Acute viral bronchiolitis and wheezy bronchitis in children

Acute viral bronchiolitis and wheezy bronchitis are very common disorders in infants and preschool children. They are caused by viruses, particularly by respiratory syncytial virus and rhinoviruses. Risk factors for severe disease include premature birth, tobacco smoke exposure and immune dysfunctions. Patient history and a physical examination are sufficient to establish a diagnosis; chest X-ray and laboratory investigations are not routinely necessary. For acute bronchiolitis, many treatment options have been suggested but only supportive measures, such as minimal handling, securing adequate oxygenation and hydration are generally recommended. Antibiotics, bronchodilators, corticosteroids und leukotriene receptor antagonists are not routinely recommended. Short-acting beta-2 agonists are the first choice for the treatment of wheezy bronchitis. Inhaled corticosteroids may be tried to control symptoms in children with frequently recurring and/or severe episodes of wheezy bronchitis. The development of bronchial asthma, however, cannot be prevented by any pharmacologic tretament.