Bronchiolitis

1. Is a respiratory distress in children less than 2 years, characterized by upper respiratory symptoms like running nose followed by lower respiratory symptoms which result in difficult breathing, wheeze (whistle chest) and crackles.
2. Bronchiolitis is caused by viral infection mostly RSV, adenovirus, parainfluenza, influenza.
3. It affects infant and children younger than 2 years during the fall and winter.
4. Risk factors for severe disease and severe complications are : Congenital Heart diseases, immune deficiency, chronic pulmonary disease, gestational age less than 36 weeks and babies whose age are smaller than 12 weeks.
5. The evaluation of infant and young children with suspected Bronchiolitis requires only history and physical examination.
6. Chest X ray and lab test is not necessary for diagnosis but maybe warranted to evaluate complications, comorbid infections or other conditions.
7. Severe bronchiolitis indicated by persistently increase respiratory efforts (tachypnea , nasal flaring, use accessory chest muscle), low O2 in blood ( hypoxia ) or stop breathing (apnea)
8. We have to rule out other problems that give same symptoms like

-lung infection ( pneumonia)

-foreign body aspiration

-congenital heart diseases