Which combination of symptoms is commonly seen in bronchiolitis in infants?

• A. High fever, productive cough, chest pain
• B. Severe dehydration with no fever
• C. Cough with chest tightness
• D. Low grade fever, tachypnea, wheezing, poor feeding

Answer: (D)

Bronchiolitis in infants causes inflammation and obstruction of the small airways, which leads to increased work of breathing and airflow limitation. The hallmark signs reflect this: tachypnea due to trying to move air through narrowed bronchioles, and wheezing from the airway narrowing. Fever is usually mild, and infants often have poor feeding because fatigue from breathing effort reduces intake. So the combination of low-grade fever, rapid breathing, wheezing, and poor feeding fits bronchiolitis best, reflecting the viral inflammation of the small airways and its impact on feeding and breathing. The other patterns are less typical: high fever with productive cough and chest pain suggests pneumonia; severe dehydration with no fever isn’t the classic bronchiolitis presentation; and cough with chest tightness is more associated with asthma in older children.