Clinical Presentation

Typically, an infant or toddler presents with routine signs and symptoms of upper respiratory infection, such as cough, sneezing, rhinitis, and low-grade fever. Dyspnea and irritability and perhaps audible wheezing soon follow. Tachypnea and nasal flaring are typical, along with signs of airway obstruction, such as a hyperexpanded chest and wheezing on auscultation, with a prolonged expiratory phase. Chest radiograph can show air trapping, peribronchial thickening, atelectasis, and patchy infiltrates. Premature infants and children with chronic disease are at special risk for respiratory failure or complications such as bacterial pneumonia, and up to 5% of patients require hospitalization for severe respiratory distress.

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