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

• A. Shortness of breath at rest
• B. Nasal discharge only
• C. Tachypnea, wheeze, cough, nasal flaring, poor feeding
• D. Wheeze without cough

Answer: (C)

Bronchiolitis in infants typically presents with lower airway involvement after a viral upper respiratory illness, leading to increased work of breathing and mucus plugging in the small airways. The combination of tachypnea (rapid breathing) shows the infant is working hard to get air in. Wheeze reflects airway narrowing from inflammation and mucus. Cough is a common sign of airway irritation and helps distinguish lower airway disease from purely nasal symptoms. Nasal flaring is a visible sign of respiratory distress, indicating the baby is using extra effort to breathe. Poor feeding occurs because difficulty breathing makes feeding tiring and can quickly lead to dehydration.

Shortness of breath at rest would suggest more severe distress than is commonly seen with typical bronchiolitis. Nasal discharge alone indicates mostly upper airway involvement without the lower airway symptoms that define bronchiolitis. Wheeze without cough ignores the frequent cough component of bronchiolitis, since the cough often accompanies the wheezing and mucus production.