Bronchiolitis natural history: Difference between revisions

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(/* Natural History Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases{{Cite book | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | t...)
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==Natural History <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases<ref>{{Cite book  | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref></SMALL></SMALL></SMALL></SMALL></SMALL>==
==Natural History <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases<ref>{{Cite book  | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref></SMALL></SMALL></SMALL></SMALL></SMALL>==
*Patients usually develop symptoms 1 week after the contact with a symptomatic patient.
*Patients usually develop symptoms 1 week after the contact with a symptomatic patient.
*The first 2-3 days the patient presents mild upper respiratory symptoms ([[cough]], [[rinorrhoea]] and low [[fever]]).
*The first 2-3 days the patient presents mild upper respiratory symptoms ([[cough]], [[rhinorrhoea]] and low [[fever]]).
*Acute pahse ([[shortness of breath]], [[wheezing]], persistent prominent [[cough]], [[tachypnea]], chest wall retraction and nasal flaring) usually developes between the third and seventh day.
*Acute phase ([[shortness of breath]], [[wheezing]], persistent prominent [[cough]], [[tachypnea]], chest wall retraction and nasal flaring) usually develops between the third and seventh day.
*Symptoms gradually disapear within the next 2 weeks (the [[cough]] may take longer)
*Symptoms gradually disappear within the next 2 weeks (the [[cough]] may take longer)


==Complications <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases<ref name="Mandell">{{Cite book  | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref></SMALL></SMALL></SMALL></SMALL></SMALL>==
==Complications <SMALL><SMALL><SMALL><SMALL><SMALL>Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases<ref name="Mandell">{{Cite book  | last1 = Mandell | first1 = Gerald L. | last2 = Bennett | first2 = John E. (John Eugene) | last3 = Dolin | first3 = Raphael. | title = Mandell, Douglas, and Bennett's principles and practice of infectious disease | date = 2010 | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | isbn = | pages = }}</ref></SMALL></SMALL></SMALL></SMALL></SMALL>==

Revision as of 16:10, 29 May 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Natural History Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[1]

  • Patients usually develop symptoms 1 week after the contact with a symptomatic patient.
  • The first 2-3 days the patient presents mild upper respiratory symptoms (cough, rhinorrhoea and low fever).
  • Acute phase (shortness of breath, wheezing, persistent prominent cough, tachypnea, chest wall retraction and nasal flaring) usually develops between the third and seventh day.
  • Symptoms gradually disappear within the next 2 weeks (the cough may take longer)

Complications Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[2]

Complications are usually observerd in patients younger than 2 months, premature infants and patients with associated conditions (congenital heart disease, chronic pulmonary disease and immunodeficiencies). A list of common complications is listed below:

  • Apnea: More common in children under 2 months of age and premature infants, it is observed in 3% to 25% of the patients. Several times it appears as the presenting manifestation, however it may be the consequence of previous mild respiratory symptoms.[2][3]
  • Aspiration:
  • Reccurrent wheezing episodes: 30%-50% of hospitalized patients with bronchiolitis present recurrent wheezing episodes, however, episodes usually deseappear before adolescence.
  • Associated bacterial infections: Most common association is with urinary tract infections (UTI) and acute otitis media (AOM), usually not related with the respiratory infection. Bacterial coinfections appear in 0%-7% of patients with bronchiolitis.

Prognosis Adapted from Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases[4]

Prognosis is generally good, as most children show gradual symptomatic improvement within 2 weeks after symptoms begin. Though the rate of hospitalizations is high (71 per 1000 infants for 2003) and has increased in the las 2 decades, the mortality rate is very low (2 deaths per 100 000 livebirths in the U.S. and 1.82 per 100 000 livebirths in th UK).

References

  1. Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier.
  2. 2.0 2.1 Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier.
  3. Wright M, Mullett CJ, Piedimonte G (2008). "Pharmacological management of acute bronchiolitis". Ther Clin Risk Manag. 4 (5): 895–903. PMC 2621418. PMID 19209271.
  4. Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett's principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier.

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