Bronchiolitis overview: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
Bronchiolitis has different range of risk factors and it can be differentiated based on the age. In adult, common risk factors in the development of bronchiolitis include exposure to [[cigarette]] smoke, living in crowded areas and immunocompromised patients. In infants, the risk factors include age < 6 months, lack of [[breast-feeding]], [[prematurity]], and young children infected with congenital heart diseases.<ref name="Respiratory Syncytial Virus Infection (RSV)">CDC https://www.cdc.gov/rsv/about/transmission.html Accessed on June 1, 2017 </ref><ref name="pmid26735994">{{cite journal| author=Meissner HC| title=Viral Bronchiolitis in Children. | journal=N Engl J Med | year= 2016 | volume= 374 | issue= 1 | pages= 62-72 | pmid=26735994 | doi=10.1056/NEJMra1413456 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26735994 }} </ref> | |||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
Revision as of 19:26, 20 June 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
Bronchiolitis is the most common lower respiratory tract infection in pediatric patients between 1 month and 2 years of age. It is usually caused by the respiratory syncytial virus (RSV) and is characterized by inflamation, edema and necrosis of the bronchiole's epithelium. Typical clinical manifestations include rhinitis, cough, wheezing, respiratory rales (crackles), use of respiratory accessory muscles and/or nasal flaring.
Historical Perspective
Classification
Bronchiolitis is a wide ranged disease that affects the small respiratory airways (bronchioles). Bronchiolitis should be classified in order to understand how it may occur and the clinical manifestation that could be observed. It is classified based on the age and the different forms of the disease. According to age, it is classified into either adult or infants. Based on the different histological and clinical forms, it can be classified into acute infectious broncholitis, bronchiolitis obliterans, proliferative bronchiolitis, diffuse panbronchiolitis and respiratory bronchiolitis.[1]
Pathophysiology
Causes
Bronchiolitis usually affects children under the age of 2, with a peak age of 3 - 6 months. It is a common, and sometimes severe illness. Respiratory syncytial virus (RSV) is the most common cause. Other viruses that can cause bronchiolitis include adenovirus, influenza and parainfluenza. It may be caused by bacterial organisms like legionella pneumophila and mycoplasma pneumonia. Other non infectious causes include smoking, collagen vascular disease and post bone marrow transplant.
Differentiating Broncholitis from Other Diseases
Epidemiology and Demographics
Bronchiolitis is one of the most common acute respiratory diseases that infects the infants and children. It affects around 3000 per 100,000 in the United States. It occurs during fall, winter and early spring. It can affect any age but it affects more the infants specially under 2 years. Bronchilitis ration in men is more than women and it is more common among the native americans, alaskans and hispanics. Bronchilitis has low mortality rate despite the high number of the hospitalizations.
Risk Factors
Bronchiolitis has different range of risk factors and it can be differentiated based on the age. In adult, common risk factors in the development of bronchiolitis include exposure to cigarette smoke, living in crowded areas and immunocompromised patients. In infants, the risk factors include age < 6 months, lack of breast-feeding, prematurity, and young children infected with congenital heart diseases.[2][3]
Natural History, Complications, and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Prevention will relay in maintain proper measures to prevent the viral dissemination during the RSV season (handwash and avoid contact with patients with symptomatic respiratory infections) and prevention of tobacco smoke exposure. In patients with high risk of developing severe infections, pasive immunization with Palivizumanb is recommended.
Secondary Prevention
References
- ↑ Ryu JH, Myers JL, Swensen SJ (2003). "Bronchiolar disorders". Am J Respir Crit Care Med. 168 (11): 1277–92. doi:10.1164/rccm.200301-053SO. PMID 14644923.
- ↑ CDC https://www.cdc.gov/rsv/about/transmission.html Accessed on June 1, 2017
- ↑ Meissner HC (2016). "Viral Bronchiolitis in Children". N Engl J Med. 374 (1): 62–72. doi:10.1056/NEJMra1413456. PMID 26735994.