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Pathogenesis and treatment of bronchiolitis
1Ohio State University College of Pharmacy.
Clinical Pharmacy
|February 1, 1993
Summary
Bronchiolitis, a common infant respiratory infection often caused by RSV, typically resolves on its own. Severe cases may require hospitalization and can lead to chronic issues, but treatment options are evolving.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pulmonology
Background:
- Bronchiolitis is the most frequent severe lower-respiratory infection in infants.
- Respiratory Syncytial Virus (RSV) causes over 80% of cases during epidemics.
- While most infections are self-limiting, 1-2% of infants require hospitalization.
Purpose of the Study:
- To review the pathogenesis, epidemiology, clinical features, sequelae, and treatment of bronchiolitis.
- To highlight risk factors for severe disease and potential long-term complications.
- To evaluate current and emerging treatment strategies.
Main Methods:
- Literature review of pathogenesis, epidemiology, clinical presentation, and outcomes.
- Analysis of risk factors for severe disease, including underlying conditions.
- Evaluation of therapeutic interventions, including supportive care and medications.
Main Results:
- Severe bronchiolitis involves respiratory epithelium necrosis, mucus hypersecretion, and inflammation leading to obstruction.
- Underlying cardiopulmonary disease, immunosuppression, or prematurity increase risk for severe RSV bronchiolitis.
- Aerosolized beta 2 agonists are recommended; systemic corticosteroids are not efficacious, while inhaled corticosteroids may help with chronic wheezing.
Conclusions:
- Bronchiolitis pathogenesis involves airway obstruction due to inflammation and debris.
- Early identification of high-risk infants is crucial for managing severe RSV bronchiolitis.
- Treatment focuses on supportive care, with aerosolized beta 2 agonists showing promise and ribavirin considered for severe cases.