Respiratory syncytial virus is the most common cause of bronchiolitis; nearly every child has been infected by 2 years of age.
Seasonal outbreaks occur worldwide, during winter months.
Characterized by cough, wheeze, respiratory distress, and hypoxia.
Most episodes are mild and self-limited.
Treatment is mostly supportive: supplemental oxygen, nasal and pulmonary toilet, respiratory support, nutritional support.
High-risk groups for severe illness include infants with a history of prematurity, chronic lung disease, complex congenital heart disease, and immunocompromise.
Immunoprophylaxis with palivizumab is available for high-risk groups.
Respiratory syncytial virus (RSV) was historically placed in the Paramyxovirus family. It has been recategorized to the order Mononegavirales as a member of the Pneumoviridae family. It is the most common cause of bronchiolitis. Symptoms include rhinorrhea, cough, wheeze, respiratory distress, and hypoxemia. RSV can also cause pneumonia in children and, rarely, in immunocompetent adults.
History and exam
- 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)
Center for Pediatric Infectious Diseases
Cleveland Clinic Children’s Hospital
FE declares that he has no competing interests.
The Steven and Nancy Calabrese Endowed Chair for Excellence in Pediatric Care, Research, and Education
Professor & Chair of Pediatrics
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University
Global Pediatric Research Operations
Cleveland Clinic Foundation
Center for Pediatric Research
Lerner Research Institute
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.
Pediatric Infectious Disease
Department of Pediatrics
Children's Medical Center
Winthrop University Medical Center
Professor of Pediatrics
School of Medicine
Stony Brook University Medical Center
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
RW declares that he has no competing interests.
Croydon University Hospital
JH declares that she has no competing interests.
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