Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- tosse
- taquipneia
- sibilância
- retrações, gemência e batimento da asa do nariz
Other diagnostic factors
- rinite
- achados clínicos variáveis
- irritabilidade, mal-estar e baixa aceitação alimentar
- febre <40 °C (<104 °F)
- estertores
- apneia
- assincronia toracoabdominal
Risk factors
- crianças <2 anos
- meses do inverno
- prematuridade ou displasia broncopulmonar
- exposição passiva à fumaça de cigarro e à poluição do ar
- desobstrução das vias aéreas e função prejudicadas
- cardiopatia congênita
- imunodeficiência
Diagnostic tests
1st tests to order
- oximetria de pulso
Tests to consider
- detecção rápida de antígeno por ensaio de imunoadsorção enzimática (ELISA)
- radiografia torácica
- reação em cadeia da polimerase via transcriptase reversa (RT-PCR)
Emerging tests
- pletismografia respiratória por indutância (PRI)
- tomografia de impedância elétrica (TIE)
Treatment algorithm
bronquiolite confirmada
Contributors
Authors
Howard B. Panitch, MD
Emeritus Professor
Division of Pulmonary and Sleep Medicine
Children's Hospital of Philadelphia
Philadelphia
PA
Disclosures
HBP is a member of the American Thoracic Society's Guideline Committee, Long-Term Oxygen Therapy for Infants and Children, past Chair of the American College of Chest Physicians' Home Based Mechanical Ventilation and Neuromuscular Disease NetWork, a member of the ATS guideline committee on bronchopulmonary dysplasia (BPD), and a member of the current new guideline committee updating the BPD Statement. He is a member of the planning committee of the Pediatric Assembly of the American Thoracic Society, and receives royalties from Up-To-Date for the review of two topics (Spirometry in Children and Bronchopulmonary Dysplasia).
Acknowledgements
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.
Disclosures
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.
Peer reviewers
Michael D. Patrick, Jr. MD
Associate Professor of Pediatrics
The Ohio State University College of Medicine
Columbus
OH
Disclosures
MDP declares that he 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
American Academy of Pediatrics Publications. AAP recommendations for the prevention of RSV disease in infants and children. Jul 2025 [internet publication].Full text
Canadian Paediatric Society. Bronchiolitis: recommendations for diagnosis, monitoring and management of children one to 24 months of age. Nov 2021 [internet publication].Full text
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.Full text Abstract
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. Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Pneumonia bacteriana
- Pneumonia por clamídia
- Fibrose cística (FC)
More DifferentialsGuidelines
- Australasian bronchiolitis guideline
- 2022 Italian guidelines on the management of bronchiolitis in infants
More GuidelinesPatient information
Asma em crianças: o que é?
Asma em crianças: perguntas a fazer ao seu médico
More Patient information
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer