Bronchiolitis

Case contributed by Dr Jeremy Jones

Presentation

Respiratory distress with cough and pyrexia. Generally unwell for 2 days, but worse over last 12 hours.

Patient Data

Age: 2 months
Gender: Male
X-ray

Generalized prominence of bronchovascular markings in a perihilar distribution but no confluence consolidation or collapse. 

Case Discussion

Nearly all children who have a chest x-ray performed will have a degree of peribronchial thickening in the perihilar regions. It's a function of the fact that only sick children get a chest x-ray.

Features here are of a viral infection and with the history and age, the most likely diagnosis is bronchiolitis.

Bronchiolitis is very common and a chest x-ray is useful to determine whether there is any additional consolidation of collapse that might require further treatment, e.g. for superimposed bacterial chest infection.

The large anterior mediastinal mass is normal - it's the thymus with its wavy edges (wave sign of Mulvey).

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