Bronchiolitis in Infants

Bronchiolitis is a term applied to any inflammatory disease which afflicts the bronchioles. When it occurs in infants of less than 1 1/2 years of age, it produces a distinct syndrome. The hospital charts of 1,200 children with bronchiolitis were reviewed for data on the salient features of the syndrome. It usually started with a mild upper respiratory infection. In the acute phase, obstruction of the bronchioles developed due to inflammatory edema and exudation; the resultant manifestations in the patient were dyspnea, cough, expiratory wheezing, and emphysema. This syndrome resembles that observed in the child with asthma who has an upper respiratory infection, but it differs in prognosis and in the fact that the infant with bronchiolitis does not improve after administration of epinephrine. The treatment is generally supportive but must be varied for the individual patient; it is directed toward the prevention of fatal complications, the most common being secondary bacterial bronchopneumonia and right heart failure.