Bronchiolitis Questions & Answers

Updated: Mar 25, 2018
  • Author: Nizar F Maraqa, MD, FAAP; Chief Editor: Russell W Steele, MD  more...
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Questions & Answers

Overview

What is bronchiolitis?

What are the signs and symptoms of bronchiolitis?

What are the signs and symptoms of severe bronchiolitis?

What are physical findings characteristic of bronchiolitis?

What is the role of lab testing in the diagnosis of bronchiolitis?

What tests are commonly performed in the evaluation of bronchiolitis?

What is the role of imaging studies in the evaluation of bronchiolitis?

What is the role of bronchoscopy in the diagnosis and management of bronchiolitis?

What is the focus of treatment of bronchiolitis in young children?

What is included in supportive care for bronchiolitis?

Which medications are used in the management of bronchiolitis?

What usually causes bronchiolitis?

What is bronchiolitis obliterans-organizing pneumonia (BOOP)?

In what age group is bronchiolitis most prevalent?

What are the goals of the AAP treatment guidelines for bronchiolitis?

What is the role of bronchioles in the pathophysiology of bronchiolitis?

What are the effects of a bronchiolar injury in bronchiolitis?

Which immunologic mechanisms play a role in the pathogenesis of bronchiolitis?

What is the role of necrosis of the respiratory epithelium in the pathophysiology of bronchiolitis?

What is the role of cytokines and chemokines in the pathophysiology of bronchiolitis?

What causes airway obstruction in the pathophysiology bronchiolitis?

What is the pathophysiology of bronchiolitis?

How is bronchiolitis infection transmitted?

How common is respiratory syncytial virus (RSV) infection in children?

What is the etiology of bronchiolitis?

What is the most etiologic agent in bronchiolitis?

What is the role of rhinoviruses in the etiology of bronchiolitis?

What percentage of bronchiolitis is caused by parainfluenza?

What percentage of bronchiolitis is caused by adenovirus?

What percentage of bronchiolitis is caused by hMPV?

What are the risk factors for hMPV bronchiolitis?

What is the role of human bocavirus (HBoV) in the etiology of bronchiolitis?

What are the risk factors for the development of bronchiolitis?

What is the prevalence of bronchiolitis in the US?

What is the global prevalence of bronchiolitis?

Which children have the highest prevalence of bronchiolitis?

Does the prevalence of bronchiolitis vary by sex?

How does the prevalence and severity of bronchiolitis vary by race?

What is risk of mortality from acute lower respiratory infection in children?

What is the prognosis of bronchiolitis?

What is the frequency of hospitalization for treatment of bronchiolitis?

What is the mortality rate for children with bronchiolitis?

What health risks are increased in children hospitalized with respiratory syncytial virus (RSV) bronchiolitis?

What is the risk of asthma in children with bronchiolitis?

What is the risk of bacterial infections in bronchiolitis?

What information about bronchiolitis should be given to patients?

What should be included in discharge instructions for bronchiolitis?

How can bronchiolitis be prevented?

Presentation

How is bronchiolitis diagnosed?

What are the signs and symptoms of bronchiolitis?

What are characteristic physical findings of bronchiolitis?

What is the basis for the diagnosis of bronchiolitis?

What is the best predictor of illness in bronchiolitis?

What is the presentation of apnea in bronchiolitis?

What is the incidence of apnea in bronchiolitis?

What are the nonrespiratory symptoms of respiratory syncytial virus (RSV) bronchiolitis?

What are possible complications of bronchiolitis?

What is the role of bronchiolitis in the etiology of asthma?

What are neurologic complications in bronchiolitis?

DDX

How are asthma and bronchiolitis differentiated?

What conditions should be included in the differential diagnoses of bronchiolitis?

What are the differential diagnoses for Bronchiolitis?

Workup

What is the role of lab tests in the diagnosis of bronchiolitis?

What are concerns regarding the use of diagnostic tests for bronchiolitis?

What diagnostic tests are commonly used for evaluation of bronchiolitis?

When should diagnostic tests be considered for bronchiolitis?

What is the role of WBC count in the evaluation of bronchiolitis?

What are the limitations of WBC count in the evaluation of bronchiolitis?

What is the risk of secondary bacterial infection in respiratory syncytial virus (RSV) bronchiolitis?

Which factors increase the likelihood of use of lab studies in the diagnosis of bronchiolitis?

What are the risk factors for concurrent bacteremia in bronchiolitis?

What is the risk of serious bacterial infections in bronchiolitis?

What is the most commonly viral agent for bronchiolitis?

How is viral testing done in the workup of bronchiolitis?

What is the role of pulse oximetry in the evaluation of bronchiolitis?

What is the role of chest radiography in the workup of bronchiolitis?

