First use of nitazoxanide in Kelleni’s protocol for managing severe bronchiolitis in a 9-month-old infant: A case report and review of literature

Table 1 Timeline of illness and clinical findings

Day	Clinical events and findings	Key actions
Day 0	Onset of mild rhinorrhea and cough after exposure to family members with viral laryngitis	Watchful monitoring
Day 3	Cough worsened, mild change in voice. No fever	Single daily ibuprofen dose started
Day 5	Fever up to 39 °C, decreased appetite, tachypnea, mild wheezing, SpO2 = 84% (room air)	Azithromycin and ibuprofen initiated. Nitazoxanide (60 mg twice daily) added based on uridine diphosphate-glucuronosyltransferase 1A1 enzyme maturation data (Strassburg et al[23], 2002)
Day 6	Fever subsided; wheezing more evident; no signs of respiratory distress or consolidation	Ibuprofen discontinued; paracetamol as needed
Day 7-10	Gradual improvement of cough, tachypnea and general condition; SpO2 = 92%	Continued hydration and supportive care including alpha amylase, levocetrizine and benproperine
Day 14	Full clinical recovery; SpO2 = 96% (room air)	All treatments completed
Day 28	Follow-up showed sustained clinical recovery. No deterioration or relapse