Bronchiolitis natural history: Difference between revisions
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==Natural History <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>== | ==Natural History <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>== |
Revision as of 13:15, 19 June 2014
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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]
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, rhinorrhea and low fever).
- Acute phase (shortness of breath, wheezing, persistent prominent cough, tachypnea, chest wall retraction and nasal flaring) usually develops between the third and seventh day.
- Symptoms gradually disappear within the next 2 weeks (the cough may take longer)
Complications Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[1]
Complications are usually observed 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.[1][2]
- Aspiration:
- Recurrent wheezing episodes: 30%-50% of hospitalized patients with bronchiolitis present recurrent wheezing episodes, however, episodes usually diseappear 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 Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[1]
Prognosis is generally good, as most children show gradual symptomatic improvement within 2 weeks after symptoms begin. Though the rate of hospitalizations is high (71 per 1000 infants for 2003) and has increased in the last 2 decades, the mortality rate is very low (2 deaths per 100 000 livebirths in the U.S. and 1.82 per 100 000 livebirths in the UK).
References
- ↑ 1.0 1.1 1.2 1.3 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.