Bronchiolitis physical examination
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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]
Physical Examination Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[1]
General appearance
- Ill or toxic appearance
- Cyanosis
Vitals
- Tachypnea
- Fever may or may not be present at the moment of the examination. The lack of fever doesn't exclude the diagnosis.
Lung
Rapid changes in respiratory signs are chracteristic 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]
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.
- ↑ 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.