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Acute bronchiolitis

Andrew Bush, professor of paediatric respirology. BMJ  2007;335:1037-1041 (17 November).

Acute bronchiolitis is a clinical diagnosis. It “is a seasonal viral illness, characterised by fever, nasal discharge and dry, wheezy cough. On examination, there are fine inspiratory crackles and/or high-pitched expiratory wheeze.

Summary points:

• Bronchiolitis caused by respiratory syncytial virus is an important and seasonal cause of respiratory morbidity in the first year of life
No effective preventive or therapeutic strategies exist, and supportive management is offered
Unnecessary investigations and ineffective treatment must be avoided
Many infants have medium to long term post-bronchiolitic symptoms, which should not be confused with true asthma and which do not respond to any current treatments
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