الفهرس 
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Abstract
SUMMARY
Bronchiolitis is an acute inflammatory injury of the bronchioles that is usually caused by a viral infection (most commonly respiratory syncytial virus). This condition may occur in persons of any age, but severe symptoms are usually evident only in young infants. Acute bronchiolitis, a viral infection of the lower respiratory tract, is one of the most substantial health burdens for infants and young children worldwide.
Bronchiolitis usually affects children younger than 2 years, with a peak in infants aged 3-6 months. Acute bronchiolitis is the most common cause of lower respiratory tract infection in the first year of life. It is generally a self-limiting condition and is most commonly associated with respiratory syncytial virus.
The detection of multiple coincident viruses in clinical settings is becoming more common since the introduction of molecular based multiplex tests, but the clinical significance of these findings remains unclear and seems to have no impact in disease severity. Both an increase in disease severity in relation to dual infections and the absence of this association have been reported.
The diagnosis of bronchiolitis is based on clinical presentation, the patient’s age, seasonal occurrence, and findings from the physical examination. When all of these are consistent with the expected diagnosis of bronchiolitis, few laboratory studies are necessary. Tests are typically used to exclude other diagnoses (eg, bacterial pneumonia, sepsis, or congestive heart failure) or to confirm a viral etiology and determine required infection control for patients admitted to the hospital. Severely ill children may have dual viral infections.
The aim of this study is to highlight the occurrence of bacterial infection in pediatric patients with bronchiolitis in Beni-Suef governorate.
This prospective descriptive study was carried out on 100 patients from inpatients of Beni-Suief university hospital from the duration of December 2018 till April 2019, The study included 100 patients (their ages range from 3months –3 years with bronchiolitis), Patients with bronchiolitis were diagnosed by clinical, laboratory and radiological investigations.
The main results of the study revealed that:
That 59%of studied infants were males and 41% were females.
Frequency of RD and other chest examination findings after 72 hours of admission was as following 20% had no RD,40% had tachypnea , 30% had Retractions and 10% had grunting .
46% of them had cough, 55% had wheeze, 40% of them had Crepitation and 40% had diminished air entery 40% had pneumonic patches on X ray findings.
Most common isolated organisms were resistant to antibiotics sensitivity.
CRP, temperature, TLC and PLT were significantly higher in patients with positive sputum culture while HB was significantly lower in patients with positive sputum culture.
The persistence of high grade fever, severe RD (RD III – IV), and wheezes after 72 hours of admission were significant risk factors to have pneumonia in patients diagnosed as bronchiolitis.
Finally we recommend for further studies about the influence of antibiotics on children with severe bronchiolitis and about bronchiolitis patients who receive treatment at home to differ between incidence bacterial coinfection and hospital acquired pneumonia.