Bronchiolitis commonly shows

• A. Severe hypoxemia always.
• B. Mild to moderate retractions, tachypnea, diffuse wheezing and crackles, mild hypoxia.
• C. Productive cough with large sputum.
• D. Sudden onset of fever.

Answer: (B)

Bronchiolitis is an inflammatory process of the small airways in young children, usually from a viral infection like RSV. The typical picture is airway obstruction with rapid breathing and some chest retractions, and auscultation often reveals diffuse wheezing and crackles from the narrowed bronchioles. Oxygen levels are usually only mildly affected, so mild hypoxemia is common rather than severe. The cough is generally nonproductive or only mildly productive, since the problem is in the small airways rather than producing large amounts of sputum. A sudden high fever isn’t the classic hallmark, and severe hypoxemia is not required for the diagnosis. So the combination of mild to moderate retractions, tachypnea, diffuse wheezing and crackles, with mild hypoxia, best fits bronchiolitis.