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Respiratory tract infectious. Respiratory tract infectious. Upper Lower Common cold Bronchitis Pharyngitis Bronchiolitis Laryngitis Pneumonia Acute otitis media Acute sinusitis.
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Respiratory tract infectious UpperLower Common cold Bronchitis Pharyngitis Bronchiolitis Laryngitis Pneumonia Acute otitis media Acute sinusitis
Upper respiratory tract infection • Etiology: Viruses: e.g rhinoviruses, adenoviruses, RSV, enteroviruses, EBV, Bacteria: e.g Streptococcus. Pnumococcus, Hemophilus influezna,moraxella catarrhalis Fungi: e.g Candida albicans,
Common cold -coryza • Viral ethiology • Clear or mucopurulent nasal discharge or nasal blockage • Fever may occur • Other symptoms : tiredness , headache, • Treatment : paracetamol, ibupropfen,
Pharyngitis Symtoms: Throat pain, Fever Physical exam: Inflammed,red pharynx , lymph nodes can be enlarged Etiology: 2/3 viral, 1/3 bacterial
Tonsilitis • Fever • red and/or swollen tonsils • white or yellow patches on the tonsils • tender, stiff, and/or swollen neck(swollen lymph nodes) • painful or difficult swallowing • Sore throat • Abdominal pain , vomiting • Antibiotic should be given (penicillin, macrolid)
Mononucleosis(glandular fever) • fever • tonsilitis (sometimes causing airway narrowing) • prominent lymphadenopathy (Neron’s neck) • hepatosplemomegaly • a maculopapullar rash • no positive reaction to antibiotic • most commonly contracted by adolescents and young adults ages • Etiology: mostly EBV
Scarlet fever • acute, bacterial, rash disease of childhood • caused by β hemolytic streptoccoccus, group B • incubation period 1-7 days ( average-3 days) acute onset, fever,vomiting, abdominal pain, • pharyngitis , tonsilitis • rash appears on 1 or 2 day- macular ,punctate intensively red • characteristic location on face- paleness around mouth, spreading downwords
Scarlet fever • characteristic tongue ( white strawberry tongue→ red strawberry tongue • haemorrhagic lesions in articular fossae ( Pastia lines) • Desquamation begins after a week from face to limbs
Acute infection of the middle ear • fever , pain in ear, irritation, loss of appetite • examination of tympanic membrane: loss of normal light reflection, bulging, red membrane
acute infection of the middle ear Complications: • mastoiditis • meningitis Reccurent ear infection may cause chronic secretory otitis media( glue ear), leading to hearing loss
Sinusitis • Sinusitis is inflammation of the paranasal sinuses Most cases are due to a viral infection • Pain, swelling, tendreness over a cheek, nasal blockage, headache • Treatment: antibiotics, histamine blockers, decongestants,
Laryngitis • Symptoms • Hoarseness or no voice at all • Dry, sore burning, throat • Coughing, barking cough • stridor • Difficulty swallowing • Sensation of swelling in the area of the larynx • Cold or flu-like symptoms • Swollen lymph nodes • Fever • Difficulty breathing (mostly in children) • Difficulty eating • Increased production of saliva in mouth
Comparison of clinical features of subglottic laryngitis and epiglottitis
Treatment of suglottic laryngitis Nebulised steroids and 0,9 % NaClsaline Systemic steroids Oxygen therapy Usually no antibiotics are needed Etiology: mostly viral or allergens
Epiglottic laryngitis Etiology: Haemophilus influenzae HIB, rare after HIB vaccinations Treatment of epiglottitis • In intensive care unit • Intubation • Antibiotic (cephalosporin II, III generation)
LTRI • Bronchitis (acute, obturative) • Bronchiolitis • Pneumonia
Bronchitis • Bronchitis is inflammation of the mucous membranes of the bronchi • Etiology: • Viruses ( Parainfluenzae, Adenovirus, RS-virus, Rhinovirus) • Bacteria (Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus) • Atopy
Symtoms of bronchitis • non-productive cough • productive cough • dyspnoe (due to obturation) • fever • vomiting • wheezing • dry rale • coarse rattling
Treatment mucolitycs (eg cysteine derivates, Ambroksol) bronchodilating drugs- Beta Agonist, Ipratropii bromidum Steroids Antibiotics- mainly used in newborns and small chlildren when bacterial infection is suspected (eg Amoxicilline, Cephalosporin antibiotics I, II generation- Cefalotin, Cefuroxim)
Broncholitis Etiology: • viruses (RS virus, Parainfluenzae, Influenzae, Adenovirus) One of the most danger LRTI due to lifethreatening respiratory insufficiency
Bronchiolitis • Typical childhood infection • Most often in infancy • Cough,expiratory dyspnoe, fever • Involvment of bronchioli • Respiratory insufficinecy • Wheezing , crackles
Bronchiolatis • Oxygen therapy, • Bronchodilators- Berodual, Ventolin, Atrovent • Steroids-nebulized and/or systemic • Nebulized epinephrine • Nebulized hypertonic saline (3%)
dyspnoe • Sternal, subcostal and intercostal recession • Nasal flaring • Hyperinflation of chest (sternum prominent, liver displaced downward) • Dyscoordination of chest and abdomen movment
Pneumonia • Pneumonia is an inflammation of the lungs. It is a serious infection in which air sacs in the lungs fill with pus and other liquid. • Pneumonia may be lobar or bronchial • Pneumonia is most common in winter and spring. • About 10 to 15 percent of children with a respiratory infection have pneumonia.
Pneumonia • The pathogens causing pneumonia vary according to the child's age: • Newborn - organisms from the mother's genital tract, particularly group B streptococcus, but also Gram-negative enterococci
Pneumonia • Infants and youngchildren -mostly respiratory viruses, particularly RSV, are most common, but olsobacterialinfectionsincludeStreptococcuspneumoniaeorHaemophilus influenzae. Bordetellapertussis and Chlamydia trachomatiscanalsocause pneumonia atthisage. Aninfrequent but seriouscauseisStaphylococcusaureus • Childrenover 5 years - Mycoplasmapneumoniae, Streptococcuspneumoniae and Chlamydia pneumoniaeare the maincauses. • At allagesMycobacteriumtuberculosisshould be considered
Pneumonia-symptoms: • fever and cough are the first to develop • persistent cough that may last three to four weeks • severe cough that may produce some mucus • chest or stomach pain • decrease in appetite • chills • breathing fast or hard • vomiting • headache • not feeling well
Pneumonia • tachypnoea, • nasal flaring • chest indrawing • crackles over the affected area • dullness on percussion, • decreased breath sounds • bronchial breathing
Pneumonia-diagnosis • chest x ray- segmental involvement,diffuse peribronchiolar densities,effusion • blood tests- e.g. blood cell count, CRP, • sputum culture • pulse oximetry
Treatment • antibiotics • Increased fluid intake • oxygen therapy • frequent suctioning of your child's nose and mouth (to help get rid of thick secretions) • medication for cough • sometimes bronchdilators