विवरण
Bronchiolitis is a common respiratory infection in infants and young children, primarily caused by the respiratory syncytial virus (RSV). It presents with nasal congestion, cough, wheezing, and difficulty breathing, often following an upper respiratory infection. Management is largely supportive, focusing on hydration, oxygen therapy, and suctioning nasal secretions. Routine use of bronchodilators, steroids, or antibiotics is not recommended. Severe cases may require hospitalization for respiratory support, such as high-flow nasal cannula or mechanical ventilation. Preventive measures include proper hand hygiene and, in high-risk infants, palivizumab prophylaxis. Prompt recognition and appropriate care are key to reducing complications and improving outcomes.
सारांश
- Bronchiolitis is a lung infection causing inflammation of the small airways (bronchioles), most common in children under 2, especially caused by RSV virus. Airway anatomy includes branching from trachea to bronchioles, with 23-25 generations of airways. The small airways, less than 2mm in diameter, are the "quiet zone" of the lung, including conducting and acinar airways.
- Management of bronchiolitis involves oxygen therapy, nebulized bronchodilators, intravenous fluids, and antibiotics. RSV immunoglobulins are not indicated in all cases. Diagnosis is primarily clinical, based on symptoms and physical examination. Severe cases require hospitalization and supportive care.
- Bronchiolitis is relatively rare in adults, often caused by viral infections like influenza. Diagnosis relies on clinical findings, symptoms, and physical examination, with HRCT as a useful tool. Treatment is supportive, including oxygen therapy, bronchodilators, and corticosteroids.
- Radiological findings on HRCT include air trapping, mosaic attenuation, centrilobular nodules, branching linear structures, ground glass opacities, and bronchiectasis. These findings vary based on infection type and severity. Non-infective bronchiolitis is rare in adults but can be caused by chemicals, dust, and environmental factors.
- Bronchiolitis is related to small airway disease, with smokers' bronchiolitis being a common cause. Viral causes include RSV, rhinovirus, coronavirus, and others. Non-infective causes include aspiration, acid reflux, toxicant inhalation, and connective tissue diseases. Epidemiology shows higher prevalence in children under two, with seasonal variation.
- Pathogenesis involves epithelial cell stimulation, release of chemokines and cytokines, and activation of inflammatory cells. This leads to airway obstruction due to inflammation and fibrosis. Clinical features involve airway obstruction, mucus production, atelectasis, labored breathing, and decreased ventilation.
- Differential diagnosis includes asthma, pneumonia, gastroesophageal reflux, and foreign body aspiration. Complications include nosocomial infections, barotrauma, and arrhythmias. Treatment is symptomatic, addressing bronchospasm, fever, and fatigue.
- Antiviral drugs for respiratory infections include amantadine and rimantadine for influenza A, ribavirin for RSV, and oseltamivir for influenza. Specific choices depend on the infecting virus and patient characteristics.
नमूना प्रमाण पत्र
वक्ताओं के बारे में
डॉ. एस.के. जिंदल
पीजीआई, चंडीगढ़ में पल्मोनरी मेडिसिन विभाग के पूर्व प्रोफेसर और प्रमुख
वित्तीय प्रकटीकरण
टिप्पणियाँ
टिप्पणियाँ
टिप्पणी करने के लिए आपको लॉगिन होना होगा।