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Clinical profile of bronchiolitis in infants younger than 90 days in Saudi Arabia
Syed Amir Ahmad1, Quais Mujawar1, Mohammed Al Othman1
1Department of Emergency Medicine, Pediatric Emergency, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Insights
In infants under 90 days old with bronchiolitis, the risk of serious bacterial infections like bacteremia and meningitis is low. Urinary tract infections are also uncommon but more frequent than meningitis or bacteremia.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
- Neonatal Care
Background:
- Bronchiolitis is a common viral illness in children affecting the small airways.
- There is a need to refine diagnostic criteria for bacterial infections in infants with bronchiolitis.
- Optimizing healthcare delivery for infants under 90 days with bronchiolitis is crucial.
Purpose of the Study:
- To determine the clinical presentation, disease course, and outcomes of bronchiolitis in infants younger than 3 months.
- To evaluate the incidence of concomitant bacterial infections in this age group.
Main Methods:
- Retrospective chart review of infants under 90 days old diagnosed with clinical bronchiolitis.
- Data collected from November 1, 2011, to April 30, 2012, at a tertiary care university hospital's Pediatric Emergency Department (PED).
- Analysis of blood, urine, and cerebrospinal fluid cultures.
Main Results:
- 141 out of 1895 infants (<90 days) were diagnosed with bronchiolitis; 35 required hospitalization.
- Bacteremia and meningitis were rare, with one documented contaminant bacteremia and no meningitis cases.
- One infant had a positive urine culture for Escherichia coli, indicating a low but present risk of urinary tract infection.
Conclusions:
- The risk of bacteremia or meningitis in febrile infants <90 days with bronchiolitis is low.
- Urinary tract infections are also uncommon but present a slightly higher risk than meningitis or bacteremia.
- Findings support current admission and treatment guidelines for this population.
Background:
Bronchiolitis is a self-limiting disease of children caused by viral infections of the small airways with a wide spectrum of illness severity. Search of the literature reveals a need for refinement of criteria for testing for concomitant severe bacterial infections as well as appropriate therapeutic interventions for patients <90-day-old diagnosed with clinical bronchiolitis. We believe that a better understanding of the disease spectrum will help optimize health-care delivery to these patients.
Aims:
The aim of this study was to determine the clinical profile at presentation, disease course and outcome of bronchiolitis in <3-month-old infants who presented to our Pediatric Emergency Department (PED) during one disease season.
Settings:
Retrospective chart review during one bronchiolitis season, from November 1, 2011 to April 20, 2012.
Subjects:
All <90-day-old infants presenting with clinical bronchiolitis presenting to Urban PED of a tertiary care university hospital during one bronchiolitis season.
Materials And Methods:
A retrospective chart review based on computer records of all emergency department visits of infants less than 90 days with a clinical diagnosis of bronchiolitis, covering the period between November 1, 2011 and April 30, 2012.
Results:
Out of the total of 1895 infants <90 days of age, 141 had a clinical diagnosis of bronchiolitis and 35 needed admission to hospital. Blood for culture was obtained from 47 infants, urine for culture was obtained from 46 infants and cerebrospinal fluid for culture was obtained from eight infants. One case of bacteremia was documented, but this was found to be a contaminant. No cases of meningitis occurred among these infants. However, one infant had a positive urine culture consistent with infection (Escherichia coli).
Conclusion:
Based on the results, it can be conclude that the risk of bacteremia or meningitis among infants <90 days of age with fever and bronchiolitis is low. The risk of urinary tract infection in this age group is also low, but it is higher than the risk for meningitis or bacteremia. Our data for admission and treatment guidelines are similar to those published from other countries.
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