Background: Broncho-obstructive syndrome (BOS), characterized by wheezing and airflow limitation, is a common complication of acute bronchitis in children. Respiratory Syncytial Virus (RSV) and Rhinovirus (RV) are the predominant etiological agents, yet their pathophysiological mechanisms and long-term prognostic implications differ significantly. Objective: This article aims to analyze the clinical and etiological relationship between BOS and specific viral pathogens (RSV and Rhinovirus) in pediatric patients and to evaluate their differential impact on disease severity and future asthma risk. Methods: A systematic review of studies published between 2019 and 2024 was conducted using PubMed and Scopus databases. The analysis focused on pediatric cohorts presenting with acute wheezing bronchitis, comparing viral prevalence, clinical phenotypes, and inflammatory markers associated with RSV and RV infections. Results: RSV is identified as the primary cause of BOS in infants under 12 months, driving obstruction via direct epithelial necrosis and mucus plugging. In contrast, Rhinovirus is more prevalent in children over 12 months and is strongly associated with atopic predispositions. Children with RV-induced BOS show a significantly higher risk of developing asthma compared to those with RSV-induced episodes. Conclusion: Differentiation between RSV and RV etiologies in BOS is clinically relevant. While RSV management focuses on supportive care for obstruction, RV-associated wheezing may warrant earlier targeted anti-inflammatory strategies and close monitoring for asthma development.

Broncho-obstructive syndrome, acute bronchitis, children, RSV, Rhinovirus, wheezing, asthma.

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