Summary
Definition
O VSR faz parte da família Pneumoviridae. Ele é a causa mais comum de infecção do trato respiratório inferior em lactentes e crianças pequenas.[1]
Os sintomas de bronquiolite incluem rinorreia, tosse, sibilância, desconforto respiratório e hipoxemia.[2]
Normalmente, o VSR causa sintomas de infecção do trato respiratório superior em indivíduos de todas as idades, bem como bronquiolite, pneumonia viral e laringite (crupe).[Figure caption and citation for the preceding image starts]: Eletromicrografia revelando os traços morfológicos do vírus sincicial respiratório (VSR)Centros de Controle e Prevenção de Doenças (CDC)/Palmer EL; usado com permissão [Citation ends].
History and exam
Key diagnostic factors
- presença de fatores de risco
- exposição ao VSR
- crianças com alto risco de infecção por VSR
- estação do inverno
- idade avançada
- imunodeficiência
- rinorreia/congestão
- taquipneia
- aumento do esforço respiratório
- tosse
- sibilo
- baixa aceitação alimentar
- cianose
- estertores
- apneia
Other diagnostic factors
- febre
Risk factors
- exposição ao vírus sincicial respiratório (VSR)
- cardiopatia congênita hemodinamicamente significativa
- história de prematuridade
- imunodeficiência
- doença pulmonar crônica
- lactentes e crianças pequenas indígenas/norte-americanos nativos/nativos do Alaska
- lactentes com idade <6 meses
- estação do inverno
- idade avançada
- exposição à fumaça de cigarro
- história familiar de asma
- Síndrome de Down
Diagnostic investigations
1st investigations to order
- oximetria de pulso
Investigations to consider
- radiografia torácica
- situação de hidratação
- teste rápido de detecção de antígeno de amostra respiratória (por exemplo, aspirado nasofaríngeo)
- reação em cadeia da polimerase via transcriptase reversa de espécime respiratório (por exemplo, aspirado nasofaríngeo)
- cultura viral de espécime respiratório (por exemplo, aspirado nasofaríngeo)
Treatment algorithm
doença leve ou autolimitada
doença moderada
doença grave
Contributors
Authors
Giovanni Piedimonte, MD, FAAP, FCCP
Vice President for Research
Professor of Pediatrics, Biochemistry & Molecular Biology
Tulane University School of Medicine
New Orleans
LA
Disclosures
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
Disclosures
MA declares that she has no competing interests.
Acknowledgements
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.
Disclosures
FE is on an advisory board for Procter and Gamble. MLW declares that he has no competing interests.
Peer reviewers
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
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.
Robert Welliver, MD
Professor of Pediatrics
Women and Children's Hospital
Buffalo
NY
Disclosures
RW declares that he has no competing interests.
Jennifer Handforth, MB ChB, MRCPCH, DTM&H
Consultant Paediatrician
Croydon University Hospital
Croydon
UK
Disclosures
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.
References
Key articles
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.Full text Abstract
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.Full text Abstract
Committee on Infectious Diseases; American Academy of Pediatrics. Red book. 32nd ed. Elk Grove Village, IL: AAP; 2021.Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Metapneumovírus humano
- Vírus da gripe (influenza)
- Vírus parainfluenza
More DifferentialsGuidelines
- Australasian bronchiolitis guideline
- Bronchiolitis in children: diagnosis and management
More GuidelinesPatient information
Asma em crianças: o que é?
Asma em crianças: perguntas a fazer ao seu médico
More Patient information
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