What radiographic finding is typical in RSV bronchiolitis/pneumonia?

• A. Hyperinflated lungs with patchy infiltrates/atelectasis
• B. Large pleural effusions
• C. Consolidation in lower lobes
• D. Normal radiographs

Answer: (A)

RSV bronchiolitis typically causes inflammation and mucus plugging in the small airways, leading to air trapping. This produces hyperinflated lungs on radiographs, often with flattened diaphragms and increased retrosternal air space. The mucus and inflammation also create patchy areas of atelectasis or mild infiltrates, especially in the perihilar and lower lung regions. Large pleural effusions are not a feature of RSV bronchiolitis, and while some cases can show consolidation, a lobar pattern is more suggestive of bacterial pneumonia. Normal radiographs can occur in mild cases, but the characteristic pattern is hyperinflation with patchy infiltrates/atelectasis.