Bronchiolitis in adults: symptoms, treatment, serious?

[Mise à jour le 8 novembre 2022 à 09h56] When we think of “bronchiolitis”, we think of “newborn”. However, bronchiolitis can also affect adults. Invited to the show “C à Vous” on France5 on Monday 7 November, the actress Isabelle Adjani appeared masked and feverish : “I try to stay with Diane’s colors (it’s on the poster of the TV movie “Diane de Poitiers” broadcast on November 7, ed), or black and white for a small suspicion of bronchiolitis, even if I am no longer a child. Here you areI find myself on cortisone, codeine to watch the show “.

Bronchiolitis is indeed possible in adults but is not due to the same virus as children (“respiratory syncytial virus” (RSV)) because adults are often immunized against it. They are other types of viruses that cause bronchiolitis. It can also be related to a disease.

Definition: what is bronchiolitis?

Bronchiolitis is inflammatory disease of the bronchioles, small branches placed at the end of the bronchi that enter the lungs and whose role is to distribute the air to the lungs. In adults, there are two types of bronchiolitis:

• acute infectious bronchiolitis
• chronic inflammatory bronchiolitis whose causes can be multiple.

What are the causes of adult bronchiolitis?

“It is possible to have bronchiolitis in adults, but unlike childhood bronchiolitis which is viral, adult bronchiolitis can have two main origins: a viral or bacterial infection or a chronic inflammatory cause“, Explains Dr. Jean-Philippe Santoni, pulmonologist.

What are the differences with bronchiolitis in children?

Acute viral bronchiolitis in infants is very common, while in adults it is less so.

In the vast majority of cases, child bronchiolitis is viral. It is caused by a virus called “respiratory syncytial virus (RSV). Since adults are often immune to the latter, other types of viruses are the cause of bronchiolitis, in particular that of the flu or bacteria. “Acute viral bronchiolitis in infants is very common, while in adults it is less so. In contrast, chronic inflammatory bronchiolitis in adults is quite common. “specifies the pulmonologist.

What are the symptoms of adult bronchiolitis?

Bronchiolitis in adults is mainly manifested by cough and shortness of breath (dyspnoea). In infants, respiratory distress often predominates. “When bronchiolitis is of infectious origin in adults, it settles down quite suddenly, with a fever. On the contrary, when it is inflammatory, development is gradualit takes place over several weeks with mainly cough and dyspnoea “comments Dr. Jean-Philippe Santoni.

How do you get adult bronchiolitis?

Non-infectious bronchiolitis often results from:

• autoimmune diseases such as rheumatoid arthritis ;
• the consequences of lung transplant and bone marrow transplant;
• inhalation of toxic gases, mineral dust, most often these are occupational diseases;
• tobacco, which can cause chronic bronchiolitis in smokers.

Is adult bronchiolitis contagious?

Chronic inflammatory bronchiolitis is not infectious and therefore not contagious.

Chronic inflammatory bronchiolitis is not infectious and therefore not contagious. On the other hand, Infectious bronchiolitis, which is most often linked to a virus or bacterium, is highly contagious.

How long does bronchiolitis last in adults?

“The fever and shortness of breath that occur in acute infectious bronchiolitis last 8 daysbut the cough may persist for two or four weeks, until the epithelium, that is, the cells lining the inside of the virus-stripped bronchioles, regenerate. Chronic inflammatory bronchiolitis can last for several months even several years and lead to respiratory failure depending on the response to treatment“, Indicates our interlocutor

When and who to consult?

excessive and worsening shortness of breath, high fever that raises suspicion of bacterial origin, or persistent symptoms for more than 7 days must lead to consultation with his primary care physician as a first intention, to which he will refer his patient a pulmonologist for further examinations.

“After a clinical suspicion, the diagnosis of bronchiolitis is confirmed by the scanner (thoracic tomodensinometric examination) in forced expiration that will allow to identify the direct and indirect signs of a bronchiolar attack. A lung biopsy may prove necessary in case of doubt “, informs Dr. Jean-Philippe Santoni.

What are the treatments for bronchiolitis in adults?

Treatment depends on the cause and context of the bronchiolitis:

• Inflammatory bronchiolitis in adults is essentially treated with corticosteroids and immunosuppressants.
• If it is a smoker’s bronchiolitis, quitting smoking is essential. It is never too late to quit smoking.
• If bronchiolitis is due to exposure to organic or mineral dust, you will need to try to eliminate exposure.
• If bronchiolitis does not resolve spontaneously with comfort medications (doliprane and good hydration within 8 days), the pulmonologist may suspect a bacterial infection.
• If a viral infection doesn’t warrant antibiotic treatment, a bacterial infection will require one, explains the pulmonologist.

Thanks to Dr. Jean-Philippe Santoni, pulmonologist responsible for prevention at the Respiro Foundation.