Iwona Kowalska, Radosław Skubiszewski, Magdalena Kowalska, Adrian Kowalski4, Alicja Nowaczyk

Bronchiolitis – diagnostic and therapeutic difficulties in pediatric patients
2020-03-15

Acute bronchiolitis is an infectious disease of the lower respiratory tract of viral etiology. The main etiological factor is respiratory syncytial virus (RSV). It occurs most often in children under the age of two due to the immaturity of the immune system and the narrow opening of the airways. It is characterized by acute inflammation, edema, necrosis, exfoliation of the epithelial cell lining at the end of the respiratory tract, as well as increased mucus production. It usually begins with a mild infection of the nasal mucosa or is preceded by contact with the patient. The main symptoms of acute bronchiolitis include: rhinitis, coughing, wheezing, activation of additional respiratory muscles, tachypnoea and auscultation over the lung fields and creaks. Diagnosis and assessment of the severity of the disease are based on the patient history and clinical picture.  A correct diagnosis should be made due to the similarity of the clinical picture of pneumonia and bronchitis before treatment. It is not advisable to perform routine additional tests because they do not contribute much to the diagnosis and assessment of the prognosis. Treatment is symptomatic, it consists primarily of irrigation and oxygen therapy. Nevertheless, the course of the disease can be very serious. For this reason, selected groups of antibacterial, antiviral, glucocorticosteroid, alpha- and beta-adrenergic drugs are often used. In this study, a preliminary analysis of safety of selected substances belonging to the above mentioned groups of drugs was performed using in silico calculation methods. The results obtained have been confirmed in the literature data - they may have toxic effects on some organs. Therefore, they should only be used if necessary.  However, it has to be remembered that the most significant prophylaxis plays an important role, consisting in the administration of a monoclonal antibody directed against RSV. Immunoglobulin is administered to patients with the highest risk of bronchitis. But, it should be remembered that it will not decrease the severity of the disease.

Keywords: Acute bronchiolitis, respiratory syncytial virus, palivizumab.\

© Farm Pol, 2020, 76 (2): 102–109