Lower Respiratory Tract Infections in Children

Question 1

What are some common infective agents in LRTIs?

Answer 1

Strep pneumoniae
H flu
Moraxella
Mycoplasma pneumoniae
Chlamydophilia pneumoniae

RSV
Parainfluenza III
Flu A and B
Adenovirus

Question 2

What is tracheitis, what usually causes it, and how do you treat it?

Answer 2

‘Croup which does not get better’
Fever
Staph or Strep cause
Treat with augmentin

Question 3

Bronchitis features, treatment?

Answer 3

Loose rattly cough with URTI
Post-tussive vomit
Chest free of wheeze
Haemophilus/pneumococcus
Mostly self-limiting
Recurs with reduced effect during winters
Try not to treat

Question 4

Bronchiolitis features, treatment?

Answer 4

LRTI of infants
Affects 30-40% of all infants
Usually RSV, sometimes paraflu III, HMPV
Nasal stuffiness, tachypnoea
Crackles with or without wheeze

Maximal observation
Minimal intervention

Check O2 sats

Question 5

When to call pneumonia vs ‘LRTI’?

Answer 5

Pneumonia if signs are focal, creps, and high fever
Otherwise ‘LRTI’

Don’t treat if mild
Oral amoxicillin first line
> Oral macrolide second line
> Only use IV if vomiting

Question 6

Empyema in children details

Answer 6

Better prognosis than in adults
Use IV antibiotics with or without drainage

Maintain oxygenation, hydration, and nutrition (as in all infections)