Background: Acute bronchiolitis is the commonest cause of lower respiratory tract infection in children under 2 years of age. There are no prospective studies in south India, which depict the viral epidemiology of bronchiolitis. Therefore, we undertook this prospective study of all the children <2 years who were admitted with suspected lower respiratory tract infection. Aim and objective: To determine the exact viral etiology in children aged <2 years with clinical suspicion of bronchiolitis. Design: Prospective observational study. Setting: A single-center study was conducted in Narayana Health City, Bengaluru. Fifty children aged <2 years with a clinical suspicion of bronchiolitis were included in the study and their nasopharyngeal swab were sent for multiplex PCR viral panel. The data were analyzed and results were reported. Results: Forty-six out of 50 children who were clinically suspected to have viral bronchiolitis showed positive result on nasopharyngeal swab PCR study. Among them 33 had single viral infection while 13 had multiple viral infections. Respiratory syncytial virus (RSV) was the most common virus involved followed by rhinovirus and parainfluenza virus. The clinical signs and symptoms had a good correlation with the laboratory diagnosis of viral bronchiolitis. Conclusion: There is an extremely good correlation between clinical features of acute viral bronchiolitis with their laboratory diagnosis. Good clinical history and physical examination can avoid undue use of antibiotics in children <2 years.
Weber MW, Mulholland EK, Greenwood BM. Respiratory syncytial virus infection in tropical and developing countries. Trop Med Int Health 1998;3(4):268–280. DOI: 10.1046/j.1365-3156.1998.00213.x
Weber MW, Dackour R, Usen S, et al. The clinical spectrum of respiratory syncytial virus disease in The Gambia. Pediatr Infect Dis J 1998;17(3):224–230. DOI: 10.1097/00006454-199803000-00010
Loscertales MP, Roca A, Ventura PJ, et al. Epidemiology and clinical presentation of respiratory syncytial virus infection in a rural area of southern Mozambique. Pediatr Infect Dis J 2002;21(2):148–155. DOI: 10.1097/00006454-200202000-00013
Doraisingham S, Ling AE. Patterns of viral respiratory tract infections in Singapore. Ann Acad Med Singapore 1986;15(1):9–14.
Cherian T, Simoes EA, Steinhoff MC, et al. Bronchiolitis in tropical south India. Am J Dis Child 1990;144(9):1026–1030. DOI: 10.1001/archpedi.1990.02150330086028
Kaur C, Chohan S, Khare S, et al. Respiratory viruses in acute bronchiolitis in Delhi. Indian Pediatr 2010;47(4):342–344. DOI: 10.1007/s13312-010-0058-6
Mansbach JM, McAdam AJ, Clark S, et al. Prospective multicenter study of the viral etiology of bronchiolitis in the emergency department. Acade Emerg Med 2008;15(2):111–118. DOI: 10.1111/j.1553-2712.2007.00034.x
Mishra P, Nayak L, Das RR, et al. Viral agents causing acute respiratory infections in children under five: a study from Eastern India. Int J Pediat 2016;2016:7235482. DOI: 10.1155/2016/7235482
Fleisher GR. Infectious disease emergencies. In: Fleisher GR, Ludwig S, ed. Textbook of pediatric emergency medicine. 4th ed., Philadelphia: Lippincott Williams & Wilkins; 2000. pp 754– pp 755.
Mazur NI, Bont L, Cohen AL, et al. Severity of respiratory syncytial virus lower respiratory tract infection with viral coinfection in HIV-uninfected children. Clin Infect Dis 2017;64(4):443–450. DOI: 10.1093/cid/ciw756
Li Y, Pillai P, Miyake F, et al. The role of viral co-infections in the severity of acute respiratory infections among children infected with respiratory syncytial virus (RSV): a systematic review and meta-analysis. J Global Health 2020;10(1):010426. DOI: 10.7189/jogh.10.010426
Frieri M, Kumar K, Boutin A. Antibiotic resistance. J Infect Public Health 2017;10(4):369–378. DOI: 10.1016/j.jiph.2016.08.007