Lower Respiratory Tract Infections Flashcards
What are some LRTIs?
What are some common infective agents?
- Bacterial
- Strep pneumoniae
- Hemophilus influenza
- Moraxella catarrhalic
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
- Viral
- RSV
- Parainfluenza III
- Influenza A and B
- Adenovirus
What are the principles of management for LRTIs?
- Make diagnosis
- Assess patient
- Oxygenation, hydration, nutrition
- To treat or not to treat
Tracheitis - aetiology
- Staph or strep invasion infection
Tracheitis - epidemiology
Uncommon
Tracheitis - presentation
- “Croup that does not get better”
- Fever, sick child
Bronchitis - aetiology
Usually haemophilus/pneumococcus
Bronchitis - epidemiology
- Very common
Bronchitis - pathophysiology
- Normal virus disturbs mucocilliary clearance
- Allowing secondary infection with bacteria
Bronchitis - presentation
- Mostly self limiting
- Loose rattly cough with URTI
- Post-tussive vomit
- Chest free of wheeze/creps
Bronchitis - management
- Reassurance
- Do not treat
Bronchiolitis - aetiology
- Usually viral, RSV
- Others include paraflu III and HMPV
Bronchiolitis - epidemiology
- Very common
- Usually infants (30-40% of them)
- <12 months old
Bronchiolitis - presentation
- Nasal stuffiness
- Tachypnoea
- Poor feeding
- Crackles +/- wheeze
- Usually lasts up to 12 days, sometimes 14
Bronchiolitis - investigations
- NPA
- Oxygen saturations
Bronchiolitis - management
- Maximal observation
- Minimal interference
- No medications proven to work
Pneumonia - aetiology
- Virus and commensal bacteria
- Wheeze makes bacterial cause unlikely
Pneumonia - presentation
- Fever
- Shortness of breath
- Cough
- Grunting
- Reduced or bronchial breath sounds
Pneumonia - treatment
- Nothing if symptoms milkd
- Always offer review
- Antibiotics
- First line – oral amoxicillin
- Second line – oral macrolide
- Only IV if vomiting
What are the 1st and 2nd line antibiotics for pneumonia in paediatrics?
- First line – oral amoxicillin
- Second line – oral macrolide
- Only IV if vomiting
What are the main differences between pneumonia and bronchiolitis for:
- age
- progression of symptoms
- presence of fever
What is pertussis also called?
Whooping cough
Pertussis - epidemiology
Common
Pertussis - presentation
- Coughing fit
- Vomiting and colour change
Pertussis - treatment
- Part of vaccination which reduces risk and severity
Empyaema - pathology
- Complication of pneumonia
- Extension of infection into pleural space
Empyaema - presentation
- Chest pain and very unwell
Empyaema - treatment
- Antibiotics +/- chest drainage
Empyaema - prognosis
- Good in contrast with adults
Are, and if so what, antibiotics are used for:
- tracheitis
- bronchitis
- pneumonia
- bronchiolitis
- empyema
