Acute Bronchiolitis

Acute bronchiolitis refers to airway inflammation and obstruction of the lower respiratory tract and is caused almost exclusively by viral infection in children younger than 2 yrs ( Bronchiolitis Alyssa H Silver and Joanne M Nazif Pediatrics in Review November 2019 , 40 (11 ) 568-576 )

Occurs in children < 2 yrs and most commonly in 1st year of life Most common serious respiratory illness in infancy Peak between 3-6 months Symptoms peak between 3-5 days- then improve 90 % infnats will get better within 3 weeks Seasonal ↑↑ during winter and early spring ( N America and Europe ) Re-infection during a single season is possible

Diagnosing bronchiolitis-Coryzal prodrome lasting 1-3 days followed by persistent cough and either tachypnoe or chest rececssion ( or both ) either wheeze or crackles on chest auscultation ( or both ) fever ( in around 30 % of cases usually < 39° ) high fever is uncommon ( ie > 39° ) poor feeding ( after 3-5 days of illness ) → rapid respiratory rate may not permit time for sucking and swallowing Young infants ( particularly < 6 weeks old ) may present with apnoe without other clinical signsSigns of resp...