Respiratory syncytial virus bronchiolitis complicated by spontaneous pneumothorax in an infant: a case report

Acute bronchiolitis is the most common viral lower respiratory tract infection in infants, with an annual incidence of 3-5% in children under 12 months, peaking between 2 and 6 months of age. Respiratory syncytial virus (RSV) is responsible for 50-80% of cases. Although generally benign, bronchiolitis may be complicated by spontaneous pneumothorax, which is reported in only 0.5-2% of hospitalized infants, making it a rare but potentially life-threatening event. We report the case of an 11-month-old female infant with a family history of maternal asthma, admitted for acute respiratory distress during a second episode of bronchiolitis. Examination revealed tachypnea, wheezing, and retractions. RSV infection was confirmed by polymerase chain reaction. Imaging showed a moderate left-sided pneumothorax with partial atelectasis. Conservative management with oxygen, nebulized salbutamol, and intravenous corticosteroids led to full recovery without invasive intervention. This rare case emphasizes the importance of considering pneumothorax in bronchiolitis with sudden deterioration. In stable infants, conservative treatment may be sufficient.