Last reviewed: September 2018
Last updated: April  2018

Summary

Definition

History and exam

Key diagnostic factors

  • exposure to respiratory syncytial virus (RSV)
  • infants at high risk for RSV infection
  • winter season
  • older adult age
  • rhinorrhea/congestion
  • tachypnea
  • increased work of breathing
  • cough
  • wheeze
  • poor feeding
  • cyanosis
  • rales
  • apnea

Risk factors

  • exposure to respiratory syncytial virus (RSV)
  • complex congenital heart disease
  • hx 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

Diagnostic investigations

Investigations to consider

  • chest x-ray
  • direct fluorescent antibody staining of respiratory specimen (e.g., nasopharyngeal aspirate)
  • reverse transcriptase polymerase chain reaction (PCR) of respiratory specimen (e.g., nasopharyngeal aspirate)
  • enzyme-linked immunosorbent assay (ELISA) of respiratory specimen (e.g., nasopharyngeal aspirate)
  • viral culture of respiratory specimen (e.g., nasopharyngeal aspirate)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Center for Pediatric Infectious Diseases

Cleveland Clinic Children’s Hospital

Cleveland

OH

Disclosures

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

Chief

Global Pediatric Research Operations

Cleveland Clinic Foundation

Director

Center for Pediatric Research

Lerner Research Institute

Cleveland

OH

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.

Peer reviewers VIEW ALL

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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