August 1983


Author Affiliations

Department of Child Health University of Nottingham Medical School Queen's Medical Centre NG7 2UH Nottingham, England

Am J Dis Child. 1983;137(8):805-806. doi:10.1001/archpedi.1983.02140340085025

Sir.—In the marginal comment "Bronchiolitis: What's in the Name?" (Journal 1983;137:11-13), McConnochie recommended that the diagnosis of bronchiolitis be made in children who meet the following criteria: (1) expiratory wheezing of acute onset; (2) age of 24 months or younger; (3) signs of viral respiratory illness, such as coryza, otitis media, or fever; (4) with or without indications of respiratory distress, pneumonia, and atopy; and (5) the first such episode.

We believe that this definition has serious limitations and will be as unpopular in the United Kingdom and Australia as the suggestion that wheeze-associated respiratory infection is equivalent to bronchiolitis.1-3 It begs the question of the relationship between acute viral bronchiolitis and asthma since, by definition, a first attack of asthma in a child younger than 2 years old, precipitated by possible rhinovirus, would be called bronchiolitis by McConnochie. We realize that, at times, it is impossible to