title: [Chest radiographs in infants hospitalized for acute bronchiolitis: real information or just irradiation?].
abstract: OBJECTIVE
  To describe the chest radiographs of infants hospitalized for acute bronchiolitis and to assess whether patient management changed after radiography.
  
  
  METHODS
  All infants hospitalized in our pediatric unit with a first episode of acute bronchiolitis from October 2010 to March 2012 were included in the study. Infants with chronic disease or transferred from a pediatric intensive care unit were excluded. The following data were collected: sex, age, neonatal history, atopy, tobacco exposure, admission criteria, treatment, laboratory parameters, ultrasonography and its outcome, results of chest radiography on admittance, the reason for a second chest radiograph, change in management as a result of the radiograph.
  
  
  RESULTS
  The study comprised 232 infants (median age 2.2 months, boys 56%, positive respiratory syncytial virus 73.4%). Among them, 227 children had a routine chest radiograph revealing distension and/or bronchial wall thickening (n=141, 62.4%), focal opacity (19.9%), or atelectasis (17.7%). This radiograph led to the prescription of antibiotics in six patients (2.6%) and allowed the diagnosis of vascular abnormality to be made in one case (0.4%). Thirty-five patients (15.4%) had a second chest radiograph during their hospitalization owing to oxygen dependency (n=21), respiratory distress (n=11), persistent fever (n=2), or no reason specified (n=1). Pneumonia (n=7) and/or atelectasis (n=15) were then found in 62.9%. Patient management (antibiotics, postural maneuvers) was modified in six patients (17.1%).
  
  
  CONCLUSIONS
  Routine chest radiographs contribute only partially to the treatment of infants hospitalized for acute bronchiolitis. However, radiography is useful when the hospitalized child does not improve at the expected rate or if the disease is severe. The indication of chest radiography in infants hospitalized for acute bronchiolitis should be discussed on a case by a case basis.
authors.affiliation: Unité de pneumologie et médecine infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: A
authors.initials: A
authors.lastname: Carsin
authors.forename: G
authors.initials: G
authors.lastname: Gorincour
authors.forename: V
authors.initials: V
authors.lastname: Bresson
authors.forename: M
authors.initials: M
authors.lastname: Oudyi
authors.forename: M
authors.initials: M
authors.lastname: David
authors.forename: J
authors.initials: J
authors.lastname: Mancini
authors.forename: B
authors.initials: B
authors.lastname: Chabrol
authors.forename: P
authors.initials: P
authors.lastname: Devred
authors.forename: E
authors.initials: E
authors.lastname: Bosdure
authors.forename: J-C
authors.initials: JC
authors.lastname: Dubus
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001988:Bronchiolitis / Q000000981:diagnostic imaging*; D003657:Decision Making; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D011014:Pneumonia / Q000175:diagnosis; D001261:Pulmonary Atelectasis / Q000175:diagnosis; D013902:Radiography, Thoracic; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents