Symptoms of respiratory syncytial infection

The incubation period of respiratory syncytial infection lasts from 3 to 7 days. Clinical manifestations of the disease depend on the age of the children.

In older children, respiratory syncytial infection usually proceeds mildly, as an acute catarrh of the upper respiratory tract, often without an increase in body temperature or with a subfebrile temperature. The general condition worsens slightly, a slight headache, slight chills, and fatigue are noted. The leading clinical symptom is a cough, usually dry, persistent, and prolonged. Breathing is rapid, with difficulty exhaling, sometimes with attacks of suffocation. Children sometimes complain of pain behind the breastbone. Upon examination, their general condition is satisfactory. Pallor and slight pastosity of the face, injection of the scleral vessels, and scanty nasal discharge are noted. The mucous membrane of the pharynx is slightly hyperemic or unchanged. Breathing is harsh, scattered dry and moist rales are heard. In some cases, the liver is enlarged. The course of the disease is up to 2-3 weeks.

In children aged 1 year, respiratory syncytial infection may begin both acutely and gradually. The body temperature rises, nasal congestion, sneezing and dry cough occur. Objectively, in the initial period, only a slight deterioration in the general condition, pale skin, scanty nasal discharge, slight hyperemia of the mucous membranes of the anterior arches, the back wall of the pharynx, and scleritis can be noted. Later, symptoms increase, indicating greater involvement of the lower respiratory tract in the process, and a picture of bronchiolitis occurs. The cough becomes paroxysmal, prolonged, and at the end of the attack, thick, viscous sputum is separated with difficulty. Sometimes coughing fits are accompanied by vomiting, appetite is reduced, and sleep is disturbed. In this period, the disease in some patients may resemble whooping cough.

In severe cases, respiratory failure symptoms rapidly increase. Breathing becomes more frequent, noisy, and expiratory dyspnea with retraction of the compliant areas of the chest occurs. Cyanosis of the nasolabial triangle and distension of the wings of the nose appear. Percussion reveals a box sound, and auscultation reveals multiple crepitating and fine-bubble moist rales. Body temperature in this period is often elevated, but may also be normal, and symptoms of intoxication are not expressed. The severity of the child's condition is due to respiratory failure. The liver is often enlarged, and the edge of the spleen is sometimes palpated.

Other clinical syndromes in respiratory syncytial infection include obstructive syndrome and, less commonly, croup syndrome. Both of these syndromes usually develop simultaneously with bronchitis.

The radiograph shows pulmonary emphysema, chest expansion, flattening of the diaphragm dome and horizontal position of the ribs, increased pulmonary pattern, and stringy roots. There may be enlargement of the lymph nodes. Damage to individual segments and development of atelectasis are possible.

In the peripheral blood, the number of leukocytes is normal or slightly increased, there is a neutrophilic shift to the left, there is an increase in the number of monocytes and atypical lymphomonocytes (up to 5%), ESR is slightly increased.

The course of respiratory syncytial infection depends on the severity of clinical manifestations, the age of children and the layering of bacterial infection. In mild cases, the symptoms of bronchiolitis disappear quite quickly - in 3-8 days. In pneumonia, the course of the disease is long - up to 2-3 weeks.

Complications are mainly caused by superimposed bacterial infection. Most often, otitis, sinusitis, and pneumonia occur.

Respiratory syncytial infection in newborns and premature babies. The disease begins gradually at normal body temperature, nasal congestion, persistent paroxysmal cough, periodic cyanosis are noted, signs of oxygen starvation quickly increase, vomiting is common. Due to the impossibility of nasal breathing, the general condition suffers: anxiety, sleep disorders appear, the child refuses to breastfeed. Pneumonia develops quickly. The number of breaths reaches 80-100/min, tachycardia is noted. Inflammatory focal infiltration and atelectasis are found in the lungs. Leukocytosis, increased ESR are noted. The course is long. The occurrence of complications is due to the layering of bacterial infection, which worsens the prognosis.

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