over the years, doctors have identified other viruses that cause bronchiolitis. These include: human rhinovirus, which causes the common cold, coronavirus, human metapneumovirus, adenovirus, and parainfluenza. […] About 30% of infants with bronchiolitis may have two viruses present in their airways. […] Some people, including premature babies born before week 32 of pregnancy and infants under 3 months of age, are more at risk of developing severe symptoms from bronchiolitis. […] Infants who were born very prematurely or have certain underlying health conditions are also at higher risk of severe bronchiolitis from RSV.
- #2 Bronchiolitis in Children – Stanford Medicine Children’s Healthhttps://www.stanfordchildrens.org/en/topic/default?id=bronchiolitis-in-children-90-P02929
Bronchiolitis is an infection of the lungs. Its when your child has swelling in the smaller airways (bronchioles) of the lung. This swelling blocks air in the smaller airways. […] The most common cause of bronchiolitis is a virus. At first, the virus causes an infection in the upper respiratory tract. This includes the nose, mouth, and throat. It then spreads downward into the windpipe (trachea) and lungs (lower respiratory tract). The virus causes inflammation and even death of the cells inside the respiratory tract. This blocks airflow in and out of the childs lungs. […] Bronchiolitis is most often caused by the respiratory syncytial virus (RSV). But these other viruses can also cause it: Rhinovirus, Parainfluenza virus, Adenovirus, Influenza, Human metapneumovirus. […] In rare cases, bronchiolitis may be caused by bacteria.
- #2 Bronchiolitis: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/961963-overview
Most cases of bronchiolitis result from a viral pathogen, such as RSV, rhinovirus, human metapneumovirus (hMPV), parainfluenza virus, adenovirus, coronavirus, influenza virus or human bocavirus. […] RSV is the most commonly isolated agent in 75% of children younger than 2 years who are hospitalized for bronchiolitis. […] Viral shedding in nasal secretions continues for 6-21 days after symptoms develop. The incubation period is 2-5 days. […] Rhinoviruses, the cause of the common cold, may cause bronchiolitis or lower respiratory tract infection and are frequently detected in dual infections. […] Parainfluenza virus causes 10-30% of all bronchiolitis cases. […] Adenovirus accounts for 5-10% of bronchiolitis cases while influenza virus accounts for 10-20%. […] The paramyxovirus hMPV, first identified in the Netherlands in 2001, has been increasingly implicated as an etiologic agent in bronchiolitis. […] Human bocavirus (HBoV), discovered in 2005, is known to cause both upper and lower respiratory tract infections and type 1 has been implicated in both bronchiolitis and pertussis-like syndromes.
- #2 Pediatric Bronchiolitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK519506/
Pediatric bronchiolitis is an acute lower respiratory tract infection primarily caused by viral pathogens. […] Respiratory syncytial virus (RSV) is the most common cause, and recent advancements in RSV vaccination are expected to help reduce the global burden of bronchiolitis. […] RSV is the leading infectious agent in acute bronchiolitis among children, accounting for up to two-thirds of cases. Human metapneumovirus and parainfluenza virus type 3 contribute to nearly half of the remaining cases. […] Although RSV is the leading pathogen causing bronchiolitis, other respiratory viruses can also contribute, albeit less frequently. These include adenoviruses, bocaviruses, coronaviruses (such as SARS-CoV-2), enteroviruses, human metapneumovirus, influenza, measles, and rhinoviruses. […] With the expansion of therapeutic options for respiratory infections, identifying the specific causative agent has become increasingly important.
- #2 Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou | BMC Infectious Diseases | Full Texthttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05772-x
Causative pathogen was detected in 83.2% (842 of 1012). The majority of these (614 [72.9%] of 842) were single virus infection. The most common pathogens detected were respiratory syncytial virus (RSV) (44.4%), MP (15.6%), and human rhinovirus (HRV) (14.4%). […] The most common pathogen detected in children with bronchiolitis is RSV, followed by MP and HRV. Coinfection leads to a longer period of illness, increased severity of the symptoms and increased risk of hypoxemia. […] The most common pathogens detected were RSV (44.4%), MP (15.6%), HRV (14.4%), HBoV (9.8%), and PIV (8.0%). Coinfection was identified in 137 (13.5%) of the patients. […] The current study indicated that a single viral infection (72.9%) was most common type of infection in children under 2years of age with bronchiolitis.
