Acute Bronchiolitis
Respiratory (12%) Core Clinical Conditions
1B The Physician Associate is able to identify the condition as a possible diagnosis: may not have the knowledge/resources to confirm the diagnosis or to manage the condition safely, but can take measures to avoid immediate deterioration and refer appropriately
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Acute bronchiolitis is an infection and inflammation of the lung's bronchioles or small airways of the lungs. It is generally caused by a virus and affects infants and toddlers (children under the age of one).
Aetiology
Respiratory syncytial virus (RSV) is the most common cause.
Influenza virus
Adenovirus
Rhinovirus
Coronavirus
Pathophysiology
Infection by the virus and invasion of the lining of the bronchioles.
This activates the immune system, which causes inflammation.
Bronchioles constriction which may cause wheezing and shortness of breath.
(most cases) infection cleared and returns to normal state.
If not resolved - progression to pneumonia.
Risk factors
Age: young individuals and elderly are more at risk.
Family history of asthma or allergies.
Weak immune system: those with chronic conditions such as diabetes, COPD, asthma, HIV/AIDs etc.
Smoking
Sign and symptoms
Fever
Tachypnoea
Shortness of breath
Hypoxia
Cough
Wheeze
Diagnosis and investigations
Blood test: full blood count (FBC), this will display raised white cell count (WCC) which may indicate infection.
Physical examination: respiratory examination, pulse oximetry, blood pressure check.
Chest X-ray: can help rule out pneumonia.
polymerase chain reaction (PCR): a swab can be performed and sent for PCR test to check for the specific causative agent.
Management
Supportive care: most cases are self-limiting. Adequate hydration and over the counter medications may help with the symptoms.
Antibiotics may be considered if complications of pneumonia.
Hospital admission if severe: patient may be commenced on oxygen therapy, IV or oral antibiotics or nebulizer.
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