Abstract

SALAS MALLEA, Ariel  and  YUCRA SEA, Marisol. Clinical and epidemiological features of bronchiolitis among hospitalized patients. Rev. bol. ped. [online]. 2005, vol.44, n.3, pp.148-152. ISSN 1024-0675.

Background: Bronchiolitis is a common worldwide disease of infants. Clinical and epidemiological patterns are unknown in our area. Objective: To determine the main epidemiological and clinical features of infants hospitalized with bronchiolitis. Setting: Department of Pulmonology at “Dr. Ovidio Aliaga Uría” Children’s Hospital. La Paz, Bolivia. Methods: All patients less than 1 year of age admitted with acute bronchiolitis during January 1, 2003 to December 31, 2004 were enrolled in the study. Patients with insufficient data on medical records were excluded from clinical descriptive analysis. Results: A total of 178 patients with bronchiolitis were admitted. The peak of hospital admissions for infants with bronchiolitis occurred between April and May. Ninety-four patients were included for descriptive analysis (n=94). Mean age at time of admission was 4.6 ± 2.8 months. Primary symptoms were cough, fever and wheezing. The mean length of stay was 3 ± 2.1 days. Relative lymphocytosis was a common finding (70%). Respiratory sincitial virus (RSV) was the most frequent isolated etiologic agent (60%). Secondary bacterial infections were diagnosed in 16 patients. Factors associated with this complication were duration of symptoms more than 3 days (OR: 8.4; CI 95%: 1.06-179.3; p <0.05), incomplete vaccination for age (OR: 5.2; CI 95%: 1.36-20.84; p <0.01) and consolidation on chest X-ray (OR: 22.8; CI 95%: 3.41193.1; p <0.01). Relative lymphocytosis was a protective factor for secondary bacterial infections (OR: 0.25; CI 95% 0.07-0.87; p <0.05). Signs of respiratory distress at admission were associated to prolonged length of stay (OR: 3.55; CI 95%: 1.1610.93; p <0.05). Conclusions: Signs of respiratory distress could guide the decision to admit patients with bronchiolitis. White blood cell count appears a useful predictor of secondary bacterial infection. Further prospective studies are necessary to better understand these issues.

Keywords : bronchiolitis; epidemiology; clinical features.

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