A 9-month-old infant with a 3-day history of clear rhinorrhea develops sudden tachypnea (respiratory rate 64/min), intercostal retractions, and diffuse bilateral expiratory wheezing. Pulse oximetry is 91% on room air. Nasopharyngeal swab is positive for Respiratory Syncytial Virus (RSV). What is the mainstay of evidence-based management for acute bronchiolitis?
Answer and explanation
Correct answer: D. Supplemental humidified oxygen and supportive hydration
- Step 1: Acute bronchiolitis is a self-limiting viral lower respiratory tract infection primarily caused by RSV in infants under 1 year of age.
- Step 2: Clinical practice guidelines explicitly recommend supportive care: maintain oxygen saturation (supplemental oxygen if ) and maintain fluid hydration. Bronchodilators, antibiotics, and steroids are not recommended.
Answer
Supplemental humidified oxygen and supportive hydration.
Why not the others: 'Cephalosporins' are ineffective against viral RSV; 'Systemic corticosteroids' show no benefit in clinical resolution or hospital stay; 'Nebulized albuterol' is not recommended for routine use as it does not alter disease trajectory.
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