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 CONCEPT
The bronquiolitis is a sharp viral infection of the low respiratory tract that it affects to nursing and small children. It is characterized by difficulty to breathe, sibilancias audible and crackling noises.
INCIDENCE
It usually appears in epidemics, principally in children <18 months of age, with maximum incidence in nursing <of 6 months. The annual incidence during the first year of life is estimated in 11 casos/100 children.
CAUSES
Virus sincitial respiratory and virus parainfluenza 3, most frequent. The contagion is carried out by direct contact; the virus is in the microdrops of the breath and is contagious easily on having sneezed or having coughed. A patient can spread the virus during 3 to 8 days, and the incubation period changes from 2 until 8 days. The most inclined and more serious children are the premature babies, which present an illness of the heart or some immunodeficiency. |
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SYMPTOMS
The bronquiolitis is recognized because, after presenting catarrhal symptoms and something of fever, the child begins having difficulty to breathe or rough respiration, sibilancias audible and crackling noises, and the cough becomes persistent and intense. There can be withdrawal of the ribs and prostration.
DIAGNOSIS
It is of clinical suspicion, more isolation of the virus or serologías specific. Distinguishing diagnosis with the asthma, the ebb gastroesofágico with aspiration of the gastric content, and the aspiration of a strange body.
TREATMENT
There is no very effective treatment for this illness. The use of corticoids is discussed, and the antibiotics only are used in case of secondary bacterial infection. Medicines are used to lower the fever, to improve the pulmonary ventilation and, in the serious cases that need to be hospitalized, there is used an antiviral medicine called Ribavirina ® in aerosol.
At present, it gets ready of a specific antibody against the virus sincitial respiratory that applies himself, in a preventive way, for the children with high risk of presenting the serious illness, with what it has been seen that diminishes the gravity of the illness and the days of hospitalization diminish.
The palivizumab - by means of antibodies monoclonales humanized, specific against the virus sincicial respiratory - can prepare the bronquiolitis appearance in patients of high risk.
In general, the illness can last between 7 and 12 days. The recurrencias are very frequent.
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CONCEPT 
