Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- cough
- tachypnea
- wheezing
- retractions, grunting, and nasal flaring
Otros factores de diagnóstico
- rhinitis
- fluctuating clinical findings
- irritability, malaise, and poor feeding
- fever <104°F (<40°C)
- crackles
- apnea
- thoracoabdominal asynchrony
Factores de riesgo
- children <2 years
- winter months
- prematurity or bronchopulmonary dysplasia
- passive tobacco smoke exposure and air pollution
- impaired airway clearance and function
- congenital heart disease
- immunodeficiency
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- pulse oximetry
Tests to avoid
- broad respiratory pathogen panels
Pruebas diagnósticas que deben considerarse
- enzyme-linked immunosorbent assay (ELISA) rapid antigen detection
- chest x-ray
- reverse transcriptase polymerase chain reaction (RT-PCR)
Algoritmo de tratamiento
confirmed bronchiolitis
Colaboradores
Autores
Howard B. Panitch, MD
Emeritus Professor
Division of Pulmonary and Sleep Medicine
Children's Hospital of Philadelphia
Philadelphia
PA
Divulgaciones
HBP is a medical editor for the Pediatric Pulmonology SubBoard of the American Board of Pediatrics. He has also been an expert witness for medical malpractice cases, but none involving infants with bronchiolitis. HBP has received royalties from Up to Date for chapter reviews. He has been on three guideline committees for the American Thoracic Society, one involving an update on the care of infants with bronchopulmonary dysplasia, one on the care of children with tracheostomies, and he is currently on one regarding the care of patients with Duchenne Muscular Dystrophy.
Agradecimientos
Professor Panitch would like to gratefully acknowledge Dr Isaac Desheng Liu, Dr Woon Li Seo, Dr Jennifer L. Nayak, Dr Caroline B. Hall, and Dr Clement L. Ren, previous contributors to this topic.
Divulgaciones
IDL, WLS, JLN, and CLR declare that they have no competing interests. CBH is an author of a number of references cited in this topic.
Revisores por pares
Michael D. Patrick, Jr. MD
Associate Professor of Pediatrics
The Ohio State University College of Medicine
Columbus
OH
Divulgaciones
MDP declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
American Academy of Pediatrics Publications. AAP recommendations for the prevention of RSV disease in infants and children. Jul 2025 [internet publication].Texto completo
Canadian Paediatric Society. Bronchiolitis: recommendations for diagnosis, monitoring and management of children one to 24 months of age. Nov 2021 [internet publication].Texto completo
Cunningham S, Rodriguez A, Adams T, et al. Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial. Lancet. 2015 Sep 12;386(9998):1041-8.Texto completo Resumen
Lin J, Zhang Y, Xiong L, et al. High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis. Arch Dis Child. 2019 Jun;104(6):564-76. Resumen
Farley R, Spurling GK, Eriksson L, et al. Antibiotics for bronchiolitis in children under two years of age. Cochrane Database Syst Rev. 2014 Oct 9;(10):CD005189.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Bacterial pneumonia
- Chlamydial pneumonia
- Cystic fibrosis (CF)
Más DiferencialesGuías de práctica clínica
- Australasian bronchiolitis guideline
- 2022 Italian guidelines on the management of bronchiolitis in infants
Más Guías de práctica clínicaFolletos para el paciente
Bronchiolitis
Asthma in children
Más Folletos para el paciente
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