BRONCHITIS AND CHILDREN

Tuesday, April 28, 2009 9:24

Bronchitis may be thought of as a cold that spreads to the windpipe (trachea) and to the air passages leading into the lungs (bronchial tubes). It may start with signs of a common cold, with nasal congestion and discharge, sneezing, watery eyes, and scratchy throat. Bronchitis may also develop without any cold symptoms appearing first.

Most cases of bronchitis are caused by viruses. These viruses cannot be cured by antibiotics. Bronchitis is contagious and is passed on in the same manner as a cold. If the disease occurs frequently, the child may have an underlying allergy. (Sometimes children with asthma tend to have repeated attacks of bronchitis.)

Signs and symptoms

The major symptoms of bronchitis are a dry, hacking cough; a low-grade fever (37.8°C, oral; 38.3°C, rectal) or no fever; and tightness and pain in the center of the chest. Often the child experiences a loss of appetite and feels generally weak and uncomfortable. After a few days the cough loosens. Occasionally, a rattling sound can be heard in the chest when the child takes a breath, but there is never any real difficulty in breathing (except that caused by nasal congestion). The entire illness may last more than a week.

There is rarely high fever or prostration (extreme exhaustion or collapse). There is never pain on the side of the chest. No blood appears in the sputum (discharge coughed up out of the lungs).

Home care

Treatment for bronchitis is similar to treatment for the common cold. Limited activity is recommended during the fever stage and the worst of the cough. Give aspirin or paracetamol for fever and body aches. Phenylephrine or oxy-metazoline nose drops may be used. A humidifier or vaporizer aids breathing. If the cough is exhausting or keeps the child from sleeping, cough medicine might help. Encourage your child to drink liquids to avoid dehydration (loss of body fluids).

Precautions

• See your doctor if any unusual symptoms occur, such as pain on the side of the chest or blood in the sputum.

• See your doctor if bronchitis occurs more than once a year.

• See your doctor if the condition worsens instead of improves after three to four days.

• Do not use oral decongestants, which may tighten the chest and aggravate a dry cough.

Medical treatment

Your child’s physical examination should include a careful examination of the chest. Throat or sputum cultures, a chest X ray, and a blood count may be taken. If bronchitis occurs frequently, your doctor will investigate the possibility of an allergy, a foreign body in the bronchial tubes, or a lowered resistance to infection. The use of antibiotics and some types of cough medicines is debatable. Antibiotics usually are not helpful for most types of bronchitis (those caused by virus), and some cough medicines can aggravate more than relieve the condition. If a child has repeated attacks of bronchitis, your doctor may give epinephrine by injection to determine if the child has an allergy. If epinephrine relieves the symptoms, it is likely the attacks are caused by an allergy.