Bronchiolitis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]Ahmed Elsaiey, MBBCH [3]

Overview

Patients infected with bronchiolitis have a toxic appearance and may be cyanotic. Fever is one of the signs of the disease, but a lack of it does not exclude the diagnosis.There may be abnormalities on inspection and auscultation of the chest, for example, intercostal and substernal retractions, wheezing, and crackles. Extrapulmonary manifestations may occur as well, including pharyngitis, conjunctivitis, arrhythmias, tachycardia, and seizures.

Physical Examination

Appearance of the Patient

Vital Signs

Skin

HEENT

In some cases of bronchiolitis, the following may be observed:[1]

Lung

Heart

In rare cases of bronchiolitis, cardiovascular manifestations may be detected. These signs include:[5][4]

Neuromuscular

Neurological manifestations can also occur in cases of RSV bronchiolitis, including:[6]

References

  1. Andrade MA, Hoberman A, Glustein J, Paradise JL, Wald ER (1998). "Acute otitis media in children with bronchiolitis". Pediatrics. 101 (4 Pt 1): 617–9. PMID 9521943.
  2. Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L; et al. (2004). "Diagnosis and testing in bronchiolitis: a systematic review". Arch Pediatr Adolesc Med. 158 (2): 119–26. doi:10.1001/archpedi.158.2.119. PMID 14757603.
  3. Mulholland EK, Olinsky A, Shann FA (1990). "Clinical findings and severity of acute bronchiolitis". Lancet. 335 (8700): 1259–61. PMID 1971330.
  4. 4.0 4.1 Eisenhut M (2006). "Extrapulmonary manifestations of severe respiratory syncytial virus infection--a systematic review". Crit Care. 10 (4): R107. doi:10.1186/cc4984. PMC 1751022. PMID 16859512.
  5. Donnerstein RL, Berg RA, Shehab Z, Ovadia M (1994). "Complex atrial tachycardias and respiratory syncytial virus infections in infants". J Pediatr. 125 (1): 23–8. PMID 8021780.
  6. Sweetman LL, Ng YT, Butler IJ, Bodensteiner JB (2005). "Neurologic complications associated with respiratory syncytial virus". Pediatr Neurol. 32 (5): 307–10. doi:10.1016/j.pediatrneurol.2005.01.010. PMID 15866430.

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