Pathophysiology of RSV Bronchiolitis

Primary Pathologic Mechanisms

RSV bronchiolitis is characterized by acute inflammation, edema and necrosis of epithelial cells lining the small airways, increased mucus production, and bronchospasm, leading to bronchiolar obstruction through a combination of epithelial destruction, inflammatory cell infiltration, and debris accumulation, as stated by the American Academy of Pediatrics 1
Excessive mucus production contributes to the obstructive process, according to the American Academy of Pediatrics 1

Bronchospasm contributes to airway narrowing, though failure to respond to bronchodilators suggests muscle spasm plays a relatively minor role compared to inflammatory obstruction, as noted by the American Academy of Pediatrics 1

The pathophysiologic changes manifest clinically as tachypnea, wheezing, crackles, use of accessory muscles, and nasal flaring, as described by the American Academy of Pediatrics 1