Abstract

CASTILLO GALVAN, Ricardo  and  CUELLO GARCIA, Carlos A.. Chest X-ray: an unnecessary resource in the diagnosis of acute bronchiolitis. Bol. Med. Hosp. Infant. Mex. [online]. 2011, vol.68, n.3, pp.213-220. ISSN 1665-1146.

Background. Bronchiolitis is one of the leading controversial pediatric diseases because of its variations in diagnosis and treatment. Use of diagnostic resources beyond the clinical features is usually unnecessary in its classic presentation. The objective of this study was to evaluate the prevalence of significant abnormalities in radiographic findings performed on infants <24 months of age who were hospitalized through the emergency department with the diagnosis of bronchiolitis, as well as to assess whether clinical variables can accurately identify children with abnormal chest X-ray in order to reduce unnecessary radiation exposure. Methods. From September 2006 to March 2007, infants aged <24 months evaluated and hospitalized through the emergency department of the Hospital San Jose Tec de Monterrey with a diagnosis of bronchiolitis were included in the study. Clinical variables were registered (age, gender, time since onset, oxygen saturation) and laboratory variables as well (leukocytes, lymphocytes, virus identified). Information from the chest X-ray was also obtained. Results. There were 128 patients included; 70% were aged <12 months. Chest X-ray was performed in 122 patients (95.31 %) and respiratory virus studies were done in 119 patients (92.96%). There were 69 patients who were positive (57.99%); respiratory syncytial virus was demonstrated in 62 samples (89.85%) and 15 patients (12.29%) showed abnormal chest X-ray (atelectasis/consolidation). No differences were found between patients with and without chest X-ray abnormalities in clinical and laboratory variables. Conclusions. Most patients with bronchiolitis had a normal chest X-ray. Our study suggests that x-rays in children with typical bronchiolitis have limited value.

Keywords : bronchiolitis; chest X-ray; atelectasis; pulmonary consolidation; respiratory syncytial virus.

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