Review article
https://doi.org/10.26800/LV-145-supl1-15
Acute bronchiolitis
Željka Vlašić Lončarić
; Dječja bolnica Srebrnjak, Zagreb
Tatjana Savić-Jovanović
; Dječja bolnica Srebrnjak, Zagreb
Mirjana Turkalj
; Dječja bolnica Srebrnjak, Zagreb
Abstract
Acute bronchiolitis is infection of lower respiratory system, it primarily affects the small airways (bronchioles) and is a common cause of illness and hospitalization of infants and young children. It is a clinical syndrome of respiratory distress, which occurs in children under 2 years of age, characterized by clinical signs of upper respiratory tract infection followed by lower respiratory tract infection. Bronchiolitis occurs when viruses enter the terminal bronchiolar epithelial cells and cause their direct damage and inflammation. Oedema of mucous membrane, excessive production of mucus and destruction of epithelial cells lead to obstruction of small airways and formation of atelectasis. Bronchiolitis is most often caused by viral infection. Although the proportion of infections with certain viruses varies depending on the season, respiratory syncytial virus (RSV) is the most common cause, followed by rhinovirus. Other causative agents are parainfluenza virus, human metapneumovirus, influenza virus, adenovirus, coronavirus and human bocavirus. Viral etiology can be confirmed with molecular diagnostics in more than 95 percent of cases. Disease is clinically manifested by fever, cough and breathing disorders. It is often preceded by clinical signs of upper respiratory tract infection, which last 1 to 3 days. Diagnosis is mainly based on the anamnesis and clinical features, laboratory and radiological diagnostics are auxiliary methods, isolation of the virus gives us the final confirmation of the disease. Duration and course of acute bronchiolitis depends on the age of the child, severity of disease, conditions associated with increased risk (premature infants, chronic lung disease) and the causative agent of the disease. In most cases, treatment is supportive. In more severe clinical cases, respiratory support (non-invasive and/or invasive) is resorted to. Despite everything, bronchiolitis is still mostly a self-limiting disease and most children do not need hospitalization and fully recover within 28 days from the onset of symptoms.
Keywords
BRONCHIOLITIS, etiology, pathogenesis, dijagnostics; CLINICAL FINDINGS; TREATMENT
Hrčak ID:
300807
URI
Publication date:
17.4.2023.
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