pediatrics
Bronchiolitis
Symptoms and Signs of Bronchiolitis
Typically, an affected infant has symptoms of upper respiratory infection with progressively increasing respiratory distress characterized by tachypnea, retractions, and a wheezy or hacking cough. Young infants (< 2 months) and infants born prematurely may present with recurrent apneic spells followed by resolution of apnea and onset of more typical symptoms and signs of bronchiolitis over 24 to 48 hours. Signs of distress may include circumoral cyanosis, deepening retractions, and audible wheezing. Fever is usually but not always present. Infants initially appear nontoxic and in no distress, despite tachypnea and retractions, but may become increasingly lethargic as the infection progresses. Hypoxemia is the rule in more severely affected infants. Dehydration may develop from vomiting and decreased oral intake. With fatigue, respirations may become more shallow and ineffective, leading to respiratory acidosis. Auscultation reveals wheezing, prolonged expiration, and, often, fine crackles. Many children have accompanying Otitis Media (Acute) . 