Lower Respiratory Tract Infections in Children Flashcards
What are the 5 most common bacterial causes of lower respiratory tract infection in children?
- Strep pneumoniae
- Haemophilus influenzae
- Moraxella catarrhalis
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
List the 4 most common viral causes of lower respiratory tract infections in children
- RSV
- Parainfluenza III
- Influenza A and B
- Adenovirus
What is tracheitis?
An infection of the trachea
Is tracheitis common or uncommon?
Uncommon
how does a child with tracheitis present?
- croup that does not go away
- Fever
- The child is unwell (whereas a child with croup appears well)
Which two types of bacteria tend to cause tracheitis?
Staph or Strep invasive infections
What is bronchitis?
An Endobronchial infection 9infection of the bronchi)
How does bronchitis present?
a loose rattly cough with an upper respiratory tract infection
After a coughing fit a child will often retch and bring up sputum
The child’s chest will be free of wheeze/creps
Which two bacteria are most commonly associated with bronchitis?
haemophilus/pneumococcus
Will a child with bronchitis be well or unwell?
Very well in themselves
What is the pathophysiological cause of bronchitis?
disturbed mucociliary clearance. The mucus subsequently pools in the airways and needs to be coughed up. Bacterial overgrowth in these pools of mucus is secondary
How long does a bronchitis cough last for?
and how long does bronchitis last for altogether (on average)?
50% of individuals have a cough that lasts for 10 days
20% of individuals will have a cough lasting for 2 weeks
Bronchitis lasts for an average of 4 weeks
How is bronchitis managed?
- Make the diagnosis
- Reassure
- Do not treat
What is bronchiolitis?
Lower respiratory tract infection (LRTI) of the small airways of infants
What is the main cause of bronchiolitis?
respiratory sensitivity virus
What are the symptoms of bronchiolitis?
Nasal stuffiness, tachypnoea, poor feeding (due to blocked nose) and crackles/wheeze
What is the difference between bronchitis and bronchiolitis?
Bronchitis is an infection of the large airways, bronchiolitis is an infection of the small airways
Do bronchiolitis infections reoccur?
No- it is a one off infection
How should bronchiolitis be managed?
Maximal observation, minimal intervention
Take a nasopharyngeal aspirate (NPA) to identify the virus (so that children with the same virus can be nursed in the same ward)
Keep an eye on oxygen saturations
What is a lower respiratory tract infection characterised by?
- A duration of around 48 hrs, fever (>38.5oC), Shortness of breath, cough, grunting (grunting maintains the end expiratory pressure keeping the airways open)
- Reduced or bronchial breath sounds on auscultation
Which three characteristics would point towards pneumonia in children rather than a lower respiratory infection?
- Signs are focal
- Creps are present on auscultation
- The child is suffering from a high fever
Which antibiotic is used to treat lower respiratory tract infections and pneumonia in children?
Amoxicillin
Oral antibiotics should be given preferentially over IV antibiotics provided that the child meets which 3 criteria?
- Antibiotics are indicated
- It is a non-severe lower respiratory tract infection
- The child is not vomiting
What is pertussis?
whooping cough
Is whooping cough common or rare?
Common
What is the characteristic symptom of whooping cough?
“Coughing fits”- cough, cough, cough, cough, cough, retch, then a big deep noisy breath in (this is the whoop)
How des empyema present in children?
The patient presents with chest pain and is very unwell
How is empyema in children treated?
Drainage +/- antibiotics
Which two lower respiratory tract infections are not treated with antibiotics?
Bronchitis and bronchiolitis
