Acute bronchiolitis

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Classification according to ICD-10
J21 Acute bronchiolitis
ICD-10 online (WHO version 2019)

Bronchiolitis is inflammation of the smallest, cartilage-free bronchial tubes (bronchioles) that particularly affects young children. At the beginning, the clinical picture resembles an acute asthma attack (spastic narrowing of the bronchioles), especially if the inflammation of the bronchioles is very extensive. Due to the small diameter of the bronchi, the mucous membrane swells so that ventilation, especially venting of the alveoli , is difficult. Typical triggers are respiratory syncytial viruses . Other common pathogens are the parainfluenza virus and the measles virus ; mycoplasma or chlamydia are less common .

clinic

The focus is on the nostrils (widening of the nostrils during inhalation), pale cyanotic skin discoloration and severe expiratory dyspnea (shortness of breath during exhalation) caused by the obstruction of the peripheral airways. During auscultation, you can hear fine bubble rattling noises or very quiet breathing sounds . The course of the disease can be difficult.

therapy

Sedation of the child is often necessary. Beta-2 mimetics (relaxation of the airways) and glucocorticoids may need to be administered. The most important measure is the adequate supply of oxygen through an oxygen mask. Keeping the nose clear is important, as babies and toddlers in particular breathe through the nose due to their elevated larynx. A parenteral nutrition is preferred since a risk of aspiration and additional irritation reducing the respiratory tract. Antibiotics can be given to avoid a secondary infection, but are rather ineffective therapeutically, since it is usually a viral infection.

A more severe disease called bronchiolitis obliterans is to be distinguished , but it practically cannot develop in people with healthy lungs.

Individual evidence

  1. ^ Klaus Holldack, Klaus Gahl: Auscultation and percussion. Inspection and palpation. Thieme, Stuttgart 1955; 10th, revised edition, ibid 1986, ISBN 3-13-352410-0 , p. 87.
  2. G.-A. von Harnack, Berthold Koletzko (ed.): Pediatric and Adolescent Medicine. 13th edition. Springer, Heidelberg 2007, ISBN 978-3-540-48632-9 , p. 386.
  3. Herbert Hof, Rüdiger Dörries: Medical Microbiology. 5th, completely revised. Edition. Thieme, Stuttgart 2014, ISBN 978-3-13-125315-6 , p. 612.