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Respiratory syncytial virus infection

Last reviewed: 17 Aug 2025
Last updated: 29 Jul 2025

Summary

定义

病史和体格检查

关键诊断因素

  • exposure to RSV
  • infants at high risk for RSV infection
  • winter season
  • older adult age
  • immune deficiency
  • rhinorrhea/congestion
  • tachypnea
  • increased work of breathing
  • cough
  • wheeze
  • poor feeding
  • cyanosis
  • rales
  • apnea
完整详情

其他诊断因素

  • fever
完整详情

危险因素

  • exposure to RSV
  • hemodynamically significant congenital heart disease
  • history of prematurity
  • immune deficiency
  • chronic lung disease
  • indigenous/American-Indians/Alaska native infants and young children
  • infants aged <6 months
  • winter season
  • older adult age
  • smoke exposure
  • family history of asthma
  • Down syndrome
完整详情

诊断性检查

首要检查

  • pulse oximetry
完整详情

Tests to avoid

  • broad respiratory pathogen panels
完整详情

需考虑的检查

  • chest x-ray
  • hydration status
  • rapid antigen detection from respiratory specimen (e.g., nasopharyngeal aspirate)
  • reverse transcriptase polymerase chain reaction of respiratory specimen (e.g., nasopharyngeal aspirate)
完整详情

治疗流程

急症处理

mild or self-limited illness

moderate illness

severe illness

撰稿人

作者

Giovanni Piedimonte, MD, FAAP, FCCP

Vice President for Research

Professor of Pediatrics, Biochemistry & Molecular Biology

Tulane University School of Medicine

New Orleans

LA

利益声明

GP declares that he has no competing interests.

Margot Anderson, MD

Assistant Professor of Clinical Pediatrics

Section of Infectious Diseases and Hospital Medicine

Tulane University School of Medicine

Tulane University

New Orleans

LA

利益声明

MA declares that she has no competing interests.

鸣谢

Dr Giovanni Piedimonte and Dr Margot Anderson would like to gratefully acknowledge Dr Frank Esper and Dr Melvin L. Wright, previous contributors to this topic.

利益声明

FE is on an advisory board for Procter and Gamble. MLW declares that he has no competing interests.

同行评议者

Leonard R. Krilov, MD

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

利益声明

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.

Robert Welliver, MD

Professor of Pediatrics

Women and Children's Hospital

Buffalo

NY

利益声明

RW declares that he has no competing interests.

Jennifer Handforth, MB ChB, MRCPCH, DTM&H

Consultant Paediatrician

Croydon University Hospital

Croydon

UK

利益声明

JH declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Bont L, Checchia PA, Fauroux B, et al. Defining the epidemiology and burden of severe respiratory syncytial virus infection among infants and children in western countries. Infect Dis Ther. 2016 Sep;5(3):271-98.全文  摘要

Ralston SL, Lieberthal AS, Meissner HC, et al; American Academy of Pediatrics. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014 Nov;134(5):e1474-502.全文  摘要

Committee on Infectious Diseases; American Academy of Pediatrics. Red book. 32nd ed. Elk Grove Village, IL: AAP; 2021.全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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