Bronchiolitis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical Examination Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases^[1]

Tachypnea
Fever may or may not be present at the moment of the examination. The lack of fever doesn't exclude the diagnosis.

Rapid changes in respiratory signs is chraracteristic of bronchiolitis.

Wheezing
Rales (crakles)
Decreasing respiratory sounds may indicate a progresion in the airway obstruction which may progress to respiratory failure.^[2]

The association between cyanosis and rales has been shown as a predictor of severity.^[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.
↑ 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.