Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- rhinorrhoea/congestion
- tachypnoea
- immunocompromise
- increased work of breathing
- cough
- wheeze
- poor feeding
- cyanosis
- rales
- apnoea
Risk factors
- exposure to RSV
- complex congenital heart disease
- history of prematurity
- immunocompromise
- chronic lung disease
- high-risk infants with no recent immunoprophylaxis against RSV
- infants aged <6 months
- winter season
- older adult age
- smoke exposure
- family history of asthma
- Down's syndrome
Diagnostic investigations
Investigations to consider
- chest x-ray
- direct fluorescent antibody staining of respiratory specimen (e.g., nasopharyngeal aspirate)
- reverse transcriptase polymerase chain reaction of respiratory specimen (e.g., nasopharyngeal aspirate)
- enzyme-linked immunosorbent assay of respiratory specimen (e.g., nasopharyngeal aspirate)
- viral culture of respiratory specimen (e.g., nasopharyngeal aspirate)
Treatment algorithm
Contributors
Authors
Center for Pediatric Infectious Diseases
Cleveland Clinic Children’s Hospital
Cleveland
OH
Disclosures
FE declares that he has is on an advisory board for Procter & Gamble.
Vice President for Research
Professor of medicine in the School of Medicine Department of Pediatrics.
Tulane University
New Orleans
LA
Disclosures
GP declares that he has no competing interests.
Dr Frank Esper and Dr Giovanni Piedimonte would like to gratefully acknowledge Dr Melvin L. Wright, a previous contributor to this topic.
Disclosures
MLW declares that he has no competing interests.
Peer reviewers
Chief
Pediatric Infectious Disease
Vice Chairman
Department of Pediatrics
Children's Medical Center
Winthrop University Medical Center
Mineola
Professor of Pediatrics
School of Medicine
Stony Brook University Medical Center
Stony Brook
NY
Disclosures
LRK has participated as an investigator in multiple clinical research trials supported by grants from MedImmune. LRK has also served as a consultant to MedImmune on medical advisory boards and is a member of their speakers' bureau.
Professor of Pediatrics
Women and Children's Hospital
Buffalo
NY
Disclosures
RW declares that he has no competing interests.
Consultant Paediatrician
Croydon University Hospital
Croydon
UK
Disclosures
JH declares that she has no competing interests.
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