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Respiratory syncytial virus bronchiolitis

Last edited: 4/22/2026

Overview

Respiratory syncytial virus (RSV) bronchiolitis is an acute lower respiratory tract infection characterized by inflammation of the small airways (bronchioles) in infants and young children, often leading to wheezing, cough, and respiratory distress 12.

Diagnosis

  • Elevated serum biomarkers can indicate severity:
  • - Higher serum SP-D levels in RSV bronchiolitis patients compared to healthy controls (mean: 125.8 ± 49.3 ng/ml vs. 44.2 ± 20.1 ng/ml) 1 - Elevated serum KL-6 levels in RSV bronchiolitis patients compared to controls (mean: 471.8 ± 236.9 U/ml vs. 127.1 ± 69.1 U/ml) 2
  • Clinical staging based on oxygen requirements:
  • - Stage A: No oxygen needed - Stage B: Requires oxygen therapy - Stage C: Requires mechanical ventilation

    Management

  • Supportive care is primary:
  • - Oxygen therapy as needed - Humidified air - Fluid management
  • No specific antiviral treatments mentioned in abstracts
  • Special Populations

  • Pediatrics: Biomarkers like SP-D and KL-6 show promise in assessing severity in pediatric patients with and without chronic heart disease 12
  • Key Recommendations

  • Monitor serum SP-D levels to assess severity of lung injury in pediatric RSV bronchiolitis patients (Evidence: Moderate) 1
  • Consider serum KL-6 levels as an additional biomarker to evaluate the extent of lung injury in RSV bronchiolitis (Evidence: Moderate) 2
  • Utilize clinical staging based on oxygen requirements for guiding management intensity (Evidence: Expert opinion) 12
  • References

    1 Kawasaki Y, Endo K, Suyama K, Sato M, Ito M, Hashimoto K et al.. Serum SP-D levels as a biomarker of lung injury in respiratory syncytial virus bronchiolitis. Pediatric pulmonology 2011. link 2 Kawasaki Y, Aoyagi Y, Abe Y, Go H, Imamura T, Kaneko M et al.. Serum KL-6 levels as a biomarker of lung injury in respiratory syncytial virus bronchiolitis. Journal of medical virology 2009. link

    Original source

    1. [1]
      Serum SP-D levels as a biomarker of lung injury in respiratory syncytial virus bronchiolitis.Kawasaki Y, Endo K, Suyama K, Sato M, Ito M, Hashimoto K et al. Pediatric pulmonology (2011)
    2. [2]
      Serum KL-6 levels as a biomarker of lung injury in respiratory syncytial virus bronchiolitis.Kawasaki Y, Aoyagi Y, Abe Y, Go H, Imamura T, Kaneko M et al. Journal of medical virology (2009)

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