Pathophysiology
Clinical meaning
RSV is the most common cause of bronchiolitis and pneumonia in infants under 1 year. The virus infects bronchiolar epithelial cells, causing necrosis, sloughing of cells into the airway lumen, peribronchiolar inflammation, and mucus production. The resulting airway obstruction causes air trapping, wheezing, and respiratory distress. Infants are particularly vulnerable because their small airways are easily obstructed. RSV is transmitted by contact with infected secretions and survives on surfaces for up to 6 hours. Treatment is primarily supportive — bronchodilators and corticosteroids are NOT recommended for routine RSV bronchiolitis. Palivizumab (Synagis) is a prophylactic monoclonal antibody for high-risk infants.