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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Respiratory Syncytial Virus Bronchiolitis: Rapid Evidence Review
Kathryn E Oppenlander1, Ariel A Chung1, Dylan Clabaugh2
1Carl R. Darnall Army Medical Center, Fort Cavazos, Texas.
Insights
Bronchiolitis, a common childhood respiratory infection caused by Respiratory Syncytial Virus (RSV), primarily requires supportive care. While most cases are self-limiting, high-risk infants may benefit from palivizumab prophylaxis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Bronchiolitis is the most frequent lower respiratory tract infection in infants and young children.
- Respiratory Syncytial Virus (RSV) is the leading viral pathogen responsible for bronchiolitis.
- RSV transmission occurs via respiratory droplets, with seasonal variations in incidence.
Purpose of the Study:
- To outline the clinical presentation, diagnosis, and management of Bronchiolitis.
- To highlight the role of Respiratory Syncytial Virus (RSV) as the primary etiological agent.
- To discuss supportive care strategies and recommended interventions.
Main Methods:
- Clinical diagnosis is the cornerstone for identifying bronchiolitis.
- Standard infection control precautions are advised for most patients.
- Prophylaxis with palivizumab is considered for high-risk infants.
Main Results:
- Initial symptoms include rhinorrhea, congestion, sneezing, and fever, progressing to cough, tachypnea, and respiratory distress.
- Routine radiography and viral testing are generally not recommended for diagnosis.
- Supportive care, including maintaining oxygen saturation above 90% and adequate hydration/nutrition, is the primary treatment approach.
Conclusions:
- Bronchiolitis management is primarily supportive, focusing on respiratory and nutritional support.
- Specific therapies like bronchodilators, corticosteroids, and antibiotics are not recommended.
- While typically self-limited, RSV bronchiolitis may be associated with an increased risk of developing asthma later in life.
Abstract:
Bronchiolitis is the most common lower respiratory tract infection in young children. Respiratory syncytial virus (RSV) is the most common viral cause of bronchiolitis. RSV is spread through respiratory droplets, and the number of cases varies with season. For most patients, standard precautions (e.g., hand hygiene, surface cleaning, avoiding contact with sick individuals) are recommended. However, prophylaxis with palivizumab may be considered for infants at high risk. Initial symptoms occur after an incubation period of four to six days and include rhinorrhea, congestion, sneezing, and fever. Signs of lower respiratory tract involvement may follow and include cough, tachypnea, retractions, difficulty feeding, and accessory muscle use. Diagnosis is typically clinical; routine use of radiography or viral testing is not recommended. Treatment of RSV bronchiolitis is mainly supportive. Oxygen saturation should be maintained above 90%. Hydration and nutrition should be maintained by nasogastric or intravenous routes, if needed. Therapies such as bronchodilators, epinephrine, nebulized hypertonic saline, corticosteroids, antibiotics, and chest physiotherapy are not recommended. Although most episodes of RSV bronchiolitis are self-limited, some children have an increased risk of asthma later in life.
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