RSV Bronchiolitis
Bronchiolitis is an acute infection of the small airways and is one of the most common causes of respiratory distress in infants. The most frequent causative agent is the respiratory syncytial virus (RSV).
The illness occurs mainly in infants under 2 years of age, with the highest incidence during the winter months.
Symptoms:
Symptoms often begin like a common cold and may progress to:
- cough
- wheezing
- fever
- faster or more laboured breathing, respiratory distress
- decreased appetite or feeding difficulty (in infants).
In most cases bronchiolitis is mild and self-limiting, but some infants may require close monitoring or hospitalisation.
Diagnosis:
Diagnosis is based on clinical examination and confirmation of infection with the aid of nasal PCR.
Treatment:
Treatment is primarily supportive and includes:
- adequate hydration
- nasal clearance with saline
- monitoring of breathing
In more severe cases the following may be needed:
- oxygen supplementation
- hospitalisation for respiratory support.
Antibiotics usually have no role in the management of simple viral bronchiolitis.
When to seek immediate medical assessment:
Seek immediate medical help when the infant:
- has difficulty breathing
- cannot feed adequately
- shows marked drowsiness or cyanosis
- has a complicated medical history
- is very young
- has low oxygen saturation.
When to see a paediatric pulmonologist:
Specialist evaluation may be needed for infants or children with:
- persistent symptoms that cannot be managed by the paediatrician
- a complicated history, such as prematurity, bronchopulmonary dysplasia, recurrent respiratory infections, etc.
