Lower respiratory tract infections-children Flashcards
name some examples of LRTIs?
tracheitis pneumonia bronchitis empyaema bronchiolitis
what are the common bacterial bacterial infectious agents for LRTIs?
strep. pneumoniae H. influenzae Moraxella catarrhalis mycoplasma pneumoniae chlamydia pneumoniae
what are the viral infectious agents of LRTIs
RSV
parainfluenza III
influenza A and B
adenovirus
what is tracheitis?
an inflammation of the trachea, basically “croup which does not get better”
what are the infectious agents for tracheitis?
staphylococci or streptococci
what is the drug used to treat tracheitis?
augmentin
what are the symptoms of tracheitis?
fever, deep cough, wheeze, difficulty breathing, often biphasic stridor
what are the symptoms of bronchitis?
loose rattly cough with urti
post-tussive vomitting
chest free of wheeze and creps
what are the bacteria responsible for causing bacterial bronchitis?
haemophilus/ pneumococcus
what is the mechanism for bacterial bronchitis (secondary infection)?
disturbed mucociliary clearance from URTI (eg. RSV or adenovirus) means that there is difficulty in clearing bacteria.
who does bronchiolitis usually affect?
infants, <12months
what are the infective agents of bronchiolitis?
RSV, parainfluenza III, HMPV (human metapneumovirus)
what are the symptoms of bronvhiolitis?
nasal stuffiness, tachypnoea, poor feeding, crackles or wheeze +/-
is bronchiolitis recurrent?
no, it is a one off infection
what is the typical history of bronchiolitis?
- child normal for first 2 days
- gradual worsening over days 2-5
- stabilises in days 5 to 7
- recovers after 7 days
what is the management of bronchiolitis?
maximal observation
minimal intervention
- cohorting
oxygen saturations according to severity
what are the general signs of a LRTI?
fever (>38.5 degrees Celsius), SOB, cough, grunting for 48 hours. reduced or bronchial breath sounds.
if there is wheeze with a LRTI is it likely to be bacterial or viral?
viral
when is it pneumonia and not a LRTI?
when signs are focal, there are creps, high fever
what are the investigations for community acquired pneumonia?
just go by clinical signs, CXR and inflammatory markers are not routine.
what is the management of community acquired pneumonia in children?
nothing if symptoms are mild
1st line- oral amoxycilllin
2nd line- oral macrolide
iv if vomiting
what does vaccination to pertussis do?
reduces risk
reduces severity
what sort of coughing comes with perussis?
coughing fits
what is are the symptoms of pertussis?
coughing fits
vomiting and colour change
what does empyaema come as a complication of?
pneumonia it is an extension of the infection into the pleural space
what are the symptoms of empyaema?
chest pain
what are the treatment options for empyaemia?
antibiotics
drainage
before antobiotics are given for LRTIs what first needs to be sorted out?
oxygenation, hydration, nutrition
are antibiotics given for tracheitis?
yes, augmentin
are antibiotics given for bronchitis?
no
are antibiotics given for pneumonia?
usually, when there has been a 2 day fever and focal signs.
are antibiotics given for bronchiolitis?
no
are antibiotics given for empyema?
yes, IV antibiotics
