EMed

Bronchiolitis

Background

  • Bronchiolitis is a viral resp. tract infection in children
  • Typically under 1 year of age
  • RSV commonest cause although other viruses are well recognised
  • Initial coryza, followed after 1-2 days with cough, ↑ work of breathing, and difficulty feeding
  • The illness typically peaks at days 1-3 after onset of ↑WoB and begins to improve after day 3
  • Cough and/or wheeze may persist for several weeks

Case definition

  • Cough
  • Tachypnoea
  • Chest retractions
  • Wheeze/creps

Key points

  • Bronchiolitis is a clinical diagnosis. Blood tests and chest x-rays are generally not required
  • Treatment is supportive, focussed on maintaining adequate oxygenation and nutrition
  • No therapies have shown clinical benefit including salbutamol, ipratropium bromide, saline nebules and steroids
  • Pyrexic (≥38°C) infants <2 months of age may have a serious bacterial infection

Management

Content by Dr Emma Fauteux, Dr Rory O' Brien. Last review Dr IOS 15/04/24.