Case of the Month #29 Bronchiolitis

Published 12/05/2022

What are the features of severe bronchiolitis?

Severe disease is characterised by signs and symptoms of impending respiratory failure.

These include:

  • Severe hypoxaemia
  • Increased work of breathing
  • Worsening episodes of apnoea
  • Inability to feed by mouth because of respiratory distress

Risk factors for severe viral bronchiolitis include:

  • Prematurity
  • Young age
  • Small weight
  • Male sex
  • Underlying medical conditions
  • Bacterial co-infection is rarely described but often reported in severe disease
  • Bronchiolitis caused by adenovirus. These patients may go on to have an obliterative bronchiolitis, in which there is widespread disease of the small and large airways, including bronchiectasis.

Jacob has severe and worsening RSV bronchiolitis with impending respiratory failure.