- #2 Bronchiolitis and Lower Respiratory Infections in Children | Children’s Hospital of Philadelphiahttps://www.chop.edu/conditions-diseases/bronchiolitis
Bronchiolitis develops when a virus in the nose and throat gets into the lungs. […] The most common cause of bronchiolitis is a virus, usually the respiratory syncytial virus (RSV). However, many other viruses have been involved, including: Parainfluenza virus, Adenovirus, Influenza, Human metapneumovirus. […] Bronchiolitis is rarely caused by bacteria. If it is, the bacteria causing it is usually mycoplasma pneumoniae. […] At first, the virus causes an infection in the upper respiratory tract, and then spreads downward into the lower tract. The virus causes inflammation and even death of the cells inside the respiratory tract. This leads to obstruction of airflow in and out of the child’s lungs. […] Bronchiolitis is caused by a virus, not a bacterial infection.
- #2 Bronchiolitis in Children | Phoenix Children’s Hospitalhttps://phoenixchildrens.org/specialties-conditions/bronchiolitis-children
Bronchiolitis is an infection of the lungs. Its when your child has swelling in the smaller airways (bronchioles) of the lung. This swelling blocks air in the smaller airways. Bronchiolitis is different than bronchitis. Bronchitis is an infection of the larger airways. […] The most common cause of bronchiolitis is a virus. At first, the virus causes an infection in the upper respiratory tract. This includes the nose, mouth, and throat. It then spreads down into the windpipe (trachea) and lungs (lower respiratory tract). The virus causes inflammation and even death of the cells inside the respiratory tract. This blocks airflow in and out of the childs lungs. […] Bronchiolitis is most often caused by the respiratory syncytial virus. But these other viruses can also cause it: Rhinovirus, Parainfluenza virus, Adenovirus, Influenza, Human metapneumovirus. […] In rare cases, bronchiolitis may be caused by bacteria.
- #2 Bronchiolitis – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565
Bronchiolitis is a common lung infection in young children and infants. It causes swelling and irritation and a buildup of mucus in the small airways of the lung. These small airways are called bronchioles. Bronchiolitis is almost always caused by a virus. […] Bronchiolitis happens when a virus infects the bronchioles, which are the smallest airways in the lungs. The infection makes the bronchioles swollen and irritated. Mucus collects in these airways, which makes it difficult for air to flow freely in and out of the lungs. […] Bronchiolitis is usually caused by the respiratory syncytial virus (RSV). RSV is a common virus that infects just about every child by 2 years of age. Outbreaks of RSV infection often happen during the colder months of the year in some locations or the rainy season in others. A person can get it more than once. Bronchiolitis also can be caused by other viruses, including those that cause the flu or the common cold. […] The viruses that cause bronchiolitis are easily spread. You can get them through droplets in the air when someone who is sick coughs, sneezes or talks. You also can get them by touching shared items such as dishes, doorknobs, towels or toys and then touching your eyes, nose or mouth.
- #2 Bronchiolitis In Children | Children’s Hospital Coloradohttps://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/bronchiolitis/
Bronchiolitis is caused by respiratory viruses. Most cases happen in babies who have respiratory syncytial virus (RSV). It may also develop after having a common cold or influenza (flu). […] The viruses that cause bronchiolitis are found in small drops of fluid in an infected person’s nose and mouth. These droplets spread through the air through sneezes, coughs or laughing. The germs can also end up on things the infected person has touched, such as doorknobs, toys and tissues.
- #2 Bronchiolitis: MedlinePlus Medical EncyclopediaLockhttps://medlineplus.gov/ency/article/000975.htm
Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles). It is usually due to a viral infection. […] Bronchiolitis usually affects children under the age of 2, with a peak age of 3 to 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. More than half of all infants are exposed to this virus by their first birthday. […] Other viruses that can cause bronchiolitis include: Adenovirus, Influenza, Parainfluenza. […] The virus is spread to infants by coming into direct contact with nose and throat fluids of someone who has the illness. […] Bronchiolitis occurs more often in the fall and winter than other times of the year. […] Risk factors of bronchiolitis include: Being around cigarette smoke, Being younger than 6 months old, Living in crowded conditions, Not being breastfed, Being born before 37 weeks of pregnancy.
