Infections: Brionchiolitis

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Infections: Brionchiolitis




Guest:  Dr. Sandra Fowler - Pediatrics

Host:  Dr. Linda Austin - Psychiatry


Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m talking, today, with Dr. Sandra Fowler who is Associate Professor of Pediatrics and a specialist in infectious disease.  Dr. Fowler, this is a time of year when bronchiolitis is something that may land a child in the hospital.  What is bronchiolitis?  What are the bronchioles?


Dr. Sandra Fowler:  The bronchioles are the small breathing tubes down in the lungs. Bronchiolitis is an inflammation of those small breathing tubes.  How that translates into an illness is that a young child gets an infection with, particularly, a virus called respiratory syncytial virus.  Another common infection that causes bronchiolitis is human metapneumovirus.  But the common way that they present is a young child, first of all, develops some cold, runny nose, but then develops a cough and wheezing, and sometimes the chest will cave in while the child is breathing, what we call retractions.  That’s a result of air getting trapped behind those swollen, narrowed breathing tubes.


Dr. Linda Austin:  You said respiratory syncytial virus and then there was another word you said. 


Dr. Sandra Fowler:  Human metapneumovirus. 


Dr. Linda Austin:  And what is that virus?


Dr. Sandra Fowler:  It’s a more recently discovered virus that causes the same disease that respiratory syncytial virus does.  It looks the same clinically but it’s just a different cause of it. 


Dr. Linda Austin:  How does bronchiolitis start?


Dr. Sandra Fowler:  Well, it starts as a typical viral upper respiratory infection.  Usually, a child will have a day or two of runny nose, maybe a little bit of cough, and then they progress to develop wheezing, more of a cough and, perhaps, even some drawing in of the chest as the child breathes. 


Dr. Linda Austin:  So that the space between the ribs kind of sucks in because the child isn’t really getting enough air. 


Dr. Sandra Fowler:  Yes.


Dr. Linda Austin:  At what point should a parent be concerned enough to give a call to the pediatrician?


Dr. Sandra Fowler:  Certainly, a child who is having very great difficulty breathing, if they’re breathing very fast so they can’t eat, certainly if they have any kind of color change, that they become dusky or blue, and show that they’re having air hunger, or if they’re wheezing, they should be evaluated.


Dr. Linda Austin:  You mentioned that it’s a virus, or there are a couple viruses that can cause this.  Of course, antibiotics don’t work with viruses, so what is the treatment?


Dr. Sandra Fowler:  The treatment is purely symptomatic.  What that means is, if the child needs oxygen to help them with their breathing, and if they are breathing so hard they can’t eat or drink, then providing them with intravenous fluids is the supportive measure that we take.


Dr. Linda Austin:  So, you keep them comfortable and make sure that they’re okay.  Can this be fatal if it’s not treated?


Dr. Sandra Fowler:  It can be fatal.  It rarely is fatal.  The children who are at highest risk of having severe disease are babies who are born prematurely, who have some type of chronic lung disease as a result of being premature.  Most parents of premature babies will already be aware that they are able to receive a medication, they receive it once a month through the RSV season, that helps prevent those babies from developing severe RSV disease.  It doesn’t prevent them completely from getting it, but it does reduce the number of babies who have to be admitted to the hospital as a result of their RSV infection. 


Another group at risk is babies, and young children, who have congenital heart disease.  And another group at risk would be children who have immunodeficiency diseases, such as cancer, or HIV infection can be a risk for more severe-type disease.  But, most of the babies who end up being hospitalized are otherwise healthy infants.


Dr. Linda Austin:  Dr. Fowler, thank you so much.


Dr. Sandra Fowler:  You’re welcome.


If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection:  (843) 792-1414.

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