Acute bronchiolitis is primarily a pediatric respiratory condition caused by inflammation of the bronchioles in response to a viral infection. The condition is a common cause of hospitalization in children in the United States, with the majority of cases caused by respiratory syncytial virus (RSV). Patients usually present with upper respiratory symptoms, such as cough and congestion, and later develop lower respiratory signs, including dyspnea, wheezing, crackles, and hypoxia, for up to 10 days. Diagnosis is clinical and treatment is directed at improving oxygenation and hydration. As the disease course is self-limiting, acute bronchiolitis has good prognosis with appropriate management.
Last updated: May 22, 2023
Acute bronchiolitis Bronchiolitis Inflammation of the bronchioles. Pediatric Chest Abnormalities is a clinical constellation of respiratory symptoms (increased work of breathing Work of breathing Respiratory muscle contraction during inhalation. The work is accomplished in three phases: lung compliance work, that required to expand the lungs against its elastic forces; tissue resistance work, that required to overcome the viscosity of the lung and chest wall structures; and airway resistance work, that required to overcome airway resistance during the movement of air into the lungs. Work of breathing does not refer to expiration, which is entirely a passive process caused by elastic recoil of the lung and chest cage. Pulmonary Examination, wheezing Wheezing Wheezing is an abnormal breath sound characterized by a whistling noise that can be relatively high-pitched and shrill (more common) or coarse. Wheezing is produced by the movement of air through narrowed or compressed small (intrathoracic) airways. Wheezing, and crackles) caused by acute inflammation Acute Inflammation Inflammation of the small airways (small bronchi Bronchi The larger air passages of the lungs arising from the terminal bifurcation of the trachea. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into bronchioles and pulmonary alveoli. Bronchial Tree: Anatomy and bronchioles Bronchioles The small airways branching off the tertiary bronchi. Terminal bronchioles lead into several orders of respiratory bronchioles which in turn lead into alveolar ducts and then into pulmonary alveoli. Bronchial Tree: Anatomy), typically secondary to viral infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease.
Pathologic changes are noted within 24 hours of contact with a pathogen:
Symptoms are on a spectrum based on the severity of the disease:
Risk stratification at admission is important to determine the appropriate level of care.
Management depends on severity:
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