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Care of the Hospitalized Child
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Anushree Algotar, Anna Tuttle, Mark R. Corkins
The supportive care for patients with bronchiolitis involves providing appropriate fluid support while children receive respiratory treatment and oxygen. Traditionally, there has been reluctance to orally feed children with bronchiolitis due to concerns about respiratory deterioration when children are breathing at higher respiratory rates and/or when they need higher rates of oxygen support. Data now shows that these children can be safely fed orally despite these concerns. In rare instances, where the child cannot be fed by mouth, nasogastric feeds are well tolerated without leading to further respiratory deterioration. Hence, these children should be continued on oral feeding whenever possible and also, this feeding should likely commence as soon as possible after admission.
Bronchiolitis
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Bronchiolitis is a common infection, usually in the first year of life, associated with significant infant morbidity. RSV is the commonest causative agent, although other viruses have also been implicated. Some, such as adenovirus, are more likely to be associated with serious long-term complications such as obliterative bronchiolitis. Epidemics of the causative agents usually occur between November and March, resulting in spikes in cases of acute bronchiolitis. Although the large majority of children by the age of 3 will have had RSV infection, re-infection is common, as the initial infection appears not to confer protective immunity to the child, a fact that has hindered the development of an effective vaccine.
Infection and immunology
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Blood cultures are positive in supraglottic croup (the organism is Haemophilus influenzae b) and in 70% of cases of bacterial meningitis. Bronchiolitis is a viral infection. Bordetella pertussis is cultured by a nasopharyngeal swab. Campylobacter is isolated by stool culture.
Airway disease in hematologic malignancies
Published in Expert Review of Respiratory Medicine, 2022
Ricardo J José, Burton F. Dickey, Ajay Sheshadri
The exact incidence of viral bronchiolitis is difficult to isolate from that of viral bronchopneumonia in immunocompromised patients due to definitional overlap [24]. Most definitions require a combination of symptoms and radiographic findings in the presence of symptoms. However, mucus plugging, a common finding in viral bronchiolitis, can often manifest as a tree-in-bud nodular infiltrate on chest CT and be misinterpreted as ‘pneumonia’[25]. Furthermore, mucus plugs can be extensive in inflammatory airway diseases, causing subsegmental atelectasis that can be misinterpreted as a bronchopneumonia [26]. Finally, viral infection is well-known to increase the incidence of secondary bacterial pneumonia, possibly due to enhanced adhesion of bacteria to epithelial surfaces [27]. Therefore, a finding of a lobar infiltrate does not rule out bronchiolitis as the etiologic cause of clinical presentation.
Immune-mediated organ pathologies of vital organs
Published in International Reviews of Immunology, 2021
Viral bronchiolitis, a lung infection caused by respiratory syncytial virus, commonly affects infants and young children up to the age of two years. Viral bronchiolitis is an acute condition that initially affects the upper respiratory tract and subsequently progresses to the lower respiratory tract with excessive inflammation and mucus production. Children with viral bronchiolitis present with a runny or stuffy nose, difficulty in breathing, coughing, and occasionally low-grade fever. Additionally, this infection can reach the ear and may cause ear infection. The last article in this issue by Dias et al. analyzes the association of inflammatory cytokine TNF-α and IFN-γ and its link with viral bronchiolitis based on the current literature [4]. This article will be of relevance to a wide readership but especially those in the fields of immunology and viral immunology (Figure 1).
Budget impact analysis of high-flow nasal cannula for infant bronchiolitis: the Colombian National Health System perspective
Published in Current Medical Research and Opinion, 2021
Jefferson Antonio Buendía, Ranniery Acuña-Cordero, Carlos E. Rodriguez-Martinez
Bronchiolitis is a viral disease characterized by respiratory distress, typically affecting infants under 12 months of age. More than a third of all infants develop bronchiolitis, of whom 3% of the patients are admitted to hospitals in developed countries1. This hospitalization rate increase between 12- 15% in developing countries especially due to problems and barriers in access to health services, especially due to untimely care generated by barriers to initial access to health services2,3. The case-fatality rate of severe bronchiolitis in the first two years of life is usually 0.5% to 1.5% in high-income countries but increases to 1.74% in Latin-American4. In Colombia, we estimate 260,873 years of life (CI 95% 208,180–347,023) were lost due to RSV bronchiolitis in Colombian children under two years5.