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!
