Pediatric Infectious Disease

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VOLUME 7 , ISSUE 1 ( January-March, 2025 ) > List of Articles

Original Article

Radiological Stewardship in Case of Acute Bronchiolitis

Kruti P Gor, Param S Patel, Snehal V Patel, Pooja Gandhi, Gayatri Parmar

Keywords : Bronchiolitis, Chest radiography, Diagnosis

Citation Information : Gor KP, Patel PS, Patel SV, Gandhi P, Parmar G. Radiological Stewardship in Case of Acute Bronchiolitis. Pediatr Inf Dis 2025; 7 (1):6-8.

DOI: 10.5005/jp-journals-10081-1447

License: CC BY-NC 4.0

Published Online: 27-01-2025

Copyright Statement:  Copyright © 2025; The Author(s).


Abstract

Aims and background: In uncomplicated acute bronchiolitis, chest radiography (CR) is not routinely recommended, yet it is still frequently done. This study seeks to evaluate the use of chest X-ray (CXR) in children with acute bronchiolitis and the influence of CXR on patient's treatment. Materials and methods: The pediatric department of SCL General Hospital (NHL Municipal Medical College), a tertiary care center in Saraspur, Ahmedabad, conducted a prospective observational study from 1st January to 29th February, 2024. All patients aged between 1 and 24 months who were clinically diagnosed with acute bronchiolitis admitted to the pediatric ward within 72 hours of symptoms were included in the study with informed consent obtained from relatives of patients. Detailed history in the form of age, sex, medical history and data of prematurity, clinical presentation, and detailed physical examination with heart rate, respiratory rate, temperature, oxygen saturation, respiratory distress, tachypnea, intercostal retractions, nasal flaring, wheezing, and crackles were included. The data was tabulated in an Excel sheet and appropriate statistical analysis using percentage calculation was done. Results: Our study was conducted from January to February 2024 with a sample size of 120 patients, all of them with a clinical diagnosis of acute bronchiolitis. Of which 62% were male patients. 95.8% of patients had no significant change in the 1st CXR, while only 4.2% of patients had significant changes. Out of 115 patients, 68 patients had mild, 24 patients had moderate, and 23 patients had severe bronchiolitis. Out of these, 30% of patients required 2nd CXR after 72 hours of admission owing to high-grade fever, complete blood count (CBC) with high neutrophilic leukocytosis, worsening of respiratory severity score, and C-reactive protein (CRP) >40. Conclusion: Chest X-ray yields nonspecific information and does not help in differentiating between viral and bacterial infection. CXR has practically no value in the case of children of bronchiolitis. The radiographic abnormalities may result in a non-indicated prescription of antibiotics.


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