Lower respiratory tract infections in children Flashcards
How common is bronchiolitis in children?
1 in 5
What are some common bacterial infective agents in LRTIs in children?
Strep pneumoniae Haemophilus influenzae Moraxella catarrhalis Mycoplasma pneumoniae Chlamydia pneumoniae
What are some common viral infective agents in LRTIs in children?
RSV
Parainfluenza II
Influenza A and B
Adenovirus
Describe tracheitis
Inflammation of the trachea, leading yo airway obstruction. “Croup which does not get better” - loud barking cough and stridor (croup), except child is unwell
What are the common infections that cause tracheitis?
Staph or strep
What is stridor?
Stridor is a high-pitched breath sound resulting from turbulent air flow in the larynx or lower in the bronchial tree
What are the symptoms of tracheitis?
Barking croup cough Inspiratory stridor (crowing) Scratchy throat Chest pain Fever Earache Headache Dizziness Laboured breathing
How do you treat tracheitis?
IV antibiotics - amoxicillin and augmentin
What is co-amoxiclav?
Amoxicillin and clavulanic acid combined
What are the symptoms of bronchitis?
Coughing up mucus Loose rattly cough Post tussle vomit - "glut" SOB Wheezing Chest discomfort Chest free of crepitations
How do you treat bronchitis?
You don’t - mostly self limiting, even if persistent
What is bronchitis?
Inflammation of bronchi, and subsequent bacteria infections, often from disturbed mucociliary clearance
What is bronchiolitis?
Inflammation of the bronchioles
What infective agents cause bronchiolitis?
RSV
Parainfluenzae
HMPV (human metapneumovirus)
How do patients with bronchiolitis presenT?
Coughing Wheezing SOB, can cause difficulty feeding Blocked nose, difficulty breathing (tongue) Ribs sucked in
How long does bronchiolitis usually last?
2 weeks
How do you manage bronchiolitis?
Maximum observation
Minimun intervention
What are the symptoms and signs of LRTIs?
Fever >38.5c SOB Cough Grunting Reduced or bronchial breath sounds
When is it pneumonia and not LRTI?
Signs are localised
Crepitations
High fever
How do you manage pneumonia in the community?
Nothing if mild
IV antibiotics if vomiting
Oram amoxycillin or macrolides
Analgesia for otitis
What is pertussis?
Whooping cough!
Highly contagious bacterial disease characterised by severe coughing fits, which can last for over 10 weeks
Vaccination reduces risk and severity
What is the only disease that causes severe coughing fits i.e. break ribs, vomit?
Pertussis/whooping cough
What organism is responsible for pertussis?
Bordetella pertussis
When are those with pertussis infectious to others?
From onset of symptoms till 3 weeks later
What are some complications of the coughing in pertussis?
Subconjunctival haemorrhages Rib fractures Urinary incontinence Hernias Vertebral artery dissection
What are the symptoms of pertussis?
Severe coughing fits + high pitched “whoop”
Sneezing and runny nose
Gasping or cessation of breathing in babies
What % of children with cough for over 2 weeks are found to be positive for pertussis?
40%
What has increased since the introduction of two pneumococcal vaccinations in Scotland?
rates of empyema
