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Bronchiolitis Diagnosis
Diagnosis
- Bronchiolitis is diagnosed based on patient history & presentation
Diagnostic criteria for bronchiolitis include, but are not limited to, the following:
- Exposure to persons with viral upper respiratory infection
- Preceding upper respiratory illness
- Signs of lower respiratory illness which may include wheezing, retractions, oxygen (O2) desaturation, nasal flaring, & other signs & symptoms described above
- Apnea, especially in premature or low birth-weight infants
- Signs of dehydration
Physical Examination
- Wheezes or fine inspiratory crackles with prolonged expiratory phase of breathing
- Barely discernible breath sounds due to bronchiolar obstruction suggest severe disease
- Palpable liver & spleen due to hyperinflation of the lungs
Laboratory Tests
- Eg Complete blood count (CBC) & chest x-ray (CXR) offer little helpful information in bronchiolitis patients
- Chest X-ray (CXR) image may show hyperinflation due to air trapping
- Chest X-ray (CXR) may be done when the diagnosis is uncertain to rule out other diseases
- Arterial blood gas (ABG) should be considered in patients with severe symptoms of bronchiolitis
- Viral cultures of nasopharyngeal secretions are not recommended
Differential Diagnosis
- Viral infections
- Asthma
- Foreign body aspiration
- Anatomic abnormalities (ie tracheoesophageal fistula, laryngeal cleft, airway hemangioma, mediastinal tumor, bronchial cyst, vascular ring)
- Congenital heart disease
- Immunodeficiency states (ie IgA deficiency, AIDS, bronchiectasis)
- Mucociliary clearance disorders (ie cystic fibrosis, primary ciliary dyskinesia)
- Aspiration syndrome (ie gastroesophageal reflux disease, phayngeal dysfunction)
- Anaphylaxis
