A 6 months old baby coming with /o increasing difficulty in breathing of 2 days duration and on examination baby is afebrile & B/L wheeze & CXR shows B/L hyperinflation of the lungs with normal WBC count, the diagnosis is –
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- Bronchiolitis
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- Asthma
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- Ch. Bronchitis
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- Pneumonia5) F.B.
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Clinical manifestations of bronchiolitis
- The usual course of disease is 1-2 days of → Fever, Rhinorrha, Cough
- This is followed by -
- Wheezing
- Cyanosis
- Tachypnea
- Nasal flaring
- Breathing pattern is shallow
- Rales, crepitation and ronchi
- Respiratory distress → retraction of intercostal space & suprasternal notch.
- Liver and spleen are pushed downward because the hyperinflated emphysematous lungs push the diaphragm downward.
- Anteroposterior diameter of chest is increased and hyperresonance is noted on percussion.
- The leukocyte count is normal or slightly elevated.
Chest X-ray
- Hyperinflation of the lung o Diaphragm is pushed down
- Lung fields are abnormally translucent.