Acute Bronchiolitis and the Asthmatic Child

Abstract

Bronchiolitis is a common respiratory infection in the allergic infant and young child and is followed hy recurrent asthma in 25 to 30%.l, Asthma is a syndrome of recurring dyspnea, more marked on expiration and associated with wheezing. The exciting cause may or may not be protein sensitization.3 Typical expiratory wheezing associated with infection in the respiratory tract is a comnion observation in non-atopic as well as atopic infants. Differentiation of bronchiolitis from asthma can be difficult. Homww-, the striking dyspnea and associated toxicity in bronchiolitis are niost helpful in making this differentiati~n.~ A variety of microorganisnis have been implicated as the etiologic agents in bronchiolitis. These include Hernophilus iiifluenzae, Diplococcus pneumoniac, Coliform bacteria and Respiratory syncytial (RS) , Adeno and Parainfluenza viruses as the most frequently suspected. Recently RS virus has been shown to be the major definable etiologic agent of the bronchiolitis syndrome.5* 6, An allergic diathesis appears to predispose the development of bronchiolitis during RS infection.s This report describes 100 hospitalized infants and children ill with acute bronchiolitis. Viral studies of 40 children implicate the role of allergy and common respiratory infections in the etiology of bronchiolitis. This study was undertaken to answer first the question whether an allergic background predisposes the development of bronchiolitis ; secondly to investigate the possibility that bronchiolitis, an infectious disease, produces and increases the incidence of bronchial asthma.