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Bronchiolitis in Child
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Bronchiolitis in Child

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Contributors: Abhijeet Waghray MD, Paritosh Prasad MD
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Synopsis

Bronchiolitis describes a clinical syndrome in children younger than 2 years of age that initially manifests with upper respiratory symptoms followed by lower respiratory tract infection and inflammation. Viral infections such as respiratory syncytial virus (RSV), rhinovirus, human metapneumovirus, parainfluenza, and influenza are often the precipitating infection, although bacterial infections may also precipitate this syndrome.

Viruses infect the terminal bronchiolar epithelial cells causing edema, excessive mucus, and obstructed small airways. Signs and symptoms begin with rhinorrhea, cough, and fever and can progress to respiratory distress. Physical exam findings often include accessory muscle use, nasal flaring, chest retractions, wheezing, prolonged expiratory phase, and coarse or fine crackles.

Risk factors for severe disease include prematurity, age <12 weeks, and underlying chronic illness such as chronic pulmonary disease or congenital heart disease. Severity of typical illness peaks at 3-5 days of symptoms, with cough typically resolving by days 8-15. Complications include dehydration, apnea, respiratory failure, and secondary bacterial infections.

Codes

ICD10CM:
J21.9 – Acute bronchiolitis, unspecified

SNOMEDCT:
4120002 – Bronchiolitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 03/19/2018
Last Updated: 04/18/2018
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Bronchiolitis in Child
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Bronchiolitis (Adult) : Dyspnea, Crackles, RR increased
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