4.1. Paediatric Respiratory - Upper / Lower Respiratory Tract Infection Flashcards
What are the Common Viral Respiratory Infective Agents?
- Adenovirus
- Influenza A / B
- Parainfluenza I / III
- Respiratory Syncytial Virus (RSV)
- Rhinovirus
What are the Common Bacterial Respiratory Infective Agents?
- H. Influenzae
- M. Catarrhalis
- Mycoplasma
- Staph. Aureus
- Streptococci
What are the Different forms of Upper Respiratory Tract Infection?
- Rhinitis (Runny Nose)
- Otitis Media
- Tonsillitis / Pharyngitis
- Croup (Laryngotracheobronchitis) / Epiglottitis
What is the concern of Rhinitis?
It is a Prodrome to Other Illnesses: 1. Pneumonia / Bronchiolitis 2. Meningitis 3. Septicaemia Note - It is far more commonly Self-Limiting Though
What are the Features of Otitis Media?
- Self-Limiting (Antibiotic Treatment doesn’t usually help)
- Primary Viral Infection / Secondary Infection with Pneumococcus / H. Influenzae
- Can Cause Spontaneous Rupture of the Ear Drum
- Treatment = Analgesia
How is Tonsillitis / Pharyngitis Treated?
- Throat Swab
- Nothing
- 10 Days Penicillin
In Comparison of Croup (Laryngotracheobronchitis) vs Epiglottitis for:
- Causative Organism?
- Incidence?
- Managed?
- Symptoms?
- Treatment?
Croup vs Epiglottitis
- Parainfluenzae I vs H. Influenzae Type B
- Common vs Rare
- Well vs Toxic
- Coryza (cold) / Stridor / Hoarse Voice / Barking Cough vs Stridor / Drooling
- Oral Dexamethasone vs Intubation and Antibiotics
What are the Different forms of Lower Respiratory Tract Infection?
- Tracheitis
- Bronchitis
- Bronchiolitis
- Pneumonia
- Pertussis - Vaccinated Against
- Empyema
What are the Features of Tracheitis?
- Fever / Sick Child
- Staph / Strep
- Treat with Augmentin
- “Croup which does not get better”
What are the Clinical Features of Bronchitis?
- Loose Rattly Cough + URTI
- Post-Tussive (Cough) Vomit - “Glut”
- No Wheeze / Creps
- Haemophilus / Pneumococcus Endobroncial Infection
- Mostly Self-Limiting
Note - 1st bad winter is the worst, gets better from there
Why does Bacterial Bronchitits occur?
Disturbed Mucociliary Clearance:
- Minor Airway Malacia
- RSV / Adenovirus
- Secondary to URTI
What are the Red Flags in Persistent Bacterial Bronchitis?
- Age - < 6 months / > 4 years
- Static Weight
- Disrupts Childs Life
- Associated Dyspnoea
- Acute Admission
Note - Will go into Remission with Antibiotics
What are the Clinical Features of Bronchiolitis?
- Common LRTI of Infants - 30-40% will have it
- Respiratory Syncytical Virus / Parainfluenzae III / HMPV
- Nasal Stuffiness
- Tachypnoea
- Poor Feeding
- Crackles +/- Wheeze
- One off - Not Recurrent!
What are the Investigations for Bronchiolitis?
- Nasopharyngeal Airway (NPA) - Cohorting
- Oxygen Saturation - Severity
Note - No need for CXR / Bloods / Culture
What are the Clinical Features of Lower Respiratory Tract Infections?
- Fever > 38.5 degrees
- Dyspnoea
- Cough
- Grunting
- Reduced Bronchial Breath Sounds
Note - Wheeze makes Bacterial Cause Unlikely