What are the signs of bronchiolitis?

  • Recession (indrawing of the lower chest) and a hyperinflated chest (over expanded due to air trapping).
  • Wheezing is usually present and is not relieved by an inhaled bronchodilator. Occasionally wheeze may be absent.
  • Rapid breathing and breathlessness (difficulty breathing)
  • Prolonged expiration
  • A dry coughing
  • Reluctance or difficulty in feeding
  • Mild fever

Cyanosis, decreased level of consciousness, inability to feed or persistent vomiting and a marked tachycardia (fast heart rate) are all dangerous signs and indicates respiratory failure. Apnoea is common in infants less than 3 months. Bronchiolitis takes about a week to recover.

Repeated bronchiolitis, especially in an older child, suggest asthma.

There is poor air entry over both lungs on auscultation. Fine crackles may be present. A chest X-ray shows air trapping due to small airway narrowing without signs of consolidation (pneumonia). Pneumothorax is an uncommon complication of bronchiolitis.

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