Diagnosis, admission, discharge

The respiratory syncytial virus should be considered as the most likely pathogen in an infant or young child with a significant acute lower respiratory tract infection during the characteristic epidemic season. While the diagnosis of an RSV infection is relatively straight forward, the clinical diagnosis applied to the associate illness is far less clear cut. Criteria for assessment is based on clinical assessment of severity at examination and associated risk factors. Social factors may further influence the likelihood of admission. Guidelines are consistent in noting that there are no scoring systems or other tests that can reliably predict the need for supportive care or HDU admission. Criteria for the administration of oxygen vary. There are marked differences in the duration of hospitalisation for RSV admission between the USA, UK and Scandinavia. Longer length of admission is associated with significantly higher rates of nosicomial infection.