Lower Respiratory Tract Infection in Children Flashcards
What infection is associated with A?
Pneumonia
What infection is associated with B?
Bronchitis
What infection is associated with C?
Empyema
What infection is associated with D?
Bronchiolitis
What infection is associated with E?
Tracheitis
What are common bacterial infective agents?
Strep pneumoniae
Haemophillus influence
Moraxella catarrhalis
Mycoplasma pneumoniae
Chlamydia pneumoniae
What are common viral infective agents?
RSV
Parainfluenza III
Influenza A and B
Adenovirus
What are the principles of patient management?
Make a diagnosis
Assess the patient
Decide to treat or not to treat
Is the prevalence of lower respiratory tract infections increasing or decreasing?
Increasing
How common is tracheitis?
Uncommon
What can tracheitis be described as?
Croup which does not get better
What are symptoms of tracheitis?
Fever
Sick child
What is tracheitis usually caused by?
Staph or strep invasive infection
Why does tracheitis lead to struggling to breath?
Swollen tracheal wall and luminal debris narrows the tracheal lumen
How common is bronchitis?
Common
What are symptoms/signs of bronchitis?
Loose rattly cough with upper respiratory tract infection
Poast-tussive vomit
Chest free of wheeze/creps
What is bronchitis usually caused by?
Haemophilus
Pneumococcus
Why does bacterial bronchitis cause problems?
Disturbed mucociliary clearance
What kind of infection is bacterial bronchitis normally?
Secondary infection
How long can a cough last for with bronchitis?
25 days
What is a typical natural history of bacterial bronchitis?
Following upper respiratory tract infection
Lasts 4 weeks
60-80% respond
First winter bad
Second winter better
Third winter fine
Caused by pneumococcus/H flu
What should you do when you see persistant bacterial bronchitis?
1) Make the diagnosis
2) Reassure
3) Do not treat
Who does bronchiolitis normally affect?
Infants
What percentage of all infants does bronchiolotis affect?
30-40%
What is bronchiolitis normally caused by?
RSV
Paraflu
HMPV
What are symptoms of bronchiolitis?
Nasal stuffiness
Tachypnoea
Poor feeding
Crackles
Maybe wheeze
What long can brionchiolitis last?
More than 16 days
When do RSV cases peak?
During winter, especially around winter
What is usually seen when diagnosis bronchiolitis?
<12 months old
One of (not recurrent)
Typical history
What is the management of bronchiolitis?
Maximal observation
Minimal intervention
What investigations should be done for bronchiolitis?
Nasopharyngeal asparate (NPA)
Oxygen saturations
What medication is proven to work for bronchiolitis?
None
What are common symptoms for lower respiratory tract infections?
Fever (>38.5oC)
Shortness of breath
Cough
Grunting
Reduced or bronchial breath sounds
Wheeze if viral
If a wheeze is heard in a lower respiratory tract infection what does it make unlikely?
Bacterial infection
What can be said about the word pneumonia?
It causes great anxiety
What are chest X-rays only used for with pneumonia?
To support clinical findings
What is not routine for community acquired pneumonia?
Chest X-ray
Inflammatory markers
What does the management of community acquired pneumonia involve?
Nothing if the symptoms are mild
Oral amoxicillin first line
Oral macrolide second choice
Only use IV if vomiting
When should you use an IV antibiotic for pneumonia?
If the patient is vomiting
What medicines are the first and seconds lines for community acquired pneumonia?
Amoxicillin is first line
Macrolide is second line
What are advantages of oral antibiotics vs IV?
Shorter hospital stay
Cheaper
What is the advantage of IV antibiotics instead of oral?
Fever cleared quicker
When should you use oral antibiotics?
Antiobiotics are indicated
Non-severe lower respiratory tract infection
Child is not vomiting
What is pertussis also known as?
Whooping cough
What is the other name for whooping cough?
Pertussis
How common is pertussis?
Common
What reduces the risk and severity of pertussis?
Vaccination
What are symptoms of pertussis?
Coughing fits
Vomiting
Colour change
What is empyaema?
Extension of infection into pleural space
What is a possible complication of pneumonia?
Empyema
What are the symptoms of empyema?
Chest pain
Very unwell
What is the prognosis of empyema like in children compared to adults?
Very good in children compared to adults
