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KMID : 0367419700110090029
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Journal of Korean Pediatric Society
1970 Volume.11 No. 9 p.29 ~ p.34
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Clinical Observation on Acute Bronchiolitis in Infants
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柳寧順/Yoo, Young Soon
金基泰/吳麟煥/李斗鳳/Kim, Kee Tae/Oh, In Whan/Lee, Du Bong
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Abstract
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This papaer presents the result of clinical study- on 86 cases of infants and young children whom had been admitted at St. Mary´s Hospital with the episode of Acute Bronchiolitis from Jan. 1965 to April 1967.
The 66 cases of them were male infants and the rest was female.
The incidence of acute bronchiolitis was highest in the winter, spring and early summer months ;from Jan. to May). Most infections occured coincidently- with epidemic of upper respiratory infections among old children.
The onset of bronchiolitis usually followed that of an upper respiratory tract infection by two or three days and was characterized principally by a dry, persistent cough (90. 7%), dyspnea (80. 2 % ) and moderate fever(79.I%). Initially, the respiratory symptomes were suggestive of bronchial asthma, over 70% of them had wheezing breathing sound or rhonchi. The clinical pattern varied in severity, in atypical cases the cough simulated so closely that of pertussis. Diarrhea and vomiting occured in
11.6 % and 8. 1 % of patients respectively, and mental drowsiness, convulsion also noted in 2.3% and 5.8% of these patients.
On physical examination 25% of these patients were found to be alert, apprehensive and exceedingly irritable. The respiration was rapid and shallow in 45.4% of these patients, expiratory grunt was heard in 38.4 % of all patients. Inspiratory chest retraction was seen in 24(27.90´) out of 86 cases
and cyanosis appeared in 11 cases(15. 1%). The mild or moderate dehydration was noted in 17 cases {19.8%; of all.
The roentgenographic examination revealed generali-zed obstructive emphysema of varying degree in 64 cases(78.0%) of these patients and the eight of them were associated with the evidence of scattered parenchymal infiltration or atelectasis.
The prognosis was a favorable outcome. One of these was fatal, who was a premature infant and also had congenital syphilis. The four of all had congenital heart diseases, they were identified clinically as one was patent ductus arteriosus and others were atrial septal defect. All of four cases developed to cardiac failure and had severe clinical course.
Nine of all patients had the evidence of recurrence within two to three months later. One of them had the two episodes of recurrence after first admission and was effectively controlled with epinephrine.
All of these patients were treated symptomatically, and placed in an atmosphere of high humidity with cold vapor. Those with moderately severe dyspnea were received oxygen therapy.
Tetracycline 20 mg40 mg/kg/day was given to all of these patients and the 52 patients were given also prednisolon 2 mg/kg/day. The rest of these, 34 patients were not given corticosteroid as control to estimate the value of corticosteroids in this disease.
The outcome of both groups were closely simulated, and the value of corticosteroids in our study was considerably skeptical.
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KEYWORD
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