What is an expected finding upon examination of a child with Bronchiolitis/RSV?

The presence of intercostal retractions and grunting is a hallmark finding in the examination of a child with bronchiolitis, particularly when caused by respiratory syncytial virus (RSV). This condition leads to significant respiratory distress as the small airways in the lungs become inflamed and obstructed.

Intercostal retractions occur when the muscles between the ribs are used more forcefully to assist with breathing due to increased work of breathing. This is often seen in cases where there is airway obstruction and difficulty in airflow, causing the chest wall to pull inward during inhalation. Grunting is a sound that can occur due to the child attempting to increase airway pressure and improve lung ventilation; it typically indicates that the child is in respiratory distress and trying to maintain aeration in the lungs.

These signs are characteristic of bronchiolitis, which is most frequently caused by RSV in infants and young children. The combination of decreased ability to ventilate effectively and the increased effort required to breathe leads to these observable physical findings. They are associated with the disease's pathophysiology, where inflammation and mucus production narrow the airways, resulting in increased resistance to airflow and struggle to breathe.

In contrast, hypoventilation, expiratory wheezing