Upon admission, baby Tu was crying, refusing food, and wheezing. His lungs presented with crackles and rhonchi. Treatment included nebulization, nasal and throat hygiene, and chest physiotherapy to loosen phlegm. After one day, his condition worsened. He developed increasing difficulty breathing at night, with a rapid respiratory rate of 45-50 times/minute. His blood oxygen saturation (SpO₂) dropped to 92%, prominent chest retractions were observed, and lung ventilation was poor.

Doctor Than Thi Thuy Linh, from the Pediatrics Department at Tam Anh General Hospital Hanoi, explained that respiratory syncytial virus (RSV) aggressively attacks bronchiole epithelial cells upon entering the respiratory tract, causing swelling and increased fluid secretion. Young children have narrow airways and easily swollen mucous membranes. Their inability to clear phlegm makes them prone to airway obstruction and difficulty breathing.

The doctor prescribed an oxygen mask at 5 liters/minute and chest physiotherapy to loosen phlegm to support baby Tu's respiration. His respiratory condition improved, his fever subsided, coughing lessened, and lung ventilation was good. He was discharged after four days.

Doctor Linh examines baby Tu before his discharge. Photo: Hai Au

Doctor Linh examines baby Tu before his discharge. Photo: Hai Au

Doctor Thuy Linh stated that respiratory syncytial virus (RSV) is a leading cause of lower respiratory infections in young children, especially those under two years old. RSV primarily spreads through respiratory droplets and contaminated surfaces. The virus can survive for several hours on objects and for a shorter time on skin. In immunocompromised individuals, viral shedding can last longer than in healthy children.

In the early stage, symptoms are easily mistaken for a common cold: nasal congestion, runny nose, cough, sore throat, sneezing, and fever. From the third to the seventh day, children may experience difficulty breathing, fatigue, and increased fussiness due to airway swelling. When the illness becomes severe, children begin breathing faster than normal, coughing persistently, and have difficulty clearing phlegm.

According to Doctor Linh, children with RSV infection face a high risk of coinfection with other pathogens, including: pneumococcus, HI, staphylococcus, influenza, Covid-19, and measles. This combination can rapidly worsen the illness, increasing the risk of complications such as pneumonia, bronchiolitis, and severe respiratory failure. Severity depends on factors like age, underlying conditions, and infection history. Some children may also exhibit signs of dehydration, apnea, or respiratory rhythm disorders.

Doctor Linh recommends proactive RSV prevention by limiting children's exposure to crowded places. Adults should frequently wash their hands with soap or specialized sanitizing solutions before caring for children. Regularly clean the child's living and play areas, and disinfect daily contact surfaces. Avoid kissing children on the face and hands, and ensure full vaccination as recommended. Parents must take their child to the hospital immediately if the child experiences severe coughing, wheezing, difficulty breathing, rapid breathing, refusal to feed, fever with cyanosis, or lethargy.

Trinh Mai