Bronchiolitis physical examination: Difference between revisions
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*[[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. | ||
Revision as of 13:25, 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.
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.