Bronchiolitis - BRONCHIOLITIS Cori Daines, MD Pediatric...

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BRONCHIOLITIS Cori Daines, MD Pediatric Pulmonology, Allergy and Immunology
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INTRODUCTION Common cause of illness in young children Common cause of hospitalization in young children Associated with chronic respiratory symptoms in adulthood May be associated with significant morbidity or mortality
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DIAGNOSIS Acute infectious inflammation of the bronchioles resulting in wheezing and airways obstruction in children less than 2 years old
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MICROBIOLOGY Typically caused by viruses RSV-most common Parainfluenza Human Metapneumovirus Influenza Rhinovirus Coronavirus Human bocavirus Occasionally associated with Mycoplasma pneumonia infection
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RESPIRATORY SYNCYTIAL VIRUS Ubiquitous throughout the world Seasonal outbreaks Temperate Northern hemisphere: November to April, peak January or February Temperate Southern hemisphere: May to September, peak May, June or July Tropical Climates: rainy season
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PARAINFLUENZA Usually type 3, but may also be caused by types 1 or 2 Epidemics in the early spring and fall
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HUMAN METAPNEUMOVIRUS Paramyxovirus first recognized in 2001 May occur together with other viruses May cause bronchiolitis or pneumonia in children
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INFLUENZA Very similar to RSV or Parainfluenza in symptoms Seasonal with similar distribution to RSV Usually epidemic in the Northern hemisphere January through April
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RHINOVIRUS More than 100 serotypes Main cause of the common cold Associated with lower respiratory tract disease in children with chronic lung disease Often found along with other viruses Usually manifests in spring and fall
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CORONAVIRUS Second most common cause of the common cold Non-SARS (Severe acute respiratory syndrome) types can cause bronchiolitis in children
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HUMAN BOCAVIRUS Discovered in 2005 Usually an issue in fall and winter May cause bronchiolitis and pertussis- like illness
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EPIDEMIOLOGY Typically less than 2 years with peak incidence 2 to 6 months May still cause disease up to 5 years Leading cause of hospitalizations in infants and young children Accounts for 60% of all lower respiratory tract illness in the first year of life
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EPIDEMIOLOGY United States National Hospital Discharge Survey 1980-1996 1.65 million hospitalizations in children less than 5 years in this period 57% younger than 6 months 81% younger than 1 year Mean hospital stay 3 days Hospitalization rates doubled over the 17 years Hospitalization more frequent in boys (62%)
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RISK FACTORS OF SEVERITY Prematurity Low birth weight
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Bronchiolitis - BRONCHIOLITIS Cori Daines, MD Pediatric...

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