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[Acute bronchiolitis in infants]
A Deschildre1, C Thumerelle, B Bruno
1Unité de pneumologie pédiatrique, hôpital Jeanne de Flandre, centre hospitalier régional universitaire de Lille, France.
Insights
Bronchiolitis, a common winter viral illness in infants, is usually mild but can be severe in high-risk infants. Prophylaxis options exist for at-risk infants, as vaccines are unavailable.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Bronchiolitis is the most frequent respiratory tract disease in infants, occurring in annual winter epidemics.
- Respiratory syncytial virus (RSV) is the primary viral agent responsible for bronchiolitis.
- While typically mild and managed supportively at home, certain infants face a high risk of severe illness.
Purpose of the Study:
- To review the etiology, clinical presentation, and management of bronchiolitis in infants.
- To identify risk factors for severe bronchiolitis requiring hospitalization.
- To discuss current and emerging prophylactic strategies for at-risk infants.
Main Methods:
- Literature review of viral respiratory infections in infants.
- Analysis of clinical data regarding risk factors for severe disease.
- Evaluation of the efficacy of various treatment modalities and prophylactic measures.
Main Results:
- Most infants experience mild symptoms, but those under 3 months, preterm, or with underlying conditions are at high risk.
- Treatments like corticosteroids and inhaled bronchodilators offer limited or unproven benefits.
- Chest physiotherapy is recommended for bronchial secretions; vaccines are not yet available.
Conclusions:
- Bronchiolitis management is primarily supportive, with hospitalization for high-risk infants.
- Prophylaxis with human RSV immunoglobulin or monoclonal antibodies should be considered for at-risk children.
- Further research is needed for effective vaccines and treatments for severe bronchiolitis.
Abstract:
Bronchiolitis is the most common disease of the respiratory tract during the first year of life, and occurs in annual epidemics in winter. The etiology is viral, and respiratory syncytial virus (RSV) is the commonest agent. Respiratory symptoms remain generally mild, and treatment just supportive and at home. Certain infants are at high risk of severe illness (age less than 3 months, preterm birth, neonatal respiratory disease, bronchopulmonary dysplasia, underlying chronic diseases), and require hospitalisation. Most treatments are of unproved (corticosteroids), or limited benefit (inhaled bronchodilators, antibiotics). Chest physiotherapy is indicated in case of bronchial secretion. Vaccine are not now available, but prophylaxis with human RSV immunoglobulin or monoclonal antibodies has to be considered for children at increased risk for severe disease.