Viral Wheeze

Question 1

Common aetiologies of viral wheeze

Answer 1

RSV

Rhinovirus

Question 2

Clinical features of viral wheeze

Answer 2

Evidence of viral illness (fever, cough, coryzal symptoms) 1-2 days preceding onset of:

SOB

Signs of respiratory distress

Expiratory wheeze throughout chest

Question 3

Investigations in viral induced wheeze

Answer 3

Neither VIW or asthma cause a focal wheeze - investigate for inhaled foreign body or tumour

Question 4

Management of viral induced wheeze

Answer 4

Supplementary O2 if required (sats <94 or working hard)

Bronchodilators (salbutamol, ipratropium bromid, magnesium sulphate)

Steroids to reduce airway inflammation (oral prednisolone, IV hydrocortisone)

Abx only if bacterial cause suspected (amoxicillin or erythromycin)

Question 5

Viral induced wheeze pathophysiology

Answer 5

Children <3 have small airways

Virus causes inflammation and oedema, swelling alveoli and restricting airflow