Bronchiolitis natural history: Difference between revisions
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*Symptoms gradually disapear within the next 2 weeks (the [[cough]] may take longer) | *Symptoms gradually disapear within the next 2 weeks (the [[cough]] may take longer) | ||
==Complications== | ==Complications <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases<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></SMALL></SMALL></SMALL></SMALL></SMALL>== | ||
Complications | Complications are usually observerd in patients younger than 2 months, premature infants and patients with associated conditions ([[congenital heart disease]], chronic pulmonary disease and [[immunodeficiencies]]). A list of common complications is listed below: | ||
*[[Apnea]]: More common in children under 2 months of age and [[premature infants]], it is observed in 3% to 25% of the patients. Several times it appears as the presenting manifestation, however it may be the consequence of previous mild respiratory symptoms.<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="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]] | *[[Aspiration]]: | ||
[[Aspiration]] | *Reccurrent [[wheezing]] episodes: 30%-50% of hospitalized patients with bronchiolitis present recurrent [[wheezing]] episodes, however, episodes usually deseappear before adolescence. | ||
Reccurrent [[wheezing]] episodes | *Associated [[bacterial]] infections: Most common association is with [[urinary tract infections]] (UTI) and [[Otitis media classification#Acute otitis media|acute otitis media]] (AOM), usually not related with the respiratory infection. [[Bacterial]] coinfections appear in 0%-7% of patients with bronchiolitis. | ||
* [[ | |||
==Prognosis== | ==Prognosis== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Natural History Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[1]
- Patients usually develop symptoms 1 week after the contact with a symptomatic patient.
- The first 2-3 days the patient presents mild upper respiratory symptoms (cough, rinorrhoea and low fever).
- Acute pahse (shortness of breath, wheezing, persistent prominent cough, tachypnea, chest wall retraction and nasal flaring) usually developes between the third and seventh day.
- Symptoms gradually disapear within the next 2 weeks (the cough may take longer)
Complications Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[2]
Complications are usually observerd in patients younger than 2 months, premature infants and patients with associated conditions (congenital heart disease, chronic pulmonary disease and immunodeficiencies). A list of common complications is listed below:
- Apnea: More common in children under 2 months of age and premature infants, it is observed in 3% to 25% of the patients. Several times it appears as the presenting manifestation, however it may be the consequence of previous mild respiratory symptoms.[2][3]
- Aspiration:
- Reccurrent wheezing episodes: 30%-50% of hospitalized patients with bronchiolitis present recurrent wheezing episodes, however, episodes usually deseappear before adolescence.
- Associated bacterial infections: Most common association is with urinary tract infections (UTI) and acute otitis media (AOM), usually not related with the respiratory infection. Bacterial coinfections appear in 0%-7% of patients with bronchiolitis.
Prognosis
Usually, the symptoms get better within a week, and breathing difficulty usually improves by the third day. The mortality rate is less than 1%.
References
- ↑ 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.
- ↑ 2.0 2.1 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.
- ↑ Wright M, Mullett CJ, Piedimonte G (2008). "Pharmacological management of acute bronchiolitis". Ther Clin Risk Manag. 4 (5): 895–903. PMC 2621418. PMID 19209271.