Pathogenesis

The virus enters the body by inhalation and infects the respiratory tract epithelium, causing death and sloughing of the cells. Bronchiolitis is a common feature of the disease; the inflamed bronchioles become partially plugged by sloughed cells, mucus, and clotted plasma that has oozed from the walls of the bronchi. The initial obstruction causes wheezing when air rushes through the narrowed passageways, sometimes causing the condition to be confused with asthma. The obstruction often acts like a one-way valve, allowing air to enter the lungs, but not leave them. In many cases the inflammatory process extends into the alveoli, causing pneumonia. There is a high risk of secondary infection because of the damaged mucociliary escalator. ■ mucociliary escalator, p. 562

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