2. • Bronchiolitis , is a clinical diagnosis
• Bronchiolitis is a viral lower respiratory tract infection, generally affecting children under 12 months of
age
3. DIAGNOSTIC CRITERIA /VALUE
• From the history and symptoms
• It typically begins with acute upper respiratory tract infection followed by onset of respiratory distress and fever and one or more of :
• Cough
• Tachypnea
• Retractions
• Widespread crackle or wheeze
• Inevestigatiions
• Pulse oximetry
• Blood gas analysis
• Chest X-ray
4. • Complete blood count
• Virological testing
• Bacteriological testing of blood and urine
• Biochemical blood analysis (urea and electrolytes)
• C reactive protein
5. FEVER
• Infants with bronchiolitis may have fever or history of fever, high fever is uncommon in bronchiolitis
6. RHINORRHEA
• Nasal discharge often precedes the onset of other symptoms as cough, tachypnea, respiratory distress,
feeding difficulty
7. COUGH
• A dry wheezy cough is characteristic of bronchiolitis , cough along with nasal symptoms, is one of the
earliest symptoms to occur
8. RESPIRATORY RATE
• Increased respiratory rate is important in lower respiratory tract infection like bronchiolitis
• Poor feeding : many infants with bronchiolitis have feeding difficulties due to dyspnea but poor feeding
is not essential for diagnosis
9. CRACKLES
• Fine insoiraotry crackers in all lungs fields are common
• wheeze: high pitched expiratory wheeze is common
10. TREATMENT
• Nasal suctions: can be used to clear secretions
• Maintaining fluid balance and hydration ; commence nasogastricnor or oba strict feeding or iv fluids if
there is feeding difficulty
• Oxygen: if spo2 is less than 92% or infant has respiratory distress or cyanosis
• Continuous positive airway pressure and negative pressure ventilation
11. • Antivirals , antibiotics , nebulised epinephrine , anti inflammatory pies, inhaled bronchodilators
• Are all not recommended for treatment of acute bronchiolitis in infants