- #2 Bronchiolitis (for Parents) | Nemours KidsHealthhttps://kidshealth.org/en/parents/bronchiolitis.html
Bronchiolitis is an infection of the respiratory tract. It happens when tiny airways called bronchioles get infected with a virus. They swell and fill with mucus, which can make breathing hard. […] Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis. Sometimes, the common cold and the flu also can cause it. […] Bronchiolitis most often affects infants and young children because their small airways can easily get blocked. It is most common during the first 2 years of life, and especially among babies. It is more common in premature babies, children with lung or heart problems, and kids with weak immune systems. […] Kids who are around secondhand smoke have a higher risk for bronchiolitis. Older kids and adults can get bronchiolitis, but the infection usually is mild.
- #2 Bronchiolitishttps://www.nhs.uk/conditions/bronchiolitis/
Bronchiolitis is caused by a viral infection, usually respiratory syncytial virus (RSV). […] RSV is very common and spreads easily in coughs and sneezes. Almost all children get it at least once before they’re 2 years old. […] It’s not usually serious, but some babies and children have a higher risk of getting bronchiolitis, particularly: babies under 6 months old, babies and children who were born prematurely, babies and children with a weakened immune system, or long-term lung or heart conditions.
- #2 Bronchiolitishttps://www2.hse.ie/conditions/bronchiolitis/
Bronchiolitis is a common chest infection in babies and young children. Its caused by a virus called respiratory syncytial virus (RSV). […] The virus that causes bronchiolitis can spread to other children. […] Breastfeeding your baby may prevent them from getting bronchiolitis. This is because babies get special proteins called antibodies from breastmilk. Antibodies can protect your child from infection. […] Children with existing health problems or who were born premature are at high risk of severe bronchiolitis. They might get monthly antibody injections. This will reduce the severity of an infection. […] There may be a link between bronchiolitis and respiratory conditions in later life. […] Research has found that some children who get repeated bouts of bronchiolitis might be more prone to getting asthma when they are older. But it is not clear whether it is bronchiolitis or other factors that have caused this.
- #2 Bronchiolitis – Pediatrics – Merck Manual Professional Editionhttps://www.merckmanuals.com/professional/pediatrics/respiratory-disorders-in-young-children/bronchiolitis
Most cases of bronchiolitis are caused by respiratory syncytial virus (RSV) […] Less frequent causes are influenza viruses A and B, parainfluenza viruses types 1 and 2, human metapneumovirus, adenoviruses, and Mycoplasma pneumoniae. […] Risk factors for more severe disease include low birth weight and prenatal exposure to tobacco smoke and secondhand smoke.
- #2 Bronchiolitis Causes & Symptomshttps://my.clevelandclinic.org/health/diseases/8272-bronchiolitis
Bronchiolitis is a viral infection that targets the small airways of a childs lungs. […] A virus causes a bronchiolitis infection. Viruses that can lead to bronchiolitis include: Respiratory syncytial virus (RSV), Influenza (flu) virus, Adenovirus, Parainfluenza, Metapneumovirus, SARS-Cov-2 (the virus that causes COVID). […] Bronchiolitis most often affects children younger than 2 years old. […] Your child may be more at risk of developing severe bronchiolitis if they: Were born before 37 weeks of pregnancy, Have a congenital (present at birth) lung or heart condition, Have a compromised immune system, Live or play in group settings like daycare. […] Complications of bronchiolitis include: Pneumonia, Asthma, Respiratory failure. […] Some children develop asthma as they grow if they had bronchiolitis when they were infants. While less common, some children may develop pneumonia after bronchiolitis. […] Yes. Since there are many viruses that can cause bronchiolitis, your child can develop the infection more than once.
