Question

A 7 month old was brought to the emergency room due to difficulty breathing.Examination revealed wheezing due to bronchitis a fever of 102 F slightly blue lips lethargie and loss of appetite. A chest X ray revealed no signs of pneumonia. A specific virus was suspected and a rapid test for that virus yielded a positive result.The virus is a negative sense single stranded RNA virus. It has spherical fors that are 150-200 nanometers in size and filamentous forms that are 50 nanometers in size. The surface of the virus has F snd G lipoproteins. The virus also makes a Matrix protein that it uses for building from the host cell.The infant was placed on oxygen therapy and given ribavirin and steroids. What is the diagnosis and the virus ?

Answer 1

Respiratory syncytial virus (RSV) is one of the most common diseases of childhood. Virtually all children have been exposed to this virus by age two. RSV causes common cold symptoms in most patients.RSV is a medium-sized (between 80 to 350 nm diameter), membrane-bound, RNA virus.The nonstructural proteins direct viral replication within the infected host cell. The structural proteins are divided into three functional groups. The matrix is made up of two membrane-associated proteins, while three proteins make up the viral capsid. In addition there are three transmembrane surface glycoproteins. Two of these, a fusion protein (F) and an attachment protein (G), are responsible for the initiation and propagation of an RSV infection. There are two subtypes of RSV, Types A and B. They differ primarily in the composition of the G protein, while the F protein is conserved between the two strains.(Polak,n.d)

Bronchiolitis is a common lung infection in young children and infants. It causes inflammation and congestion in the small airways (bronchioles) of the lung. Bronchiolitis is almost always caused by a virus. Typically, the peak time for bronchiolitis is during the winter months.Complications of severe bronchiolitis may include:

• Blue lips or skin (cyanosis). Cyanosis is caused by lack of oxygen.
• Pauses in breathing (apnea). Apnea is most likely to occur in premature infants and in infants within the first two months of life.
• Dehydration.
• Low oxygen levels and respiratory failure.(Mayo clinic)

The diagnosis is BRONCHIOLITIS and virus is RESPIRATORY SYNCYTIAL VIRUS.

Ref:

1. Mayo clinic, Bronchiolitis,Patient care and health information.
2. Mark J. Polak,n.d,Respiratory Syncytial Virus (RSV): Overview, Treatment, and Prevention Strategies,Medscape