Acute bronchiolitis

ROBERT IGBEDE

1. ACUTE BRONCHIOLITIS BY ROBERT IGBEDE

2. INTRODUCTION It is a common respiratory tract infection in young children It can be broken down in two parts, bronchiole (an anatomical location in the lungs) and itis (inflammation of) Definition: it is the inflammation of the brochioles caused by a viral respiratory tract infection in children 2 years and below

3. ETIOLOGY Although they are some viral infection that cause bronchiolitis ( eg . Parainfluenza virus, meta- pneumo virus MPV, Adenovirus), the major culprit of brochiolitis is RSV. RSV(respiratory syncitial virus) has about 50-75% diagnose rate and is the most likely cause of bronchiolitis

4. MODE OF TRANSMISSION It can be spread cough or improper disposal of contaminated sanitizing material and inadequate hygiene It can be contracted by inhalation if around diseased individual that are coughing Also, by touching contaminated materials and self inoculating

5. PATHOPHYSILOGY Early stages: 1 st sign of bronchiolitis is upper respiratory tract infection (runny nose and nasal congestion) mimicking the common cold Late stages: the virus makes its way down the tract to cause an infection in the bronchioles and this what differentiates it from the common cold

6. SIGNS Congestion Cough Fever (not always) Wheezing Air trapping Hypoxemia (O2 sats ) -Increased heart rate -Increased breathing -Fatigue -Lethargy

7. RISK FACTORS Contact with the diseased children Season (fall and winter) Poor immune system Age (<2years) Prematurity (<35weeks gestation) Preexisting lung disease Smoke exposure

8. DIFFERETIAL DIAGNOSIS Asthma Allergic reactions Pneumonia Foreign body aspiration

9. LAB TESTS NAAT and PCR: Nasal swap of the oropharynx to check for presence of RSV Chest x-ray: Peribronchiolar cuffing, Air trapping (hyperinflation) by flattening of the diaphragm

10. PREVENTION Handwashing Avoid sick children Improvement of immune system by breast feeding Prevent smoke exposure Palivizumab (for high risk children alone)

11. TREATMENT Low risk children with O2 sats >92% and have low chance of getting severe can be treated at home Low risk children with O2 sats of <92% and high risk children should be treated in the hospital Supportive therapy: treating symptoms, assisting the child’s system be effective in fighting off the disease, NO MEDICATION

12. SUPPORTIVE THERAPY Hydration nutrition Improve breathing (oxygen*, beta agonists**, hypertonic saline solution**, corticosteroids***, epinephrine***)

13. THANK YOU