BMJ 1995;310:4-5 (7 January)
Editorials
Bronchiolitis
Tachypnoea (>50 breaths/min) warrants admission to hospital
Bronchiolitis is a pathological description that has come to be used as
a clinical diagnosis. It is primarily a disease of the small airways,
causing these to be obstructed by inflammatory exudate. More than 70% of
cases are caused by respiratory syncytial virus, which in temperate
climates results in a sharp winter epidemic lasting two to five
months.1 Bronchiolitis is a disease of infancy, characterised by
cough, fever, tachypnoea, diffuse crackles, hyperinflation, and chest
retraction. Wheezes are a less constant feature,1 2 3 and
bronchiolitis should be distinguishable clinically from infantile asthma
by the presence of widespread crackles. Unfortunately, the diagnostic
criteria for bronchiolitis have varied considerably, with consequent
blurring of the distinction between it and asthma.4
Over 95% of infants have been infected with respiratory syncytial virus
by the end of their second winter; 40% of the infections in infancy
affect the lower respiratory . . . [Full text of this article]

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