Inflammation of the bronchioles

Aetiology

• Viral, most commonly (up to 80%) due to respiratory syncytial virus (RSV)
• Generally occurs in children under 1 year, most common in children under 6 months
  • Most common cause of a serious lower respiratory tract infection in children under 1
• Winter epidemics

Clinical features

Symptoms

• Viral URTI symptoms (coryzal symptoms) - running or snotty nose, sneezing, mucus in throat and watery eyes
• Dyspnoea
• Tachypnoea
• Poor feeding
• Mild fever (under 39ºC)
• Apnoeas

Signs

• Signs of respiratory distress
• Wheeze and crackles on auscultation

Flags for referral

NICE recommend immediate referral (usually by 999 ambulance) if they have any of the following:

• Apnoea (observed or reported)
• Child looks seriously unwell to a healthcare professional