PEDIATRICS Vol. 39 No. 6 June 1967, pp. 924-928
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THE DIAGNOSIS AND MANAGEMENT OF BRONCHIOLITIS

D. Holdaway M.B., M.R.C.P.1, A. C. Romer Ph.D.1, and P. S. Gardner M.D., Dip. Bact.1

1 Departments of Child Health and Virology, Royal Victoria Infirmary, Newcastle upon Tyne, England

We have described our concept of bronchiolitis—an acute epidemic disease of infants and young children with obstruction of terminal bronchi and bronchioles, secondary hypoxia, and exhaustion. RSV is the commonest virus to invade the lower respiratory tract in young children. This probably explains the high incidence of this organism in bronchiolitis, but a control population is necessary for interpretation of the virus isolations. Only four RSV infections were found in 295 children (1.4%) without respiratory disease compared with 124 in 211 children (59%) with bronchiolitis. Neither adenoviruses nor other viruses were isolated from the cough swabs of "control children." This confirms not only the etiological significance of RSV in bronchiolitis but also suggests that adenoviruses isolated in this disease may also be causally related. Treatment is described and we accept in spirit, if not in detail, the judgment of Reynolds and Cook that "oxygen is vitally important in bronchiolitis and there is little conclusive evidence that any other therapy is consistently or even occasionally useful." The indications for the correct, and sometimes necessary, use of antibiotics need more precise definition by therapeutic trial and a better understanding of the causes of death in this disease.