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Diagnosis of premature bronchiolitis

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Diagnosis is primarily clinical, based on symptoms. It also involves asking the baby's parents questions, and a physical examination.

The illness usually starts as catarrh in the upper respiratory tract (nose, mouth, throat), which may worsen over the course of 2 to 3 days. At first the baby presents sneezing, coughing, mucus and sometimes a fever. Over the following 2-3 days the coughing intensifies, symptoms of lower airway (bronchi and bronchioles) obstruction appear with laboured breathing, rapid breathing (tachypnoea) and irritability.

There is notable respiratory distress in the most severe cases, with the child refusing to feed and displaying signs of fatigue.

Apnoea (pauses in breathing lasting a few seconds) can be a symptom of bronchiolitis, especially in young and premature infants, and is a significant risk factor for developing a severe case of bronchiolitis. RSV can cause apnoea in infants, even when they do not display any signs of bronchiolitis.

When performing a pulmonary auscultation, the most common finding is expiratory wheezing (whistling sounds in the chest), although inspiratory crackles (sounds produced by air passing through liquid substances in the bronchi or alveoli) are also frequently heard. Wheezing can often be heard with the naked ear, without the aid of a stethoscope (audible wheezing).

Substantiated information by:

Sandra Suñol nurse

Published: 14 September 2021
Updated: 14 September 2021

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