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Virtual Pediatric Hospital: Paediapaedia: Bronchiolitis Paediapaedia: Chest and Airway Diseases

Bronchiolitis

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Respiratory distress in a child less than 18 months old.

Etiology/Pathophysiology:
Acute viral respiratory illness leads to edema and infiltration of bronchial walls which leads to inflammatory obstruction of small peripheral pulmonary airways. Mucous plugging also contributes to small airway obstruction. The infant airway has several features which distinguish it from the adult airway and help to increase the susceptibility to and effect of inflammatory bronchiolar narrowing in infancy: it is easily plugged by mucous or inflammatory debris, the collateral pathways of ventilation - pores of Cohn and Lambert - are less well developed, it has more mucous glands in the airways, and the airways are more collapsible in response to airway pressure changes.

Pathology:
Edema and inflammatory infiltration of the bronchial walls.

Imaging Findings:
The chest is hyperinflated. There is peribronchial cuffing and overdistended airways. Overtime focal segmental/subsegmental atelectasis may be seen.

DDX:

References:
See References Chapter.

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