Bronchiolitis history and symptoms: Difference between revisions
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==History and Symptoms== | ==History and Symptoms== | ||
*Bronchiolitis should be suspected when acute onset of [[upper respiratory tract infection]] | *Bronchiolitis should be suspected when acute onset of [[upper respiratory tract infection]] is followed by [[lower respiratory tract infection]] [[symptoms]] ([[wheezing]], [[cough]], and [[shortness of breath]]), in a child younger than 2 years.<ref name="Mandell">{{Cite book | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref><ref name="pmid27549684">{{cite journal| author=Florin TA, Plint AC, Zorc JJ| title=Viral bronchiolitis. | journal=Lancet | year= 2017 | volume= 389 | issue= 10065 | pages= 211-224 | pmid=27549684 | doi=10.1016/S0140-6736(16)30951-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27549684 }} </ref> | ||
*The [[incubation period]] of [[Human respiratory syncytial virus|respiratory syncytial virus (RSV)]] is 2-8 days; therefore [[symptoms]] begin within one week of contact with a [[symptomatic]] patient.<ref name="pmid19209271">{{cite journal| author=Wright M, Mullett CJ, Piedimonte G| title=Pharmacological management of acute bronchiolitis. | journal=Ther Clin Risk Manag | year= 2008 | volume= 4 | issue= 5 | pages= 895-903 | pmid=19209271 | doi= | pmc=PMC2621418 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19209271 }} </ref> | *The [[incubation period]] of [[Human respiratory syncytial virus|respiratory syncytial virus (RSV)]] is 2-8 days; therefore [[symptoms]] begin within one week of contact with a [[symptomatic]] patient.<ref name="pmid19209271">{{cite journal| author=Wright M, Mullett CJ, Piedimonte G| title=Pharmacological management of acute bronchiolitis. | journal=Ther Clin Risk Manag | year= 2008 | volume= 4 | issue= 5 | pages= 895-903 | pmid=19209271 | doi= | pmc=PMC2621418 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19209271 }} </ref> | ||
*Patients usually present with [[symptoms]] of a mild [[upper respiratory infection]] which include [[fever]], [[cough]], and [[nasal discharge]].<ref name="pmid19209271">{{cite journal| author=Wright M, Mullett CJ, Piedimonte G| title=Pharmacological management of acute bronchiolitis. | journal=Ther Clin Risk Manag | year= 2008 | volume= 4 | issue= 5 | pages= 895-903 | pmid=19209271 | doi= | pmc=PMC2621418 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19209271 }} </ref> | *Patients usually present with [[symptoms]] of a mild [[upper respiratory infection]] which include [[fever]], [[cough]], and [[nasal discharge]].<ref name="pmid19209271">{{cite journal| author=Wright M, Mullett CJ, Piedimonte G| title=Pharmacological management of acute bronchiolitis. | journal=Ther Clin Risk Manag | year= 2008 | volume= 4 | issue= 5 | pages= 895-903 | pmid=19209271 | doi= | pmc=PMC2621418 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19209271 }} </ref> | ||
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*[[Fever]] is usually not high; in the case of high [[fever]], other causes should be ruled out, such as [[bacterial infections]]. | *[[Fever]] is usually not high; in the case of high [[fever]], other causes should be ruled out, such as [[bacterial infections]]. | ||
*[[Apnea]] is a severe manifestation of [[RSV]] [[infection]] and is more common in children under 3 months of age and [[premature]] infants.<ref name="pmid19209271">{{cite journal| author=Wright M, Mullett CJ, Piedimonte G| title=Pharmacological management of acute bronchiolitis. | journal=Ther Clin Risk Manag | year= 2008 | volume= 4 | issue= 5 | pages= 895-903 | pmid=19209271 | doi= | pmc=PMC2621418 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19209271 }} </ref> | *[[Apnea]] is a severe manifestation of [[RSV]] [[infection]] and is more common in children under 3 months of age and [[premature]] infants.<ref name="pmid19209271">{{cite journal| author=Wright M, Mullett CJ, Piedimonte G| title=Pharmacological management of acute bronchiolitis. | journal=Ther Clin Risk Manag | year= 2008 | volume= 4 | issue= 5 | pages= 895-903 | pmid=19209271 | doi= | pmc=PMC2621418 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19209271 }} </ref> | ||
*[[Lethargy]] is also common | *[[Lethargy]] is also common. | ||
*Post-tussive vomiting may be seen. | |||
*Poor feeding secondary to [[tachypnea]] may lead to [[dehydration]].<ref name="Mandell">{{Cite book | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref> | |||
*History of [[cyanosis]] is related to severe disease.<ref name="pmid16860701">{{cite journal| author=Smyth RL, Openshaw PJ| title=Bronchiolitis. | journal=Lancet | year= 2006 | volume= 368 | issue= 9532 | pages= 312-22 | pmid=16860701 | doi=10.1016/S0140-6736(06)69077-6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16860701 }} </ref> | *History of [[cyanosis]] is related to severe disease.<ref name="pmid16860701">{{cite journal| author=Smyth RL, Openshaw PJ| title=Bronchiolitis. | journal=Lancet | year= 2006 | volume= 368 | issue= 9532 | pages= 312-22 | pmid=16860701 | doi=10.1016/S0140-6736(06)69077-6 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16860701 }} </ref> | ||
Revision as of 16:26, 21 August 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
Bronchiolitis occurs mainly in infants. The patient usually gives a history of nasal congestion and expectoration of phlegm. The classical presentation of bronchiolitis is fever, cough, and dyspnea. The virus is transmitted from person to person by direct contact with nasal fluids or via airborne droplets. Although RSV generally causes only mild symptoms in adults, it can cause severe illness in an infant. Bronchiolitis is seasonal and appears more often in the fall and winter months. Bronchiolitis is a very common reason for infants to be hospitalized during winter and early spring. It has been estimated that by 1 year of age, more than half of all infants have been exposed to RSV.
History and Symptoms
- Bronchiolitis should be suspected when acute onset of upper respiratory tract infection is followed by lower respiratory tract infection symptoms (wheezing, cough, and shortness of breath), in a child younger than 2 years.[1][2]
- The incubation period of respiratory syncytial virus (RSV) is 2-8 days; therefore symptoms begin within one week of contact with a symptomatic patient.[3]
- Patients usually present with symptoms of a mild upper respiratory infection which include fever, cough, and nasal discharge.[3]
- Symptoms of lower respiratory tract infection include:[1]
- Fever is usually not high; in the case of high fever, other causes should be ruled out, such as bacterial infections.
- Apnea is a severe manifestation of RSV infection and is more common in children under 3 months of age and premature infants.[3]
- Lethargy is also common.
- Post-tussive vomiting may be seen.
- Poor feeding secondary to tachypnea may lead to dehydration.[1]
- History of cyanosis is related to severe disease.[4]
References
- ↑ 1.0 1.1 1.2 Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier.
- ↑ Florin TA, Plint AC, Zorc JJ (2017). "Viral bronchiolitis". Lancet. 389 (10065): 211–224. doi:10.1016/S0140-6736(16)30951-5. PMID 27549684.
- ↑ 3.0 3.1 3.2 Wright M, Mullett CJ, Piedimonte G (2008). "Pharmacological management of acute bronchiolitis". Ther Clin Risk Manag. 4 (5): 895–903. PMC 2621418. PMID 19209271.
- ↑ Smyth RL, Openshaw PJ (2006). "Bronchiolitis". Lancet. 368 (9532): 312–22. doi:10.1016/S0140-6736(06)69077-6. PMID 16860701.