RESPIRATORY SYNCYTIAL VIRUS-INFECTION IN INFANTS AND YOUNG-CHILDREN

Respiratory syncytial virus (RSV) is the most common cause of lower re spiratory tract infections in infants and young children. Epidemics oc cur yearly from December to March or April, leading to 100,000 hospita lizations in the United States at an estimated cost of $300 million. P hysical examination findings may include clear coryza, evidence of res piratory distress, wheezing, and dehydration. Complications include ap nea. Mortality runs as high as 0.5% to 1.5% in hospitalized patients. Diagnosis is based on clinical presentation, seasonal pattern, and mic robiologic testing. Therapy remains largely supportive. The prepondera nce of evidence argues for the use of bronchodilators, especially epin ephrine or albuterol, in the treatment of acute bronchiolitis. Steroid s do not seem to confer any advantage. Ribavirin is expensive and shou ld be used very selectively in infants at high risk for serious RSV di sease. These infants may benefit from prophylaxis with RSV immune glob ulin.