Bronchiolitis in infancy. Old and new problems

Abstract

Bron­ chiolitis is an infection produced by the syncytial respiratory distress and wheezing. The anatomic-physiological pathogenesis is clear,  but the immunological mechanisms that intervene aggravating the process are disputed (probable anomalies of T-lymphocytes and hyperproduction of IgE). Treatment is based in oxygenotherapy, fluidtherapy and physiotherapy, meanwhile antibiotics, bronchodilators and corticosteroids are inefficient. Ribavirin in aerosol can be effective. In serious cases is necessary artificial ventilation. The prognosis is an uncertain aspect, being  possible the reiteration of episodes of wheezing, some degree of bronchial hyperactivity and apparition of asthma more fre­ quently that in the rest of the population. Functional abnormalities have also been de­ scribed in asymptomatic children after episodes of bronchiolitis. The role of the genetic charge and the own viral infection are uncertain. Other problem is the relationship between  bronchiolitis and sudden infant death syndrome.