- #2 Respiratory Syncytial Virus Bronchiolitis in Children | AAFPhttps://www.aafp.org/pubs/afp/issues/2017/0115/p94.html
Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. […] Although RSV infection is the most common cause of bronchiolitis, there are many other viral pathogens that can lead to bronchiolitis. […] It is unclear if having multiple pathogen infection increases the severity of the clinical course. […] Most children recover uneventfully, although underlying chronic lung disease, congenital anomalies, immunocompromised state, and hemodynamically significant heart disease in patients with bronchiolitis are associated with progression to severe disease or mortality. […] There are few long-term risks associated with bronchiolitis, but infection with rhinovirus or severe RSV bronchiolitis is associated with an increased risk of asthma that can persist into adulthood.
- #2 Bronchiolitishttps://www.rch.org.au/kidsinfo/fact_sheets/bronchiolitis/
Bronchiolitis is a common chest infection in young children, caused by a viral infection of the lungs. […] Antibiotics are not given because bronchiolitis is caused by a virus. Antibiotics do not cure viruses. […] Some studies have shown a correlation between some types of bronchiolitis and the later development of asthma. However, there are many potential explanations for this, including a genetic tendency for sensitive airways, or exposure to triggers like cigarette smoke.
- #2 Managing Long-Term Effects of Bronchiolitis: Expert Guidancehttps://www.kidsvillepeds.com/blog/1182881-what-is-bronchiolitis-disease/
Understanding these causes and risk factors is essential for parents and caregivers. […] The primary focus of treatment is to ease the symptoms and ensure the child’s comfort while the infection runs its course. […] There are limited medications specifically approved for treating bronchiolitis. […] In some cases, doctors may recommend inhaled medications such as bronchodilators to help relax the airways and improve breathing. […] While there is no vaccine specifically for RSV, certain vaccinations play a crucial role in preventing respiratory infections that can lead to bronchiolitis. […] Routine vaccinations, such as those against influenza (flu) and pertussis (whooping cough), indirectly contribute to reducing the risk of bronchiolitis. […] Children who have acute bronchiolitis may experience ongoing respiratory issues.
- #2 Bronchiolitis: Symptoms, Treatment and Preventionhttps://patient.info/chest-lungs/bronchiolitis-leaflet
Bronchiolitis is a viral chest infection. It is usually caused by a viral infection called respiratory syncytial virus (RSV). Other viruses are sometimes the cause. RSV is a common cause of colds. In some babies RSV can also infect lower down the airways to cause bronchiolitis. […] Bronchiolitis occurs when a viral infection attacks the bronchioles, causing them to become swollen and filled with mucus. […] RSV infection, commonly responsible for bronchiolitis, causes many coughs and colds in adults and children. It is impossible to avoid it totally. […] Babies with bronchiolitis who have been breastfed and those who live in a smoke-free home, tend to get a less severe bout of the illness. This is compared to non-breastfed babies and those who live with smokers. […] At present, there is an antibody injection (palivizumab/Synagis), which can be given monthly during the RSV season to help prevent severe bronchiolitis. […] Newer treatments have been developed. One, nirsevimab (Beyfortus) is a long-acting antibody that can be given to babies to protect them from severe bronchiolitis. Another, currently called RSVpreF, is a vaccine given to pregnant women.
- #2 Bronchiolitis – Symptoms, Causes, Images, and Treatment Optionshttps://www.epocrates.com/online/diseases/28/bronchiolitis
Bronchiolitis is the leading cause of hospital admission in infants under 1 year of age. […] Respiratory syncytial virus (RSV) is the most common cause.
- #3 Bronchiolitis: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/961963-overview
Most cases of bronchiolitis result from a viral pathogen, such as RSV, rhinovirus, human metapneumovirus (hMPV), parainfluenza virus, adenovirus, coronavirus, influenza virus or human bocavirus. […] RSV is the most commonly isolated agent in 75% of children younger than 2 years who are hospitalized for bronchiolitis. […] Viral shedding in nasal secretions continues for 6-21 days after symptoms develop. The incubation period is 2-5 days. […] Rhinoviruses, the cause of the common cold, may cause bronchiolitis or lower respiratory tract infection and are frequently detected in dual infections. […] Parainfluenza virus causes 10-30% of all bronchiolitis cases. […] Adenovirus accounts for 5-10% of bronchiolitis cases while influenza virus accounts for 10-20%. […] The paramyxovirus hMPV, first identified in the Netherlands in 2001, has been increasingly implicated as an etiologic agent in bronchiolitis. […] Human bocavirus (HBoV), discovered in 2005, is known to cause both upper and lower respiratory tract infections and type 1 has been implicated in both bronchiolitis and pertussis-like syndromes.
