A 6 months old baby coming with H/o increasing difficulty in breathing of 2 days duration and on examination baby is afebrile & B/L wheeze & CXR shows B/L hyperinflation of the lungs with normal WBC count, the diagnosis is -

Ans. is `a' i.e., Bronchiolitis Clinical manifestations of hronchiolitis o The usual course of disease is 1-2 days of --> Fever, Rhinorrha, Cough o This is followed by - Wheezing Tachypnea Breathing pattern is shallow Cyanosis Nasal flaring Rales, crepitation and ronchi Respiratory distress --> retraction of intercostal space & suprasternal notch. o Liver and spleen are pushed downward because the hyperinflated emphysematous lungs push the diaphragm downward. o Anteroposterior diameter of chest is increased and hyperresonance is noted on percussion. o The leukocyte count is normal or slightly elevated. Chest X-ray o Hyperinflation of the lung o Diaphragm is pushed down o Lung fields are abnormally translucent.