Association of fever and severe clinical course in bronchiolitis

Abstract

Little attention has been given to the relation between fever and the severity of bronchiolitis. Therefore, the relation between fever and the clinical course of 90 infants (59 boys, 31 girls) hospitalised during one season with bronchiolitis was studied prospectively. Fever (defined as a single recording > 38.0°C or two successive recording > 37.8°C) was present in 28 infants. These infants were older (mean age, 5.3 v 4.0 months), had a longer mean hospital stay (4.2 v 2.7 days), and a more severe clinical course (71.0% v 29.0%) than those infants without fever. Radiological abnormalities (collapse/consolidation) were found in 60.7% of the febrile group compared with 14.8% of the afebrile infants. These results suggest that monitoring of body temperature is important in bronchiolitis and that fever is likely to be associated with a more severe clinical course and radiological abnormalities. (Arch Dis Child 1999;81:231-234)

Differences in management of bronchiolitis between hospitals in The Netherlands

“…Leucocytosis, increased CRP levels and lobar consolidations on the chest X-ray are found in up to 30% of infants with viral bronchiolitis (most commonly in infants with severe disease) and do not allow for adequate identi®cation of patients with bacterial infection [4,17,18]. Similarly, the degree of fever is associated more strongly with a severe clinical course of viral bronchiolitis than with bacterial superinfection [5]. In a placebo-controlled randomized trial, intravenous ampicillin did not improve clinical recovery in infants hospitalized with acute bronchiolitis.…”

Utility of sepsis evaluation in infants 90 days of age or younger with fever and clinical bronchiolitis

“…From 23 to 31% of cases of bronchiolitis are associated with fever. [1][2][3] There is much controversy regarding the appropriateness and the extent of routine testing for bacterial infections that should be performed when evaluating febrile infants. Clinical guidelines recommending the testing of blood, urine and cerebrospinal fluid for most, if not all, of these infants has been suggested if there is no obvious source.…”

Faktor-Faktor yang Berhubungan dengan Bronkiolitis Akut

“…3 Bronkiolitis akut pada umumnya terjadi pada usia di bawah 2 tahun, 8,9 pada penelitian kami rerata usia pasien 9,1 (SB 5,68) bulan.…”

“…2 Angka kejadian rawat inap IRA-B tiap tahun berkisar antara 3000 [3][4][5] sampai 50.000-80.000 bayi, 6 kematian sekitar 2 per-100.000 bayi. 3,7 Bronkiolitis akut bersifat musiman, pada umumnya terjadi pada usia kurang dari 2 tahun dengan puncak kejadian pada usia 6 bulan pertama, 8,9 serta lebih sering pada laki-laki. 6,9 Pasien bronkiolitis akut berat mempunyai risiko mengalami mengi berulang atau asma.…”