Upper Respiratory Tract Infections in Children Flashcards
What is the fine line between bacterial colonisation and infection?
Epithelium
What are the side effects of antibiotics?
Diarrhoea, Oral Thrush, Nappy rash, Allergic Reaction, Multi resistance
What fraction of all admission to hospital are due to upper respiratory tract infections?
over 1/3
What do upper respiratory tract infections often come with?
Fever
What are the two dilemma’s linked to UTI’s?
Antibiotics or not?, prodrome to serious illness?
What are the three things to advise a child that comes to see you early on in their UTI?
Paracetamol, sugary fluids and time
How many cold is normal in the winter months?
2
What do you do if youre not too sure how far into an infection the child is?
Get the parents to review them
What is rhinutis?
Infection that results in a runny nose
What is otitis media?
Infection of the ears
What secondary infection is linked to otitis media?
Pneumococcus
What is the main treatment to use in otitis media?
Analgesia
How do you diagnose tonsillitis/pharyngitis?
Throat swab
What is the treatment for tonsillitis/pharyngitis?
Nothing or 10 days on penicillin
What do children with streptococci usually have?
Scarlet fever, pink rash that feels like sandpaper, sick for about a week,
What is the cause of croup?
Para flu I
What are the symptoms of croup?
Stridor and a barking cough
What is the treatment for croup?
oral dexamethasone or prednisolone
what is the cause of epiglottis?
H.influeza type B
What are the symptoms of epiglottis?
Stridor and drooling.
What is the treatment for epiglottis?
intubation and antibiotics
What are some URTI?
- Otitis media
- Pharyngitis
- Laryngitis
- Epiglottitis
- Croup
- Rhinitis
What are examples of viral infective agents?
- Adenovirus
- Influenza A, B
- Para’flu I, II
- RSV
- Rhinovirus
What are examples of bacterial infective agents?
- H influenza
- M catarrhalis
- Mycoplasma
- Staph. aureus
- Streptococci (S. Pyogenes, S. pneumoniae)
What are examples of bacterial infective agents?
- H influenza
- M catarrhalis
- Mycoplasma
- Staph. aureus
- Streptococci (S. Pyogenes, S. pneumoniae)
What is rhinitis a prodrome to?
- Pneumonia
- Bronchiolitis
- Meningitis
- Septicaemia
Describe the appearance of otitis media?
Erythema (rash)
Bulging drum
How can otitis media occur?
- As a primary viral infection
- As a secondary infection with pneumococcus/ H’flu
Why is it advisable to not treat otitis media with antibiotics?
- Often the main symptom is pain and that can be treated with analgesics
- Antibiotics would take effect from day 2/3 after the worst of the symptoms
- Studies show that a large proportion of those who took antibiotics suffered from side effects
- The benefits do not outweigh the negatives
- First do no harm
How long does the earache associated with otitis media usually last?
Usually up to 8 days
What are the benefits of delaying treatment for otitis media?
- Fewer patients are treated unnecessarily saving money and decreasing risk of antibiotic resistance
- Fewer people experience side effects
What is definite about treatment for otitis media?
- Analgesia works
- Antibiotics may work after 24 hours but they are not advised
- The illness resolves within a short period of time
What should not be given to treat tonsillitis?
Amoxycillin
How can bacterial and viral tonsillitis be differentiated?
The only way is for a throat swab to be sent to the lab and cultured to see if bacterial colonies grow. Culturing takes 48 hours
What is the dilemma surrounding whether to treat tonsillitis with antibiotics or not?
Culturing takes 48 hours to show if it is bacterial and will respond to antibiotics. However within this time the infection will start to improve by itself
What is another name for croup?
Laryntracheobronchitis
How does the child appear with croup?
Well
How does the child appear with epiglottitis?
Toxic and very well
What is the dilemma between diagnosis of croup/ epiglottitis?
- You need to get it right
- Epiglottitis is the differential diagnosis for croup
- However, epiglottitis is extremely serious as it can block the airways
What are the majority of URTIs caused by?
Pathogens
What is normally not useful in the treatment of URTIs?
Antibiotics
What are most URTIs?
Self limiting
