Pediatric Respiratory Infections

Question 1

Differentiate Bacterial pneumonia from Viral

Answer 1

Bacterial: Sudden onset, high fever, productive cough
Viral: Gradual, low fever, diffuse infiltrates

Question 2

Identifying sypmtoms to pneumonia bugs

Answer 2

1. Bordetella pertusis- Extreme lymphocytosis
2. Congenital pneumonia - Group B strep
3. Chlamydia - Eosinophilia, conjunctivitis and lung issues
4. MRSA - Pneumatoceles (round pockets of air) on CXR

Question 3

Mycoplasma Pneumonia

Answer 3

MCC of pneumonia in school age children
Tx: < 8yrs- Azithromycin, Clathromycin
> 9yrs - Tetracycline, Doxycycline

Question 4

Common Cold

Answer 4

Yellow-green discharge means its NOT BACTERIA, its Viral; Don’t use Abx

Tx: OTC cold medications do NOT work
Use single-ingredient products

Question 5

Acute Bacterial Sinusitis

Answer 5

MCC is S. pneumoniae; Has 3 patterns to presentation
Dx: CT/MRI w/ contrast whenever suspected of having orbital or CNS complication
Tx: Penicillin w/ Clavulanic acid for 7 days after symptoms disappear

Question 6

Agents of Otitis Media

Answer 6

S. pneumonia, H. influenza;
Chronic/Persistent: Staph aureus, Pseudomonas
Viral - RSV

Question 7

Types of OM

Answer 7

1. Acute: Rapid short onset
2. OM w/ Effusion: Asymptomatic w/ possible ↓hearing
3. Recurrent: 3+ AOM in 6 months OR 4+ in 12 months
4. Persistent: SSx persist ≥72 hr after start Abx OR Relapse w/in 7 days of Abx
5. Chronic: Persistent otorrhea

Question 8

Dx of OM

Answer 8

1. Bulging of TM = bacterial OR bacterial/viral
2. Typanocentesis: needle aspiration & culture; Gold standard
3. Must have 2 of: Abnormal TM color, Opacity of TM or decreased motility

Question 9

Tx of OM

Answer 9

1st line: Amoxicillin +/- clavulanic acid
2nd line: cephalosporin
3rd line: Clindamycin + tympanocentesis
4. DO NOT GIVE PROPHYLATIC Tx