Fast Five Quiz: Overview of Pediatric Respiratory Syncytial Virus

Asif Noor, MD

Disclosures

March 03, 2022

RSV is the most common cause of lower respiratory tract infection in infants and children younger than 2 years. Bronchiolitis is the main clinical presentation, followed by pneumonia. RSV infection causes acute inflammatory injury to the bronchioles and other parts of the small airways.

Asthma and bronchiolitis have overlapping clinical features. Asthma is characterized by bronchoconstriction and inflammation of the airways. It presents with recurrent wheezing in children, often triggered by a viral infection or an allergen. Physical examination findings in asthma include decreased air entry and wheezing (bronchoconstriction). Bronchiolitis, on the other hand, affects infants and children younger than 2 years. It presents with increased work of breathing (eg, increased respiratory rate, retractions), crackles and occasionally wheezing (mucus plugging).

Pertussis is a highly contagious infection caused by Bordetella pertussis. The clinical presentation of pertussis is divided into three stages:

  • Catarrhal: Upper respiratory symptoms (eg, rhinorrhea); lasts 1-2 weeks

  • Paroxysmal: Repeated coughing spells followed by an inspiratory whoop in infants and young children; lasts 2-4 weeks

  • Convalescent: Cough gradually improves over 4-12 weeks

Pertussis remains a significant cause of morbidity and mortality in infants younger than 2 years.

Croup is a common pediatric upper respiratory tract illness, which affects the larynx and trachea. Croup manifests as hoarseness, a seal-like barking cough, inspiratory stridor, and a variable degree of respiratory distress. Viruses result in croup in children who are 6 months to 3 years of age. Parainfluenza 1 and 2 are the most common causes. RSV can lead to croup; however, bronchiolitis is the most common clinical syndrome.

Learn more about the presentation of RSV.

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