Bronchiolitis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]

Overview

Physical Examination

General appearance

Vitals

  • Tachypnea
  • Fever may or may not be present at the moment of the examination. The lack of fever doesn't exclude the diagnosis.

Lung

Rapid changes in respiratory signs are characteristic of bronchiolitis.

Inspection

  • Chest retractions:
  • Intercostal retractions
  • Substernal retractions
  • Nasal flaring in infants

Auscultation

The association between cyanosis and rales has been shown as a predictor of severity.[2][3]

References

  1. Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L; et al. (2004). "Diagnosis and testing in bronchiolitis: a systematic review". Arch Pediatr Adolesc Med. 158 (2): 119–26. doi:10.1001/archpedi.158.2.119. PMID 14757603.
  2. Mulholland EK, Olinsky A, Shann FA (1990). "Clinical findings and severity of acute bronchiolitis". Lancet. 335 (8700): 1259–61. PMID 1971330.
  3. Eisenhut M (2006). "Extrapulmonary manifestations of severe respiratory syncytial virus infection--a systematic review". Crit Care. 10 (4): R107. doi:10.1186/cc4984. PMC 1751022. PMID 16859512.


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