Bronchiolitis

Definition

Pathophysiology

Risk factors for Severe Disease

Clinical Features

File:RSV.PNG

Figure 1. Peribronchial Cuffing Typical of Bronchiolitis (occlusion of small airways via mucus plugging leads to atelectasis and prominent appearance of bronchioles). 

Another common finding is shifting atelectasis.

Treatment

The Bottom Line:

Complications

References

1) Richard N, Komurian-Pradel F, Javouhey E, et al. The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis. Pediatr Infect Dis J 2008; 27:213.

2) Hall CB, Powell KR, Schnabel KC, et al. Risk of secondary bacterial infection in infants hospitalized with respiratory syncytial viral infection. J Pediatr 1988; 113:266.

3) Thorburn K, Harigopal S, Reddy V, et al. High incidence of pulmonary bacterial co-infection in children with severe respiratory syncytial virus (RSV) bronchiolitis. Thorax 2006; 61:611.

4) Roqué i Figuls M, Giné-Garriga M, Granados Rugeles C, Perrotta C. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24months old. Cochrane Database Syst Rev. 2012 Feb 15;2:CD004873. doi:10.1002/14651858.CD004873.pub4. Review. PubMed PMID: 22336805.

5).Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev 2013; 7:CD006458.

6) Jat KR, Chawla D. Surfactant therapy for bronchiolitis in critically ill infants. Cochrane Database Syst Rev 2012; 9:CD009194.

7) Shein SL, Kong M, McKee B, O'Riordan M, Toltzis P, Randolph AG. Antibiotic Prescription in Young Children With Respiratory Syncytial Virus-Associated Respiratory Failure and Associated Outcomes. Pediatr Crit Care Med. 2019 Feb;20(2):101-109.PMID: 30720644.