Bronchiolitis : Causes, Symptoms,Types, Diagnosis And Treatment

Saturday, June 28th 2014. | Disease

Bronchiolitis : Causes, Symptoms,Types, Diagnosis And Treatment

Bronchiolitis is an acute viral infection of the lower respiratory tract of infants that shows a definite seasonal pattern (peaks during the winter months and persists through early spring). The disease most commonly affects infants between the ages of 2 and 10 months.
Respiratory syncytial virus is the most common cause of bronchiolitis, accounting for 45% to 60% of all cases. Parainfluenza viruses are the second most common cause. Bacteria serve as secondary pathogens in only a small minority of cases.
Clinical Presentation
  • As a result of limited oral intake due to coughing combined with fever, vomiting, and diarrhea, infants are frequently dehydrated.
  • The diagnosis of bronchiolitis is based primarily on history and clinical findings. The isolation of a viral pathogen in the respiratory secretions of a wheezing child establishes a presumptive diagnosis of infectious bronchioloitis.
Treatment
  • Bronchiolitis is a self-limiting illness and usually requires no therapy (other than reassurance and antipyretics) unless the infant is hypoxic or dehydrated.
  • In severely affected children, the mainstays of therapy for bronchiolitis are oxygen therapy and intravenous fluids.
  • Aerosolized β-adrenergic therapy appears to offer little benefit for the majority of patients but may be useful in the child with a predisposition toward bronchospasm.
  • Because bacteria do not represent primary pathogens in the etiology of bronchiolitis, antibiotics should not be routinely administered. However, many clinicians frequently administer antibiotics initially while awaiting culture results because the clinical and radiographic findings in bronchiolitis are often suggestive of a possible bacterial pneumonia.
  • Ribavirin may be considered for bronchiolitis caused by respiratory syncytial virus in a subset of patients (those with underlying pulmonary or cardiac disease or with severe acute infection). Use of the drug requires special equipment (small-particle aerosol generator) and specifically trained personnel for administration via oxygen hood or mist tent.

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