Acute Bronchiolitis: A Study of 207 Cases

1962 ◽  
Vol 1 (2) ◽  
pp. 75-81
Author(s):  
Bruce D. Ackerman

Acute bronchiolitis is an important clinical syndrome seen in infants and young children. It is most common in infants between the ages of two and seven months. The disease is characterized by recurrent epidemics during which a large number of cases are seen over a period of one to two months. The presenting history is usually dominated by the symptom of cough. Physical examination reveals an acutely ill infant with a characteristic cough, labored respirations, an emphysematous chest, and high-pitched expiratory wheezes. The clinical course is typically characterized by severe respiratory difficulty for one to two days followed by sudden improvement. Respiratory embarrassment is sometimes extreme and on rare occasions fatal. The etiology most often appears to be infection with a viral agent.

2021 ◽  
Vol 9 ◽  
Author(s):  
Sainan Chen ◽  
Yuqing Wang ◽  
Anrong Li ◽  
Wujun Jiang ◽  
Qiuyan Xu ◽  
...  

Objective: In recent years, the incidence of Bordetella pertussis infection in infants and young children has been increasing. Multiple studies have suggested that B. pertussis may be one of the pathogens of bronchiolitis in infants and young children. However, the prevalence and clinic characteristic of B. pertussis in bronchiolitis is controversial. This prospective descriptive study evaluated the prevalence and clinical manifestations of infants and young children hospitalized for bronchiolitis with B. pertussis.Methods: Children hospitalized with bronchiolitis were eligible for a prospective study for 36 months from January 1, 2017, to December 31, 2019. Besides B. pertussis, 10 common respiratory viruses and Mycoplasma pneumoniae (MP) were confirmed by laboratory tests. Medical records of patients were reviewed for demographic, clinical characteristics, and laboratory examination.Results: A total of 1,092 patients with bronchiolitis were admitted. B. pertussis was detected in 78/1,092 (7.1%) patients. Of the 78 patients with B. pertussis bronchiolitis, coinfections occurred in 45 (57.7%) patients, most frequently with human rhinovirus (28/78, 35.9%), followed by MP (9/78, 11.4%), and human bocavirus (6/78, 7.7%). The peak incidence of B. pertussis infection was in May. A high leukocyte count could help distinguish B. pertussis–associated acute bronchiolitis from other acute bronchiolitis etiologies. After excluding coinfections, children with B. pertussis–only bronchiolitis exhibited a milder clinical presentation than those with RSV-only infection; also, children with MP-only and other pathogen infections revealed similar severity. The morbidity of B. pertussis was common (31/78, 39.7%) in infants with bronchiolitis under 3 months.Conclusion: In summary, B. pertussis is one of the pathogens in children with bronchiolitis, and coinfection of B. pertussis with other viruses is common in bronchiolitis. B. pertussis should be considered when patients hospitalized with bronchiolitis present a longer course and have an elevated leukocyte count. Patients with B. pertussis–associated bronchiolitis present a milder clinical presentation.


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