Respiratory Syncytial Virus
Respiratory (12%) Core Clinical Conditions
1A: Able to diagnose and manage
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Respiratory Syncytial Virus (RSV) is a common respiratory pathogen that can affect individuals of all ages, but is more severe in children.
Aetiology
Single stranded RNA virus.
Highly contagious.
Spreads by respiratory secretions and contact with contaminated surfaces or objects.
Pathophysiology
RSV enters the body and begins infecting the host and replicating in the airways.
Causes inflammation and damage to the respiratory epithelium.
Swelling, increased mucus production, congestion of airways.
Immune response = further damage to airways + fever, cough and wheeze.
Risk factors
Age: common in children under the age of 2. Elderly over age of 65.
Exposure to infected individuals.
Background of asthma, allergies or other respiratory conditions.
Weak immune system: those with chronic conditions such as diabetes, COPD, asthma, HIV/AIDs etc.
Smoking, air pollution and other environmental causes.
Sign and symptoms
Cough, fever, sore throat, wheeze, SOB, fatigue
In children you may observe symptoms of respiratory distress: tachypnea, wheezing, reduced feeds, high fever and cyanosis.
Diagnosis and investigations
Physical examination: general exam e.g. cardio, respiratory, GI examination, pulse oximetry, respiratory rate and capillary refill.
Oxygen saturation measurement: if low O2 (<95%) severe, therefore hospital admission advised.
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 (paracetamol or ibuprofen) may help with the symptoms, mentioning to patients that there is no cure.
Explain to patients, common colds can last about a week and up to 14 days in children, however a mild cough might last 3 weeks.
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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