In a new clinical practice guideline, the American Academy of Pediatrics (AAP) outlines recommendations for diagnosing and managing bronchiolitis, the most common lower respiratory infection in children under age 2. The symptoms of bronchiolitis often mirror those of asthma or bacterial pneumonia, resulting in misdiagnosis and incorrect treatment.
To standardize the diagnosis and treatment of bronchiolitis, “Clinical Practice Guideline: Diagnosis and Management of Bronchiolitis” recommends that clinicians not routinely order X-rays or laboratory tests for children suspected of bronchiolitis, but instead diagnose and assess disease severity by conducting a thorough medical history of the child and detailed physical examination.
Bronchiolitis is inflammation of the bronchioles, the smallest air passages of the lungs. The term usually refers to acute viral bronchiolitis, a common disease in infancy. This is most commonly caused by respiratory syncytial virus (RSV, also known as human pneumovirus). Other viruses which may cause this illness include metapneumovirus, influenza, parainfluenza, coronavirus and rhinovirus.
For treatment, the report recommends close monitoring of the child’s hydration, oxygen level, and ability to drink and retain fluids.
The report does not recommend the routine use of antibiotics, steroids, or bronchodilators to treat bronchiolitis.