Wheezing in a Paediatric Essay

2853 WordsAug 30, 201412 Pages
Wheezing in the Pediatric Patient A wheeze is a high-pitched, musical, continuous sound that originates from oscillations in narrowed airways. Wheezing is most often the result of bronchiolitis in infants and asthma in older children. This article will discuss the similarities and differences between these two childhood diseases, along with management of the infant or child with wheezing. Bronchiolitis Epidemiology In children under 1 year of age, the respiratory syncytial virus (RSV) is estimated to be responsible for up to 70% of cases in previously healthy children.1 RSV is a virus of the family Paramyxoviridae, which includes many common respiratory viruses, such as those that cause measles and mumps. The name RSV derives from the fact that it A) is a virus that causes respiratory tract infections, and B) combines with nearby viruses to form a syncytia, or virus mass. The virus is so ubiquitous that nearly all children will have had an RSV infection by their second birthday. After first-time exposure to RSV, 25%-40% of infants and children will exhibit signs or symptoms of bronchiolitis, and 0.5%-2% will require hospitalization. Most children hospitalized for RSV infection are under 6 months of age.2 Bronchiolitis attributable to RSV was the leading cause of hospitalization among the general population of infants in the United States between 1997-2000, accounting for an estimated 96,000 hospitalizations during that time.3 Mortality associated with bronchiolitis has decreased in past decades, although young infants can still die from bronchiolitis. Those tend to be the sick ones who then develop bronchiolitis.3,4 The mortality rate is less than 1%, with fewer than 500 deaths a year attributed to RSV in the United States. Increased morbidity and mortality occurs in high-risk patients,3,5,6 including those younger than 6 weeks old, and those with a
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