Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- 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
Outros fatores diagnósticos
- febre
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- oximetria de pulso
Investigações a serem consideradas
- 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)
Algoritmo de tratamento
doença leve ou autolimitada
doença moderada
doença grave
Colaboradores
Autores
Giovanni Piedimonte, MD, FAAP, FCCP
Vice President for Research
Professor of Pediatrics, Biochemistry & Molecular Biology
Tulane University School of Medicine
New Orleans
LA
Раскрытие информации
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
Раскрытие информации
MA declares that she has no competing interests.
Выражение благодарностей
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.
Раскрытие информации
FE is on an advisory board for Procter and Gamble. MLW declares that he has no competing interests.
Рецензенты
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
Раскрытие информации
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
Раскрытие информации
RW declares that he has no competing interests.
Jennifer Handforth, MB ChB, MRCPCH, DTM&H
Consultant Paediatrician
Croydon University Hospital
Croydon
UK
Раскрытие информации
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.
Список литературы
Основные статьи
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.Полный текст Аннотация
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.Полный текст Аннотация
Committee on Infectious Diseases; American Academy of Pediatrics. Red book. 32nd ed. Elk Grove Village, IL: AAP; 2021.Полный текст
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Metapneumovírus humano
- Vírus da gripe (influenza)
- Vírus parainfluenza
Больше ОтличияGuidelines
- Australasian bronchiolitis guideline
- Bronchiolitis in children: diagnosis and management
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