Bronchiolitis is a clinical diagnosis preceding upper respiratory illness and/or rhinorrhea.
Signs of respiratory illness which may include wheezing, retractions, oxygen desaturation, color change, nasal flaring.
There is also presence of apnea especially in premature or low birthweight infants, signs of dehydration and exposure to persons with viral upper respiratory infections.
Symptoms are usually worst on the 3rd-5th day of illness and then improve gradually.
  1. American Academy of Pediatrics Committee on Infectious Diseases and Committee on Fetus and Newborn. Revised indications for the use of Palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections. Pediatrics. 2003 Dec;112(6)(Suppl Pt 1):1442-1446. Accessed 21 Jul 2010. PMID: 14654627
  2. Brown KK. Chronic cough due to nonbronchiectatic suppurative airway disease (bronchiolitis): ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1):132S-137S. http://chestjournal.chestpubs. org/. Accessed 16 Jul 2010. PMID: 16428702
  3. American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006 Oct;118(4):1774-1793. doi: 10.1542/peds.2006-2223. Accessed 16 Jul 2010. PMID: 17015575
  4. Seiden JA, Scarfone RJ. Bronchiolitis: an evidenced-based approach to management. Clin Ped Emerg Med. 2009 Jun;10(2):75-81.
  5. Goodman D. Inflammatory disorders of the small airways. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson textbook of Pediatrics. 17th ed. Philadelphia: Saunders, Elsevier; 2004
  6. MedWorm
  7. MedWorm
  8. Scottish Intercollegiate Guidelines Network. Bronchiolitis in children: a national clinical guideline. SIGN. Nov 2006. Accessed 16 Jul 2010.
  9. Academy of Medicine of Malaysia. Clinical practice guidelines on pneumonia and respiratory tract infections in children. Oct 2001. Accessed 16 Jul 2010.
  10. Child and Adolescent Health Service Princess Margaret Hospital for Children. Clinical practice guideline: bronchiolitis. Oct 2008. Accessed 16 Jul 2010.
  11. Cincinnati Children’s Hospital Medical Center. Evidence based clinical practice guideline for medical management of bronchiolitis in infants less than 1 year of age presenting with a first time episode. May 2006. Accessed 16 Jul 2010.
  12. Mazza D, Harris C, Turner T, Wilkinson F. The Royal Australian College of General Practitioners. Evidenced based guideline for the management of bronchiolitis. 2008. Accessed 16 Jul 2010.
  13. Archer ND. Guidelines for the management of bronchiolitis in children. United Bristol Healthcare. Aug 2007. Accessed 16 Jul 2010.
  14. UCSD Medical Group. Pediatric bronchiolitis. Jun 1998. Accessed 14 Feb 2005.
  15. Paediatric Clinical Practice Guideline Steering Group; NSW Ministry of Health. Infants and children: acute management of bronchiolitis. 2nd ed. New South Wales Ministry of Health. Jan 2012.
  16. Shetty N. Guidelines for management of moderate to severe bronchiolitis. North West and North Wales Paediatric Critical Care Network. Jun 2012. Accessed 27 Jan 2014.
  17. Working Group of the Clinical Practice Guideline on Acute Bronchiolitis, Fundació Sant Joan de Déu. Clinical practice guideline on acute bronchiolitis. Catalan Agency for Health Technology Assessment and Research (CAHTA). 2010. Accessed 27 Jan 2014.
  18. National Institute for Health and Care Excellence. Bronchiolitis in children. National Institute for Health and Care Excellence (NICE). May 2015. Accessed 10 Aug 2015.
  19. Ralston SL, Lieberthal AS, Meissner HC, et al; American Academy of Pediatrics. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014 Nov;134(5):e1474-e1502. doi: 10.1542/peds.2014-2742. Accessed 10 Aug 2015. PMID: 25349312
  20. McCulloh R, Koster M, Ralston S, et al. Use of intermittent vs continuous pulse oximetry for nonhypoxemic infants and young children hospitalized for bronchiolitis: a randomized clinical trial. JAMA Pediatr. 2015 Oct;169(10):898-904. doi: 10.1001/jamapediatrics.2015.1746. PMID: 26322819
  21. Coates BM, Camarda LE, Goodman DM. Wheezing, bronchiolitis, and bronchitis. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier, Inc; 2016:2044-2050.e1.
  22. Crowe JE. Respiratory syncytial virus. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier, Inc; 2016:1606-1609.e1.
  23. Florin TA, Plint AC, Zorc JJ. Viral bronchiolitis. Lancet. 2017 Jan;389(10065):211-224. doi: 10.1016/S0140-6736(16)30951-5. PMID: 27549684
  24. Piedra PA, Strak AR. Bronchiolitis in infants and children: clinical features and diagnosis. UpToDate. Nov 2016.
  25. Smith DK, Seales S, Budzik C. Respiratory syncytial virus bronchiolitis in children. Am Fam Physician. 2017 Jan;95(2):94-99. PMID: 28084708
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