Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1999 Sep;81(3):231–234. doi: 10.1136/adc.81.3.231

Association of fever and severe clinical course in bronchiolitis

A El-Radhi 1, W Barry 1, S Patel 1
PMCID: PMC1718060  PMID: 10451396

Abstract

Little attention has been given to the relation between fever and the severity of bronchiolitis. Therefore, the relation between fever and the clinical course of 90 infants (59 boys, 31 girls) hospitalised during one season with bronchiolitis was studied prospectively. Fever (defined as a single recording > 38.0°C or two successive recording > 37.8°C) was present in 28 infants. These infants were older (mean age, 5.3 v 4.0 months), had a longer mean hospital stay (4.2 v 2.7 days), and a more severe clinical course (71.0% v 29.0%) than those infants without fever. Radiological abnormalities (collapse/consolidation) were found in 60.7% of the febrile group compared with 14.8% of the afebrile infants. These results suggest that monitoring of body temperature is important in bronchiolitis and that fever is likely to be associated with a more severe clinical course and radiological abnormalities.



Full Text

The Full Text of this article is available as a PDF (69.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barry W., Cockburn F., Cornall R., Price J. F., Sutherland G., Vardag A. Ribavirin aerosol for acute bronchiolitis. Arch Dis Child. 1986 Jun;61(6):593–597. doi: 10.1136/adc.61.6.593. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Berman S., Shanks M. B., Feiten D., Horgan J. G., Rumack C. Acute respiratory infections during the first three months of life: clinical, radiologic and physiologic predictors of etiology. Pediatr Emerg Care. 1990 Sep;6(3):179–182. doi: 10.1097/00006565-199009000-00003. [DOI] [PubMed] [Google Scholar]
  3. Brandenburg A. H., Jeannet P. Y., Steensel-Moll H. A., Ott A., Rothbarth P. H., Wunderli W., Suter S., Neijens H. J., Osterhaus A. D., Siegrist C. A. Local variability in respiratory syncytial virus disease severity. Arch Dis Child. 1997 Nov;77(5):410–414. doi: 10.1136/adc.77.5.410. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dawson K. P., Long A., Kennedy J., Mogridge N. The chest radiograph in acute bronchiolitis. J Paediatr Child Health. 1990 Aug;26(4):209–211. doi: 10.1111/j.1440-1754.1990.tb02431.x. [DOI] [PubMed] [Google Scholar]
  5. Fleming P. J., Howell T., Clements M., Lucas J. Thermal balance and metabolic rate during upper respiratory tract infection in infants. Arch Dis Child. 1994 Mar;70(3):187–191. doi: 10.1136/adc.70.3.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Henderson F. W., Collier A. M., Clyde W. A., Jr, Denny F. W. Respiratory-syncytial-virus infections, reinfections and immunity. A prospective, longitudinal study in young children. N Engl J Med. 1979 Mar 8;300(10):530–534. doi: 10.1056/NEJM197903083001004. [DOI] [PubMed] [Google Scholar]
  7. Isaacs D. Bronchiolitis. BMJ. 1995 Jan 7;310(6971):4–5. doi: 10.1136/bmj.310.6971.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Isaacs D. Production of interferon in respiratory syncytial virus bronchiolitis. Arch Dis Child. 1989 Jan;64(1):92–95. doi: 10.1136/adc.64.1.92. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lebel M. H., Gauthier M., Lacroix J., Rousseau E., Buithieu M. Respiratory failure and mechanical ventilation in severe bronchiolitis. Arch Dis Child. 1989 Oct;64(10):1431–1437. doi: 10.1136/adc.64.10.1431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lugo R. A., Nahata M. C. Pathogenesis and treatment of bronchiolitis. Clin Pharm. 1993 Feb;12(2):95–116. [PubMed] [Google Scholar]
  11. McConnochie K. M., Roghmann K. J. Wheezing at 8 and 13 years: changing importance of bronchiolitis and passive smoking. Pediatr Pulmonol. 1989;6(3):138–146. doi: 10.1002/ppul.1950060303. [DOI] [PubMed] [Google Scholar]
