Overview

• Inflammation and infection in the bronchioles. Most common cause is respiratory syncytial virus (RSV) [75-80% of cases].
• Very common in winter. Usually occurs in children under 1 year.
• Risk Factors for more severe episode → underlying congenital heart disease. Also prematurity, bronchopulmonary dysplasia and immunodeficiency.

Making Diagnosis

Clinical Features

• Coryzal Symptoms → runny nose, sneezing, mucus in throat, watery eyes.
• Respiratory Distress → use of accessory muscles, subcostal/intercostal recessions, nasal flaring, head bobbing, cyanosis, tracheal tugging.
• Dyspnoea (heavy laboured breathing) and tachypnoea.
• Poor Feeding.
• Apnoeas → episodes where child strops breething.
• Wheezes + Crackles on auscultation.

<aside> 💡 Coryzal phase (with low-grade fever) preceding respiratory symptoms (dry cough, breathlessness, wheezing, crackles, feeding difficulties). SYMPTOMS PEAK BETWEEN DAYS 3-5.

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CONSIDER PNEUMONIA IF: HIGH FEVER (≥39) OR PERSISTENTLY FOCAL CRACKLES.

Investigations

• Immunofluorescence of nasopharyngeal secretions may show RSV.