Bronchiolitis
Definition
First episode of wheezing associated with URTI and signs of respiratory distress
Epidemiology
Etiology
Clinical Presentation
Investigations
Treatment
Source
Toronto Notes 2012
www.rch.org.au 2011
First episode of wheezing associated with URTI and signs of respiratory distress
Epidemiology
- The most common LRTI in infants
- Peak incidence at 6 months, winter or early spring
- Occurs in children prone to airway reactivity, increased incidence of asthma in later life
- Generally under 12 months. If > 12 months, consider overlap with asthma
Etiology
- respiratory syncytial virus (RSV) (>50% - most common)
- parainfluenza, influenza, rhinovirus, adenovirus
Clinical Presentation
- prodrome of URTI with cough and fever
- feeding difficulties, irritability
- wheezing, respiratory distress lasting for 5-6 d
Investigations
- CXR (only needed in severe disease, poor response to therapy, chronic episode)
- Air trapping, peribronchial thickening, atelectasis, increased linear markings
- Nasopharyngeal swab
- Direct detection of viral antigen (immunofluorescence)
- **WBC usually normal
Treatment
- Mild distress
- Supportive: oral or IV hydration, antipyretics for fever
- Humidified 0 2 (maintain 0 2 sat >92%)
- Moderate to severe distress
- As above - rarely, intubation and ventilation
Source
Toronto Notes 2012
www.rch.org.au 2011