How is it Diagnosed?
Bronchiolitis is a common viral respiratory infection in infants and young children,
primarily caused by the Respiratory Syncytial Virus (RSV). Diagnosis is largely clinical,
based on history and physical examination. It typically presents with symptoms such as
nasal congestion, cough, fever, wheezing, and difficulty breathing. A history of recent
upper respiratory tract infection followed by increased respiratory effort in a child
under two years old is characteristic.
On physical examination, clinicians may note tachypnea, chest retractions, wheezing, or
crackles. Pulse oximetry is routinely used to assess oxygen saturation and determine
the severity of respiratory compromise. In moderate to severe cases, or if the diagnosis
is uncertain, a chest X-ray may be done, which may reveal hyperinflated lungs, patchy
infiltrates, or peribronchial thickening, though it's not routinely needed.
Nasopharyngeal swab testing for RSV and other viruses via rapid antigen detection or
PCR may be employed in hospital settings for infection control purposes, but they are
not always necessary for diagnosis or management.
Laboratory tests like a complete blood count (CBC) or blood cultures are generally not
required unless there's a concern for secondary bacterial infection. Diagnosis remains
clinical, and imaging or labs are used selectively. Management is mostly supportive.