Upper and lower resp tract- children Flashcards
What bacteria will usually cause lower respiratory tract infection?
Pneumococcus, Haemophilus, Staph, Moraxella
What bacteria come from the outside?
pertussis, TB
What are the important things to remember for infection?
oxygenation, hydration, nutrition
Characteristics of rhinitis?
Very common, ~10 per year
Winter months
Self-limiting condition
The dilemma here is..…
Prodrome to other illnesses
Pneumonia, bronchiolitis
Meningitis
Septicaemia
Review if not sure
Give characteristics of otitis media?
Common, self-limiting, painful ear
Not “a bit pink”
Primary viral infection
Secondary infection with Pneumococcus/ H’flu
Spontaneous rupture of drum
Antibiotic treatment usually doesn’t help
What is used for pain in otitis media?
analgesia
when should antibiotics be used?
amoxycillin if child <2 and bilateral otitis media
child systematically unwell
What should be done for tonsillitis/pharyngitis?
viral or bacterial?
don’t give amoxycillin
Symptoms of croup?
caused by paraflu
common
well child
stridor, hoarse voice, barking cough
management of croup?
oral dexamethosone
Give characteristics of epiglottitis?
rare
toxic
stridor, drooling
treatment- intubation and antibiotics
Give characteristics of tracheitis?
uncommon
staph or strep invasive infection
fever
DOES need antibiotics
Bacterial bronchitis mechanism?
disturbed mucociliary clearance
minor airway malacia
RSV/adenovirus
bacterial infection/overgrowth is secondary
Give characteristics of Bronchitis?
very common
overgrowth of the endogenous bacteria that are in the child’s airways
pneumococcus/haemophilus
loose rattly cough
Management for persistent bacterial bronchitis?
make the diagnosis
reassure
do not treat* cough part of our innate immune defence
Give characteristics of Bronchiolitis?
very common LRTI
usually RSV (respiratory syncitium)
blocked nose, increased SOB and difficulty breathing
low grade fever
Bronchiolitis timeline?
symptoms last for two weeks typically
peak before christmas
for three days-cough gets worse and so does breathing
(syncitium has been formed and is shedding into airways)
Difference between asthma viral induced wheeze and bronchiolitis?
bronchiolitis only affects children under 12 months
and is a one off thing and a typical history
AND asthma attack develops over hours
Management of bronchiolitis?
maximal observation
minimal intervention
oxygen saturations
medicines proven to work in bronchiolitis?
nothing.
When is it pneumonia and when is it not?
signs are in one area
creps
high fever
treatment of child with 48 hour history of cough and increasing sob(chest infection)?
Oral amoxicillin- short course of low dose antibiotics
Oral or IV antibiotics?
oral wine
shorter hospital stay
cheaper
fever for a few more hours however
difference between LRTI and bronchiolitis?
LRTI- In all ages
More rapid onset of symptoms
Fever
Bronchiolitis- Aged <12 months
3 days before reach peak
Fever rarely >38oC
