- • Bronchiolitis caused by respiratory syncytial virus is an important and seasonal cause of respiratory morbidity in the first year of life
- • No effective preventive or therapeutic strategies exist, and supportive management is offered
- • Unnecessary investigations and ineffective treatment must be avoided
- • Many infants have medium to long term post-bronchiolitic symptoms, which should not be confused with true asthma and which do not respond to any current treatments
Acute bronchiolitis is a clinical diagnosis. A UK Delphic process reached a 90% consensus that bronchiolitis “is a seasonal viral illness, characterised by fever, nasal discharge and dry, wheezy cough. On examination, there are fine inspiratory crackles and/or high-pitched expiratory wheeze.”1 Internationally, the definition is sometimes broadened to include a first episode of acute viral wheeze. It is an annual and major cause of morbidity in infancy. Acute bronchiolitis is a very common serious respiratory illness in children. Inappropriate treatment is often prescribed, and the relation between such treatment and subsequent asthma is unclear. This review focuses on management in the community and hospital ward.