- #3 Bronchiolitis in Children – Stanford Medicine Children’s Healthhttps://www.stanfordchildrens.org/en/topic/default?id=bronchiolitis-in-children-90-P02929
Bronchiolitis is an infection of the lungs. Its when your child has swelling in the smaller airways (bronchioles) of the lung. This swelling blocks air in the smaller airways. […] The most common cause of bronchiolitis is a virus. At first, the virus causes an infection in the upper respiratory tract. This includes the nose, mouth, and throat. It then spreads downward into the windpipe (trachea) and lungs (lower respiratory tract). The virus causes inflammation and even death of the cells inside the respiratory tract. This blocks airflow in and out of the childs lungs. […] Bronchiolitis is most often caused by the respiratory syncytial virus (RSV). But these other viruses can also cause it: Rhinovirus, Parainfluenza virus, Adenovirus, Influenza, Human metapneumovirus. […] In rare cases, bronchiolitis may be caused by bacteria.
- #3 Bronchiolitis – UF Healthhttps://ufhealth.org/conditions-and-treatments/bronchiolitis
Risk factors of bronchiolitis include: Being around cigarette smoke, Being younger than 6 months old, Living in crowded conditions, Not being breastfed, Being born before 37 weeks of pregnancy. […] Most cases of bronchiolitis cannot be prevented because the viruses that cause the infection are common in the environment.
- #3 Bronchiolitis | Better Health Channelhttps://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bronchiolitis
Bronchiolitis is a chest infection caused by a virus. It affects the small breathing tubes in the lungs. […] Bronchiolitis is a common viral chest infection in babies under 6 months of age. […] Smoking in the household increases the risk of babies getting bronchiolitis or any other respiratory illness. […] Bronchiolitis can be passed on to others. […] Bronchiolitis does not mean a child will develop asthma. […] Wheezing or bronchiolitis in babies does not mean that a baby will progress to more persistent symptoms and develop asthma in childhood.
- #3 Bronchiolitishttps://www2.hse.ie/conditions/bronchiolitis/
Bronchiolitis is a common chest infection in babies and young children. Its caused by a virus called respiratory syncytial virus (RSV). […] The virus that causes bronchiolitis can spread to other children. […] Breastfeeding your baby may prevent them from getting bronchiolitis. This is because babies get special proteins called antibodies from breastmilk. Antibodies can protect your child from infection. […] Children with existing health problems or who were born premature are at high risk of severe bronchiolitis. They might get monthly antibody injections. This will reduce the severity of an infection. […] There may be a link between bronchiolitis and respiratory conditions in later life. […] Research has found that some children who get repeated bouts of bronchiolitis might be more prone to getting asthma when they are older. But it is not clear whether it is bronchiolitis or other factors that have caused this.
- #3 Managing Long-Term Effects of Bronchiolitis: Expert Guidancehttps://www.kidsvillepeds.com/blog/1182881-what-is-bronchiolitis-disease/
Severe cases of bronchiolitis, especially those requiring hospitalization, can occasionally lead to developmental delays. […] For children who have experienced severe bronchiolitis, especially those requiring intensive medical care, there may be psychological impacts such as anxiety or fear of respiratory distress.
- #3 Bronchiolitis â Zero To Finalshttps://zerotofinals.com/paediatrics/respiratory/bronchiolitis/
Bronchiolitis involves infection and inflammation in the bronchioles, the small airways of the lungs. It occurs most commonly in the winter months. Respiratory syncytial virus (RSV) is the most common cause. Other causes include rhinovirus and adenovirus. […] Around half of infants with RSV infection go on to develop bronchiolitis. A typical course of illness involves: […] Management of bronchiolitis involves: […] The guidelines recommend against nebulised hypertonic saline, bronchodilators, steroids and antibiotics. […] Palivizumab is a monoclonal antibody that targets the respiratory syncytial virus. It involves monthly injections and is given to high-risk babies, such as ex-premature and those with congenital heart disease.