Bronchiolitis is an acute inflammatory injury of the bronchioles that is usually caused by a viral infection (most commonly respiratory syncytial virus). 

 

 

 

 Patients should be made as comfortable as possible (held in a parent’s arms or sitting in the position of comfort). Administer saline nose drops and perform nasal and oral suctioning. Deep oral and nasal suctioning is not routinely needed. Carefully monitor the patient for apnea. Pay attention to temperature regulation in small infants. [8]

Cardiorespiratory monitoring is essential. Pulse oximetry is a helpful tool; hypoxia is common. It is vital to have a clear picture of the patient’s clinical respiratory status and the severity of disease. The ability to maintain adequate hydration should be assessed by observing the patient's oral intake. Many dyspneic infants have difficulty taking a bottle.

Although young infants have the unique ability to breathe and swallow simultaneously, the risk of aspiration is significant when the respiratory rate is higher than 60 breaths/min. Fever and hyperpnea may contribute to excessive fluid losses. For these reasons, infants who are hospitalized with bronchiolitis require careful fluid monitoring and provision of nasogastric or intravenous (IV) fluids when hyperpnea precludes safe oral feeding.

An early effort should be made to isolate or cohort patients who are confirmed or likely to have RSV infection, especially from other patients at risk for severe disease. Institute standard and contact isolation precautions to prevent nosocomial transmission.

Antibiotics are not indicated unless bacterial infection is highly suspected (eg, by a toxic appearance, hyperpyrexia, consolidation or focal lobar infiltrates on chest radiography, leukocytosis, or positive bacterial cultures). [3] Concomitant otitis mediais common and may be treated with oral antibiotics.

 

Most people with pyelonephritis do not have complications if appropriately treated with bacteria-fighting medications called antibiotics.

In rare cases, pyelonephritis may cause permanent kidney scars, which can lead to chronic kidney disease, high blood pressure, and kidney failure. These problems usually occur in people with a structural problem in the urinary tract, kidney disease from other causes, or repeated episodes of pyelonephritis.

Infection in the kidneys may spread to the bloodstream—a serious condition called sepsis—though this is also uncommon.

 

 

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