Bronchiolitis physical examination: Difference between revisions
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===Vitals=== | ===Vitals=== | ||
*[[Fever]] may or may not be present at the moment of the examination. The lack of [[fever]] doesn't exclude the diagnosis. | *[[Fever]] may or may not be present at the moment of the examination. The lack of [[fever]] doesn't exclude the diagnosis. | ||
===Skin=== | |||
*Cyanosis may be associated with bronchiolitis. | |||
===HEENT=== | ===HEENT=== | ||
Revision as of 13:26, 21 June 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]
Overview
Physical Examination
General appearance
- Ill or toxic appearance
- Cyanosis
Vitals
- Fever may or may not be present at the moment of the examination. The lack of fever doesn't exclude the diagnosis.
Skin
- Cyanosis may be associated with bronchiolitis.
HEENT
In some cases of bronchiolitis the following may be observed:[1]
- Conjuctivitis
- Otitis media
- Pharyngitis
Lung
Rapid changes in respiratory signs are characteristic of bronchiolitis.
Inspection
- Chest retractions:
- Intercostal retractions
- Substernal retractions
- Nasal flaring in infants
Auscultation
- Wheezing
- Rales (crakles)
- Decreasing respiratory sounds may indicate a progression in the airway obstruction which may evolve to respiratory failure.[2]
The association between cyanosis and rales has been shown as a predictor of severity.[3][4]
References
- ↑ Andrade MA, Hoberman A, Glustein J, Paradise JL, Wald ER (1998). "Acute otitis media in children with bronchiolitis". Pediatrics. 101 (4 Pt 1): 617–9. PMID 9521943.
- ↑ Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L; et al. (2004). "Diagnosis and testing in bronchiolitis: a systematic review". Arch Pediatr Adolesc Med. 158 (2): 119–26. doi:10.1001/archpedi.158.2.119. PMID 14757603.
- ↑ Mulholland EK, Olinsky A, Shann FA (1990). "Clinical findings and severity of acute bronchiolitis". Lancet. 335 (8700): 1259–61. PMID 1971330.
- ↑ Eisenhut M (2006). "Extrapulmonary manifestations of severe respiratory syncytial virus infection--a systematic review". Crit Care. 10 (4): R107. doi:10.1186/cc4984. PMC 1751022. PMID 16859512.