Both asthma and bronchiolitis are referred to as inflammation of the air passages in the lungs. These air passages include the trachea, bronchi, and bronchioles. This inflammation results in narrowing of the airways. The narrowed airways, then, lead to the symptoms of shortness of breath associated with asthma and bronchiolitis.
Causes
Common asthma triggers include allergies to things like dust or pollens well as infections. Other environmental and occupational allergens can trigger asthma.
Bronchiolitis is an infection that affects the lower respiratory tract of infants and children less than 24 months of age. Bronchiolitis is usually caused by viruses. Symptoms include runny nose, fever, cough, wheezing, and difficulty breathing.
Most cases of bronchiolitis are caused by:
- Respiratory syncytial virus
- Rhinovirus
Less frequent causes are influenza A and B viruses, parainfluenza virus types 1 and 2, human metapneumovirus, adenovirus, and Mycoplasma pneumonia.
The virus spreads from the upper to the lower airways, reaching the bronchioles where it triggers an inflammatory response. The resulting swelling and causes a partial obstruction that is more pronounced on exhalation and results in air being trapped in the lungs
Signs and Symptoms
Patients with asthma and bronchiolitis have similar symptoms like shortness of breath (dyspnea,) chest tightness, audible wheezing, and coughing.
Coughing may not be present in all asthma patients.
Typically, an affected child will present with symptoms of upper airway infection, with the progressive onset of respiratory distress characterized by fast heartbeat (tachypnea,) chest retractions, and a catarrhal or wheezing cough. Young infants (<2 months) and infants born prematurely may present with recurrent apnea (not breathing) seizures followed by resolution of apnea and onset of more typical symptoms of bronchiolitis within 24-48 h. Signs of distress include blue lips, and audible dyspnea. Fever is frequently, but not always, present.
Diagnosis
The two commonly used tests to diagnose asthma are spirometry, and challenge tests. Spirometry measures how much and how quickly a patient can blow air out of the lungs. It is often used to determine the amount of airway obstruction a patient has. Challenge tests consist of measuring a patient’s response to artificially induced asthma symptoms as well as to asthma medications.
To diagnose bronchiolitis, the following steps are taken:
- Clinical evaluation
- Pulse oximetry
- Chest X-ray for severe cases
- Respiratory syncytial virus antigen test in children with severe conditions
The diagnosis of bronchiolitis is suspected based on history, objective examination, and the appearance of symptoms during an outbreak.
Treatment
Bronchodilators, which make breathing easier by relaxing or dilating the muscles in the lungs and widening the airways, are often prescribed in case of asthma and bronchiolitis. Patients with mild asthma exacerbations are instructed to self-administer 2 to 4 puffs of inhaled albuterol (which is a short-acting β₂ adrenergic receptor agonist) up to 3 times every 20 minutes.
Treatment for bronchiolitis is supportive; bronchodilators sometimes relieve symptoms but probably do not shorten hospitalization, and systemic corticosteroids are not indicated in infants with previously healthy bronchiolitis.
There is no vaccine for the causes of bronchiolitis. A monoclonal antibody (mab) drug for respiratory syncytial virus (palivizumab) may be given to some high-risk infants to reduce the frequency of hospitalization.
Contact us
In case of urgent medical care assistance, AfterOurs Urgent Care offers immediate telemedicine services through telemedicine appointments, where medical providers are available to offer assistance. Anyone who experiences signs and symptoms requiring urgent medical attention can simply book their appointment with AfterOurs Urgent Care to directly talk to an expert. If your medical issue is not appropriate for telemedicine, we will let you know and refer you to an in-person facility.
When to visit a doctor:
If your experience dyspnea or cough at night, then you should seek medical care to rule out any possibility of serious complications.
Treatment for asthma and bronchiolitis is available at AfterOurs Urgent Care.