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Bronchiolitis

Bronchiolitis is a common respiratory disease in infants under 2 years old caused predominantly by viral infections like RSV. It involves inflammation and obstruction of the small airways. Symptoms include fever, cough, wheezing, respiratory distress, and hypoxemia. Treatment is generally supportive with oxygen, hydration, and respiratory support. Hospitalization may be required in severe cases. Most cases resolve within 1-2 weeks, but it can occasionally cause serious complications like apnea.

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723 views12 pages

Bronchiolitis

Bronchiolitis is a common respiratory disease in infants under 2 years old caused predominantly by viral infections like RSV. It involves inflammation and obstruction of the small airways. Symptoms include fever, cough, wheezing, respiratory distress, and hypoxemia. Treatment is generally supportive with oxygen, hydration, and respiratory support. Hospitalization may be required in severe cases. Most cases resolve within 1-2 weeks, but it can occasionally cause serious complications like apnea.

Uploaded by

Ez Ball
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Bronchiolitis

 Common disease of LRT of infants, results from


inflammatory obstruction of small airways
 It occurs in the first 2 years of life
 Peak incidence at approximately 6 month of age
 Highest during winter and early spring
 Occurs sporadically and epidemically
Etiology
 Predominantly viral illness
 RSV > 50%
 Parinfluenza virus
 Mycoplasma
 Same adenovirus
 Most common in male infants between 3- 6 month
who have not breast fed
Phathophysiology
 characterized by bronchiolar obstruction due to
edema and accumulation of mucoid cellular debris
and by invasion of the small bronchial radicals by virus
 Resistance in the small air passage is increased during
the inspiratory and expiratory phase
 Small radius of air way lead to air trapping and over
inflation
conti
 Atelectasis may occur when an obstruction became
complete and trapped air is absorbed
 Impairs normal exchange of gases in the lungs
 ventilation - perfusion mismatch results in hypoxemia
 Hypercapnia occurs when respiratory rate exceeds 60
breaths /min
Clinical manifestation
 Sx history of exposure to adults minor respiratory
disease with in a weak.
 Mild RTI with nasal discharge and sneezing
 Fever (38.5-39c) and loss of appetite
 Gradual development of respiratory distress
characteristic by paroxysmal wheezing, cough,
dyspnea, and irritability
conti
 Sn tachypinc with hyper-expanded chest and often in
extreme distress.
 RR 60-80 breaths /min, severe air hunger and cyanosis
 IC and SC retraction
 Palpable liver and spleen as result of over inflation of
lung
conti
 Crackles may be heard at the end of inspiration and
expiration
 Expiratory phase is prolonged leading to audible
wheeze.
Investigation
 Roentgnographic exam
hyperinflation increased AP diameter
scattered area of consolidation in 30%
 Virus demonstration in nasopharyngeal secretion by
antigen detection
DDX
 Asthma- family hx, repeated episodes, sudden
onset without proceeding infection,
eosnophillia, favorable to treat.
 Cystic fibroses
 Heart failure
 Foreign body in the trachea
 Pertusis
 Organophosphate poising, B, pneumonia
Course and prognosis
 Critical phase is the first 48-72 hrs
 Case fatality rate is 1%
 Death occurs from, paroxysmal apneic spell, severe
uncompensated respiratory acidosis or profound
dehydration
Prevention
 RSV immuno globline IV or IM administration prior or
during RSV season.
Hospitalization
 Supportive Rx- place an atmosphere cold, humidified
oxygen to relive hypoxemia and reduce insensible
water lose.
 Comfortable sitting at 30-40 degree angle with head
and chest slightly elevated.
 Ribovirine administered by aerasol may be considered
for infant with CHD or broncopulmonry dysplasia

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