Médecine pulmonaire et respiratoire

Objectives: Viral Bronchiolitis is a seasonal respiratory infection predominant in children less than 2 years, commonly caused by the Respiratory Syncytial Virus (RSV). Typical symptoms of this infection include fever, cough, rhinorrhoea and wheezing. Most cases resolve with supportive measures however, there have been investigations on the post- infectious sequalae of this disease. This literature review aims to investigate what post- infectious sequalae have been reported in literature and how often are they present in patients diagnosed with viral bronchiolitis.

Methods: A literature review format was used for this paper with articles being collected from databases including PubMed, Google Scholar and the Cochrane Library. Free full text articles from 2010 onwards were acquired to obtain a wider range of articles and case reports to be accessed.

Discussion: Post-infectious sequelae can be divided into pulmonary and extrapulmonary manifestations. According to one study, 48% of the patients diagnosed with bronchiolitis presented with asthma, the most common pulmonary manifestation of this disease. Other, pulmonary manifestations included post-infectious bronchiolitis obliterans, spontaneous pneumopericardium, pneumorrachis and pneumomediastinum. Extrapulmonary manifestations included cardiac arrhythmias, apnea, seizures, hyponatremia and hepatitis.

Conclusion: Viral bronchiolitis can predispose a patient to developing both pulmonary and extrapulmonary complications. Pre-existing cardiovascular conditions can increase the predisposition of this infection and result in complications afterwards. Larger case control studies would be recommended to assess the statistical significance and the odds of developing post-infectious sequelae.