What findings from a chest radiography suggest bronchiolitis?

When is chest radiography indicated in the evaluation of bronchiolitis?

What is the role of ECG in the workup of bronchiolitis?

Treatment

How is bronchiolitis managed?

What is the role of bronchodilator therapy for bronchiolitis?

What is the role of corticosteroids in the treatment of bronchiolitis?

Which agents have not shown efficacy in the management of respiratory syncytial virus (RSV) bronchiolitis?

What is the efficacy of drug treatment for bronchiolitis in infants?

Why do admission rates for bronchiolitis vary between general EDs and pediatric EDs?

What are the AAP recommended treatments for bronchiolitis?

What are the AAP-AAFP-ACCP-ATS treatment guidelines for bronchiolitis?

What has been the effect of treatment guidelines for bronchiolitis?

What is the initial management of bronchiolitis?

What are the indications for antibiotics in the management of bronchiolitis?

When is hospitalization indicated for treatment of bronchiolitis?

When should ICU admission be considered for bronchiolitis?

What is the focus of supportive care for bronchiolitis?

What is the indication for oxygen supplementation in the management of bronchiolitis?

How is dehydration treated in patients with bronchiolitis?

What is the indication for mechanical ventilation in the management of bronchiolitis?

What are considerations regarding pharmacologic therapy for bronchiolitis?

What is the role of bronchodilators in the treatment of bronchiolitis?

What is the efficacy of bronchodilators for the treatment of bronchiolitis?

How should use of bronchodilators be monitored in the treatment of bronchiolitis?

What is the role of ribavirin aerosol therapy for bronchiolitis?

What is the efficacy of ribavirin for the treatment of bronchiolitis?

What is the role of antibiotics for the treatment of bronchiolitis?

What coinfections are possible in patients with respiratory syncytial virus (RSV) bronchiolitis?

What is the role of corticosteroids and glucocorticoids for the treatment of bronchiolitis?

What is the role of anti-inflammatory agents for the treatment of bronchiolitis?

When may corticosteroids be useful for the treatment of bronchiolitis?

What is the role of cromoglycate for the treatment of bronchiolitis?

What is the role of hypertonic saline for the treatment of bronchiolitis?

What is the role of chest physiotherapy for the treatment of bronchiolitis?

What are possible complications of therapy for bronchiolitis?

How can the complications of therapy for bronchiolitis be prevented?

What should be considered prior to discharge of a child with bronchiolitis?

What discharge criteria for bronchiolitis have been proposed?

How soon after discharge for bronchiolitis should a child be seen by a primary physician?

Which inpatient treatments for bronchiolitis should be continued following discharge?

Which group of infants with bronchiolitis are at highest risk of return ED visits after discharge?

How can the transmission of respiratory syncytial virus (RSV) bronchiolitis be prevented?

What is the status of a respiratory syncytial virus (RSV) vaccine?

What has been shown to prevent respiratory syncytial virus (RSV) bronchiolitis?

What is the role of palivizumab in the prevention of respiratory syncytial virus (RSV) bronchiolitis?

Why is palivizumab for the prevention of respiratory syncytial virus (RSV) bronchiolitis limited to high-risk patients?

What is the role of motavizumab in the prevention of respiratory syncytial virus (RSV) bronchiolitis?

What is the effect of breastfeeding on disease progression of respiratory syncytial virus (RSV) bronchiolitis?

Which specialists should be consulted for the treatment of bronchiolitis?

What long-term monitoring is needed following treatment of bronchiolitis?

What are the possible long-term pulmonary sequelae of respiratory syncytial virus (RSV) bronchiolitis?

What pathogens cause bronchiectasis after bronchiolitis and what are long-term outcomes?

What is the association between immunoglobulin deficiency and recurrent bronchiolitis?

Guidelines

What are the AAP recommendations for the diagnosis, treatment, and prevention of bronchiolitis in children younger the 2 years old?

What guidelines may be helpful for bronchiolitis?

Medications

Which medications are used in the treatment of bronchiolitis?

How does oxygen administration affect the efficacy of other therapies for bronchiolitis?

What is the role of heliox in the treatment of bronchiolitis?

When are medical therapies used to treat bronchiolitis in pediatric patients?

Which medications in the drug class Corticosteroids are used in the treatment of Bronchiolitis?

Which medications in the drug class Decongestant, Intranasal are used in the treatment of Bronchiolitis?

Which medications in the drug class Antiviral, Other are used in the treatment of Bronchiolitis?

Which medications in the drug class Antibiotics, Other are used in the treatment of Bronchiolitis?

Which medications in the drug class Monoclonal Antibodies are used in the treatment of Bronchiolitis?

Which medications in the drug class Alpha/Beta Agonists are used in the treatment of Bronchiolitis?