  12. McIntosh E. D., De Silva L. M., Oates R. K. Clinical severity of respiratory syncytial virus group A and B infection in Sydney, Australia. Pediatr Infect Dis J. 1993 Oct;12(10):815–819. doi: 10.1097/00006454-199310000-00004. [DOI] [PubMed] [Google Scholar]
  13. Mulholland E. K., Olinsky A., Shann F. A. Clinical findings and severity of acute bronchiolitis. Lancet. 1990 May 26;335(8700):1259–1261. doi: 10.1016/0140-6736(90)91314-z. [DOI] [PubMed] [Google Scholar]
  14. O'Dempsey T. J., Laurence B. E., McArdle T. F., Todd J. E., Lamont A. C., Greenwood B. M. The effect of temperature reduction on respiratory rate in febrile illnesses. Arch Dis Child. 1993 Apr;68(4):492–495. doi: 10.1136/adc.68.4.492. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Outwater K. M., Crone R. K. Management of respiratory failure in infants with acute viral bronchiolitis. Am J Dis Child. 1984 Nov;138(11):1071–1075. doi: 10.1001/archpedi.1984.02140490071018. [DOI] [PubMed] [Google Scholar]
  16. Rakshi K., Couriel J. M. Management of acute bronchiolitis. Arch Dis Child. 1994 Nov;71(5):463–469. doi: 10.1136/adc.71.5.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ray C. G., Minnich L. L., Holberg C. J., Shehab Z. M., Wright A. L., Barton L. L., Taussig L. M. Respiratory syncytial virus-associated lower respiratory illnesses: possible influence of other agents. The Group Health Medical Associates. Pediatr Infect Dis J. 1993 Jan;12(1):15–19. [PubMed] [Google Scholar]
  18. Shaw K. N., Bell L. M., Sherman N. H. Outpatient assessment of infants with bronchiolitis. Am J Dis Child. 1991 Feb;145(2):151–155. doi: 10.1001/archpedi.1991.02160020041012. [DOI] [PubMed] [Google Scholar]
  19. Sterner G., Wolontis S., Bloth B., de Hevesy G. Respiratory syncytial virus. An outbreak of acute respiratory illnesses in a home for infants. Acta Paediatr Scand. 1966 May;55(3):273–279. doi: 10.1111/j.1651-2227.1966.tb17654.x. [DOI] [PubMed] [Google Scholar]
  20. Tristram D. A., Miller R. W., McMillan J. A., Weiner L. B. Simultaneous infection with respiratory syncytial virus and other respiratory pathogens. Am J Dis Child. 1988 Aug;142(8):834–836. doi: 10.1001/archpedi.1988.02150080040017. [DOI] [PubMed] [Google Scholar]
  21. Walsh E. E., McConnochie K. M., Long C. E., Hall C. B. Severity of respiratory syncytial virus infection is related to virus strain. J Infect Dis. 1997 Apr;175(4):814–820. doi: 10.1086/513976. [DOI] [PubMed] [Google Scholar]
  22. Wang E. E., Law B. J., Boucher F. D., Stephens D., Robinson J. L., Dobson S., Langley J. M., McDonald J., MacDonald N. E., Mitchell I. Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of admission and management variation in patients hospitalized with respiratory syncytial viral lower respiratory tract infection. J Pediatr. 1996 Sep;129(3):390–395. doi: 10.1016/s0022-3476(96)70071-9. [DOI] [PubMed] [Google Scholar]
  23. Wang E. E., Law B. J., Stephens D. Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) prospective study of risk factors and outcomes in patients hospitalized with respiratory syncytial viral lower respiratory tract infection. J Pediatr. 1995 Feb;126(2):212–219. doi: 10.1016/s0022-3476(95)70547-3. [DOI] [PubMed] [Google Scholar]
  24. el-Radhi A. S., Banajeh S. Effect of fever on recurrence rate of febrile convulsions. Arch Dis Child. 1989 Jun;64(6):869–870. doi: 10.1136/adc.64.6.869. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. el-Radhi A. S., Rostila T., Vesikari T. Association of high fever and short bacterial excretion after salmonellosis. Arch Dis Child. 1992 Apr;67(4):531–532. doi: 10.1136/adc.67.4.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. van Woensel J. B., Wolfs T. F., van Aalderen W. M., Brand P. L., Kimpen J. L. Randomised double blind placebo controlled trial of prednisolone in children admitted to hospital with respiratory syncytial virus bronchiolitis. Thorax. 1997 Jul;52(7):634–637. doi: 10.1136/thx.52.7.634. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES