Lower RTI in adults + children 2 Flashcards
Common infective agents in children
BACTERIAL
-S.pneumonae, H.influenzae, moraxella catarrhalis, Klebsiella pneumoniae
VIRAL
-RSV, parainfluenza 3, Influenza A/B, Adenovirus, human metapneumovirus
- Immunisation history
- secondary bacterial infection
Laryngotracheobronchitis ( croup) symptoms and cause
- viral infection
- large airways(narrowing)
- inspiratory stridor, hoarseness, RD
- rhinorrhoaea, fever
- WORSE AT NIGHT!
What age are you more likely to get Croup?
-6m-6yrs ( peak 2 yrs)
Rating of Croup
see slide 9
Management of Croup
- supportive, reassurance, worsening advice
- oral once off dose dexamethasone(0.15ml/kg) steroid
Admission of croup + treatment
- Moderate/sever
- Oxygenation
- Nebulised adrenaline
- Supportive
Epiglottitis symptoms + cause
- fever, difficulty swallowing/breathing
- drooling, sore throat
- H.influenzar vauses this
Bacterial tracheitis symptoms
- ’’ croup that doesn’t get better’’
- differential diagnosis of croup
Treatment of epiglottitits
-H.influenzae(vaccine)
Treatment of bacterial tracheitis + Cause
co-amoxiclav
-straphylococcus/streptococcus invasive infection
What is Bronchiolitis + the type of infection
- Inflammation of bronchioles + mucous acc in small airways
- type of RSV infection(respiratory syncytial virus)
When is bronchiolitis common?
-winter peak period
Symptoms of bronchiolitis
- cold symptoms( fever, congestion ) THEN cough.
- tachypnoea
- crackles +/-wheeze
How is bronchiolitis spread? How long does it last
- droplet ( air borne)
- days-weeks
Bronchiolitis management
- observe oxygenation, NPA?
- NO CXR, Bloods/cultures
Safety net of bronchiolitis
-RD, (tachypnoea, indrawing, sternal recession, nasal flaring, grunting, cyanosis if severe, see-saw breathing, tripod positioning, subcostal recession), other risk factors, systemically unwell (not feeding, poor urine output)
Whooping cough (bordetella pertussis) symptoms
- Cold like symptoms
- coughing fits(ALOT), vomiting due to cough
- red face
- inspiratory ‘‘whooping’’ sound
Treatment of whooping cough
< 3 weeks: macrolide antibiotics (clatithromycin, erythromycin, azithromycin)
Special considerations of whooping cough treatment
- pregnancy, immunisation 16-32wks, <6m
- post exposure prophylaxis
- vaccination
When is whooping cough common?
2-5 yearly cycle
What is Bronchitis
- inflammation of bronchi
- endobronchial infection
Symptoms of bronchitis
- loose rattly cough with URTI
- post-tussive vomit - ‘‘glut’
- chest free of wheeze/creps
- child is well
Causes of bronchitis
-haemophilus/pneumococcus
Describe the mechanism/cause of bacterial bronchitis
- disturbed mucocilary-escalator system
- RSV/adenovirus
- minor airway malacia
- secondary infection
Symptoms of LRTI/Pneumonia in neonates
-grunting, poor feeding, irratable, lethary, tachypnoea, cough (unusal)
Symptoms of LRTI/Pneumonia in infants
-cough, tachynoea, grunting, respiratory disress, not feeding, irratbile, preceding URTI
Complications of pneumonia in kids
empyema
-extension of infection in pleural space
Viral induced wheeze symptoms + treatment
- 6m-5yrs associated with viral infection of airways
- infection that causes symptoms of asthma
- bronchodilators (B2 agonist)
When is asthma diagnosed?
> 5yrs
