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Bronchiolitis (See Also: Respiratory Syncytial Virus)

Bronchiolitis (See Also: Respiratory Syncytial Virus) is a topic covered in the 5-Minute Pediatric Consult.

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Acute infection of the lower respiratory tract in infants and young children leading to mononuclear infiltration of the bronchiolar epithelium, causing edema and mucus plugging of the small airways


  • Peak season is November through April, with some variation by state in the United States (begins earlier in the Southeast).
  • Most common cause of infant hospitalization
    • ~150,000 hospitalizations per year in the United States
    • Hospitalization rates tripled from 1980 to 1997 with the advent of pulse oximetry but have decreased slightly over the last decade.
  • Most recent estimate ~15 hospitalizations per 1,000 person-years for children <2 years of age
  • Approximately 1/3 of all children will get bronchiolitis in the first 2 years of life.

General Prevention

  • Hand hygiene is the only preventative measure for otherwise healthy infants and children.
  • Palivizumab can be given to high-risk infants and young children (see “Respiratory Syncytial Virus” [RSV] section for discussion of RSV immunoprophylaxis).


  • RSV is the most common causative organism, but other organisms include the following:
    • Human rhinovirus
    • Adenovirus
    • Human metapneumovirus
    • Enterovirus
    • Coronaviruses
    • Influenza viruses
    • Parainfluenza viruses
    • Mycoplasma pneumoniae
    • Human bocavirus
  • Majority of bronchiolitis cases are caused by one virus, but viral coinfections (two or more viruses) may occur in ~1/4 of cases.

Risk Factors

  • Patients at high risk of severe bronchiolitis:
    • Premature infants (<36 weeks’ gestation)
    • Young infants (<2 to 3 months of age)
    • Congenital heart disease
    • Chronic lung disease (including bronchopulmonary dysplasia [BPD])
    • Low birth weight
    • Cystic fibrosis
    • Immunodeficiency
    • Neuromuscular diseases
    • Trisomy 21
  • Exposure to cigarette smoke is a risk factor for more severe disease.

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Cabana, Michael D., editor. "Bronchiolitis (See Also: Respiratory Syncytial Virus)." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617401/all/Bronchiolitis__See_Also:_Respiratory_Syncytial_Virus_.
Bronchiolitis (See Also: Respiratory Syncytial Virus). In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617401/all/Bronchiolitis__See_Also:_Respiratory_Syncytial_Virus_. Accessed April 22, 2019.
Bronchiolitis (See Also: Respiratory Syncytial Virus). (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617401/all/Bronchiolitis__See_Also:_Respiratory_Syncytial_Virus_
Bronchiolitis (See Also: Respiratory Syncytial Virus) [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 22]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617401/all/Bronchiolitis__See_Also:_Respiratory_Syncytial_Virus_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bronchiolitis (See Also: Respiratory Syncytial Virus) ID - 617401 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617401/all/Bronchiolitis__See_Also:_Respiratory_Syncytial_Virus_ PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -