Category Archives: Pediatrics

It’s ALSO that time of year: Respiratory Syncytial Virus

Symptoms: Over 2 to 3 days development of wheezing, a so called “tight” wheezy cough, fever (usually low grade), cyanosis, tachypnea, retraction, fatigue.

Diagnosis:

Upon physical exam the above symptoms are noted, on auscultation inspiratory crackles and wheezing are usually present. Hydration status should be noted, as RSV is a diffuse small airway disease, leading to bronchiolitis.

Non-specific lab tests such as ABGs, CBC, and O2 sat., and age of child help determine candidates for admittance. Secretions can be analyzed using PCR but are expensive, a sophisticated virology lab is required in terms of antigen detection.

Imaging X-Ray is commonly ordered, revealing (nonspecific) hyperinflated lung fields, diffuse interstitial infiltrates, and in more advanced cases focal atelectasis.

DDx: Asthma, bronchitis, adenovirus, pneumonia, metapnuemovirus, influenza.

Treatment:  See part 2 coming soon!

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