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Bronchiolitis in children


Bronchiolitis is a lower respiratory infection caused by Respiratory Synctial Virus (RSV) and more commonly in infants. Its more common respiratory infection in infant and young children below 2 years of age.


Secondary bacterial infection may occur. It is most severe in young infants. Episodes of wheeze may occur for months after an attack of bronchiolitis, but eventually will stop.

Bronchiolitis presents with wheeze that is a high-pitched whistling sound near the end of each expiration. It is caused by spasmodic narrowing of the distal airways.

The other causes of wheezes include apart  from bronchiolitis in children after 2 years of age is Asthma 

Signs and symptoms includes;

  • Cough

  • Runny nose

  • Stuffy nose

  • Mild fever (not always present)

  • Wheezing sound when the child breathes out

  • Difficult in breathing

Diagnostic Criteria

  • There are no specific Criteria but use one or more of the following features to make a Diagnostic of Bronchiolitis

  • First episode of wheeze in a child aged<2years old

  • Hyperinflation of chest, prolonged expiration.

  • Reduced air entry if very severe.

  • Poor or no response to a rapid-acting bronchodilator.

  • Increased resonance to percussion.

  • Rhonchi and or crackles on auscultation of the chest may be present



  • Chest X ray

  • FBP

  • CRP

  • Blood Culture and Sensitivity

  • Serum Electrolytes to exclude other Diagnostic


  • Treat as an outpatient unless the child has signs of respiratory distress.

Pharmacological Treatment

  • Give Paracetamol 15mg/kg if the temperature is above 38.5°C

Non pharmacological treatment

  • Give Oxygen 1-2L/min if there are signs of severe respiratory distress


If the child fails to respond to oxygen therapy, or the child’s condition worsens suddenly, obtain a chest X-ray and other lab investigations to rule out other complications.

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Last updated on 24.08.2020


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