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16.2.5

Bronchiolitis

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 16, Respiratory Conditions.

Clinical Description

Airway inflammation and obstruction of the lower respiratory tract and is caused almost exclusively by viral infection in children younger than 2 years

Signs and Symptoms

  • Preceding history of nasal discharge
  • Fever
  • Cough
  • Shortness of breath
  • Tachypnoea
  • Wheezing
  • Signs of respiratory distress (intercostal recessions, head bobbing, grunting)
  • Apnoea
  • Hypoxaemia

Treatment

SUPPORTIVE

  • Give oxygen
  • Ensure adequate hydration,
  • Use NGT if poor feeding or IV fluids if severe respiratory distress
  • Nasal suctioning to clear secretions
  • Antipyretics
  • Consider CPAP if severe respiratory distress
  • Do not give antibiotics
  • Bronchodilators e.g., salbutamol have no benefit in bronchiolitis

Complications

  • Pneumothorax
  • Respiratory failure

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