Bronchiolitis in adults: symptoms, treatments, serious?

[Mise à jour le 8 novembre 2022 à 09h56] When we think “bronchiolitis”, we think “infant”. However, bronchiolitis can also affect adults. Invited to the show “C à Vous” on France5 on Monday November 7, the actress Isabelle Adjani appeared masked and feverish : “I try to stay with the colors of Diane (she is on the poster for the TV movie “Diane de Poitiers” broadcast on November 7,, editor’s note), namely black and white because of a small suspicion of bronchiolitis, even though I’m no longer a baby. SoI find myself on cortisone, codeine to watch the show.”

Bronchiolitis is indeed possible in adults but is not due to the same virus as in children (“respiratory syncithial virus” (RSV)) because adults are often immunized against it. Those 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 located at the end of the bronchi that enter the lungs, and whose role is to distribute air to the lungs. In adults, there are two types of bronchiolitis:

• acute infectious bronchiolitis
• chronic inflammatory bronchiolitis the causes of which may be multiple.

What causes 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 babies?

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

In the vast majority of cases, baby’s bronchiolitis is viral. It is caused by a virus called “respiratory syncithial virus (RSV). Since adults are often immune to the latter, other types of virus are the cause of bronchiolitis, in particular that of the flu, or bacteria. “Acute viral bronchiolitis in infants is very common, that in adults 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 (dyspnea). In infants, it is often the difficulty in breathing that predominates. “When bronchiolitis is of infectious origin in adults, she settles in quite suddenly, with a fever. Conversely, when inflammatory, development is gradualit is carried out over several weeks with mainly cough and dyspnea”comments Dr. Jean-Philippe Santoni.

How can you catch adult bronchiolitis?

Non-infectious bronchiolitis often results from:

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

Is adult bronchiolitis contagious?

Chronic inflammatory bronchiolitis is non-infectious and therefore non-contagious.

Chronic inflammatory bronchiolitis is non-infectious and therefore non-contagious. In contrast, infectious bronchiolitis, which is most often linked to a virus or bacteria, is very contagious.

How long does bronchiolitis last in adults?

“The fever and shortness of breath occurring in acute infectious bronchiolitis last 8 daysbut the cough may persist for two to four weeks, until the epithelium, namely the cells that line the inside of the bronchioles stripped by the virus, regenerates. 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 symptoms persisting for more than 7 days must lead to consultation with his general practitioner as first intention, who will direct his patient to a pulmonologist for further examinations.

“After a clinical suspicion, the diagnosis of bronchiolitis is confirmed by the scanner (thoracic tomo densinometric examination) in forced expiration which will make it possible 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?

The treatment depends on the cause and the context of the bronchiolitis:

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

Thank you to Dr Jean-Philippe Santoni, lead prevention pulmonologist at the Breath Foundation.